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Successful immune reconstitution decreases leukemic relapse and improves survival in recipients of unrelated cord blood transplantation.

Publication ,  Journal Article
Parkman, R; Cohen, G; Carter, SL; Weinberg, KI; Masinsin, B; Guinan, E; Kurtzberg, J; Wagner, JE; Kernan, NA
Published in: Biol Blood Marrow Transplant
September 2006

Allogeneic hematopoietic stem cell transplantation (HSCT) is established therapy for selected patients with acute leukemia. After transplantation, antileukemic immune responses are believed to eliminate residual leukemia cells and decrease the likelihood of relapse. However, the clinical effect of successful antigen-specific immune reconstitution after HSCT on the likelihood of leukemic relapse and overall survival is not known. Pediatric recipients of unrelated cord blood transplants who underwent transplantation for acute leukemia were sequentially evaluated for their development of antigen-specific T-lymphocyte immunity to herpes viruses. The clinical effect of a positive antigen-specific response on relapse-free survival was determined. The presence of an antigen-specific response resulted in a relapse-free survival advantage (P = .0001), which was primarily due to a decrease in leukemic relapse (P = .003). Proportional hazards modeling for time to relapse and time to relapse or death defined 3 variables that were strongly associated with a poor outcome: female gender, poor remission status before transplantation, and negative antigen-specific T-lymphocyte proliferation. Notably neither acute nor chronic graft-versus-host disease had any effect on the incidence of leukemic relapse. Successful antigen-specific immune reconstitution after unrelated cord blood transplantation results in decreased leukemic relapse and improved overall survival.

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Published In

Biol Blood Marrow Transplant

DOI

ISSN

1083-8791

Publication Date

September 2006

Volume

12

Issue

9

Start / End Page

919 / 927

Location

United States

Related Subject Headings

  • Transplantation, Homologous
  • Sex Factors
  • Remission Induction
  • Recurrence
  • Recovery of Function
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma
  • Male
  • Leukemia, Myeloid, Acute
  • Infant
  • Immunology
 

Citation

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Parkman, R., Cohen, G., Carter, S. L., Weinberg, K. I., Masinsin, B., Guinan, E., … Kernan, N. A. (2006). Successful immune reconstitution decreases leukemic relapse and improves survival in recipients of unrelated cord blood transplantation. Biol Blood Marrow Transplant, 12(9), 919–927. https://doi.org/10.1016/j.bbmt.2006.05.008
Parkman, Robertson, Geoff Cohen, Shelly L. Carter, Kenneth I. Weinberg, Bernadette Masinsin, Eva Guinan, Joanne Kurtzberg, John E. Wagner, and Nancy A. Kernan. “Successful immune reconstitution decreases leukemic relapse and improves survival in recipients of unrelated cord blood transplantation.Biol Blood Marrow Transplant 12, no. 9 (September 2006): 919–27. https://doi.org/10.1016/j.bbmt.2006.05.008.
Parkman R, Cohen G, Carter SL, Weinberg KI, Masinsin B, Guinan E, et al. Successful immune reconstitution decreases leukemic relapse and improves survival in recipients of unrelated cord blood transplantation. Biol Blood Marrow Transplant. 2006 Sep;12(9):919–27.
Parkman, Robertson, et al. “Successful immune reconstitution decreases leukemic relapse and improves survival in recipients of unrelated cord blood transplantation.Biol Blood Marrow Transplant, vol. 12, no. 9, Sept. 2006, pp. 919–27. Pubmed, doi:10.1016/j.bbmt.2006.05.008.
Parkman R, Cohen G, Carter SL, Weinberg KI, Masinsin B, Guinan E, Kurtzberg J, Wagner JE, Kernan NA. Successful immune reconstitution decreases leukemic relapse and improves survival in recipients of unrelated cord blood transplantation. Biol Blood Marrow Transplant. 2006 Sep;12(9):919–927.
Journal cover image

Published In

Biol Blood Marrow Transplant

DOI

ISSN

1083-8791

Publication Date

September 2006

Volume

12

Issue

9

Start / End Page

919 / 927

Location

United States

Related Subject Headings

  • Transplantation, Homologous
  • Sex Factors
  • Remission Induction
  • Recurrence
  • Recovery of Function
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma
  • Male
  • Leukemia, Myeloid, Acute
  • Infant
  • Immunology