Results of unrelated cord blood transplant in fanconi anemia patients: risk factor analysis for engraftment and survival.

Published

Journal Article

We retrospectively analyzed results of unrelated cord blood transplantation (UCBT) in 93 Fanconi anemia (FA) patients. Median age at transplantation was 8.6 years (1-45). The units transplanted were HLA-A, -B, or -DRB1 identical in 12 cases, 1 HLA mismatch in 35 cases, and 2 or 3 HLA differences in 45 cases. The median number of nucleated cells (NC) and CD34+ cells infused of recipient weight was 4.9x10(7)/kg and 1.9x10(5)/kg, respectively. Participating centers selected the preparative regimen of their choice, in 57 patients (61%), it included Fludarabine. Graft-versus-host disease (GVHD) prophylaxis consisted mostly of cyclosporine with prednisone. Cumulative incidence (CI) of neutrophil recovery was 60+/-5% at day +60. In multivariate analysis, Fludarabine containing regimen and NC infused>or=4.9x10(7)/kg were associated with higher probability of recovery. CI of grade II-IV acute and of chronic GVHD (aGVHD, cGVHD) was 32%+/-5% and 16%+/-4%, respectively. Overall survival (OS) was 40%+/-5%. In multivariate analysis, factors associated with favorable outcome were use of Fludarabine in the conditioning regimen, number of NC infused>or=4.9x10(7)/kg, and negative cytomegalovirus (CMV) serology in the recipient. In conclusion, factors easily modifiable such as donor selection and a Fludarabine-containing regimen can considerably improve survival in FA patients given a UCBT. These data are the basis for designing prospective protocols.

Full Text

Duke Authors

Cited Authors

  • Gluckman, E; Rocha, V; Ionescu, I; Bierings, M; Harris, RE; Wagner, J; Kurtzberg, J; Champagne, MA; Bonfim, C; Bittencourt, M; Darbyshire, P; Fernandez, M-N; Locatelli, F; Pasquini, R; Eurocord-Netcord and EBMT,

Published Date

  • September 2007

Published In

Volume / Issue

  • 13 / 9

Start / End Page

  • 1073 - 1082

PubMed ID

  • 17697970

Pubmed Central ID

  • 17697970

International Standard Serial Number (ISSN)

  • 1083-8791

Digital Object Identifier (DOI)

  • 10.1016/j.bbmt.2007.05.015

Language

  • eng

Conference Location

  • United States