Salvaged single-unit cord blood transplantation for 26 patients with hematologic malignancies not in remission
Braz. j. med. biol. res
; 48(10): 871-876, Oct. 2015. tab, ilus
Article
Dans En
| LILACS
| ID: lil-761603
Responsable en Bibliothèque :
BR1.1
ABSTRACT
Treatments for patients with hematologic malignancies not in remission are limited, but a few clinical studies have investigated the effects of salvaged unrelated cord blood transplantation (CBT). We retrospectively studied 19 patients with acute leukemia, 5 with myelodysplastic syndrome (MDS with refractory anemia with excess blasts [RAEB]), and 2 with non-Hodgkin's lymphoma who received 1 CBT unit ≤2 loci human leukocyte antigen (HLA)-mismatched after undergoing myeloablative conditioning regimens between July 2005 and July 2014. All of them were in non-remission before transplantation. The infused total nucleated cell (TNC) dose was 4.07 (range 2.76-6.02)×107/kg and that of CD34+ stem cells was 2.08 (range 0.99-8.65)×105/kg. All patients were engrafted with neutrophils that exceeded 0.5×109/L on median day +17 (range 14-37 days) and had platelet counts of >20×109/L on median day +35 (range 17-70 days). Sixteen patients (61.5%) experienced pre-engraftment syndrome (PES), and six (23.1%) patients progressed to acute graft-versus-host disease (GVHD). The cumulative incidence rates of II-IV acute GVHD and chronic GVHD were 50% and 26.9%, respectively. After a median follow-up of 27 months (range 5-74), 14 patients survived and 3 relapsed. The estimated 2-year overall survival (OS), disease-free survival (DFS), and non-relapse mortality (NRM) rates were 50.5%, 40.3%, and 35.2%, respectively. Salvaged CBT might be a promising modality for treating hematologic malignancies, even in patients with a high leukemia burden.
Texte intégral:
1
Indice:
LILACS
Sujet Principal:
Lymphome malin non hodgkinien
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Anémie réfractaire avec excès de blastes
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Leucémie aigüe biphénotypique
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Transplantation de cellules souches de sang du cordon
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Allogreffes
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Maladie du greffon contre l'hôte
Type d'étude:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limites du sujet:
Adolescent
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Adult
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Child
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Female
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Humans
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Male
langue:
En
Texte intégral:
Braz. j. med. biol. res
Thème du journal:
BIOLOGIA
/
MEDICINA
Année:
2015
Type:
Article