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Results of a prospective multicentre myeloablative double-unit cord blood transplantation trial in adult patients with acute leukaemia and myelodysplasia.

Publication ,  Journal Article
Barker, JN; Fei, M; Karanes, C; Horwitz, M; Devine, S; Kindwall-Keller, TL; Holter, J; Adams, A; Logan, B; Navarro, WH; Riches, M ...
Published in: Br J Haematol
February 2015

Double-unit cord blood (CB) grafts may improve engraftment and relapse risk in adults with haematological malignancies. We performed a prospective high-dose myeloablative double-unit CB transplantation (CBT) trial in adults with high-risk acute leukaemia or myelodysplasia (MDS) between 2007 and 2011. The primary aim was to establish the 1-year overall survival in a multi-centre setting. Fifty-six patients (31 acute myeloid leukaemia, 19 acute lymphoblastic leukaemia, 4 other acute leukaemias, 2 myelodysplastic syndrome [MDS]) were transplanted at 10 centres. The median infused total nucleated cell doses were 2·62 (larger unit) and 2·02 (smaller unit) x 10(7) /kg. The cumulative incidence of day 100 neutrophil engraftment was 89% (95% confidence interval [CI]: 80-96). Day 180 grade II-IV acute graft-versus-host disease (GVHD) incidence was 64% (95%CI: 51-76) and 36% (95%CI: 24-49) of patients had chronic GVHD by 3-years. At 3-years post-transplant, the transplant-related mortality (TRM) was 39% (95%CI: 26-52), and the 3-year relapse incidence was 11% (95%CI: 4-21). With a median 37-month (range 23-71) follow-up of survivors, the 3-year disease-free survival was 50% (95%CI: 37-63). Double-unit CBT is a viable alternative therapy for high-risk acute leukaemia/ MDS in patients lacking a matched unrelated donor. This is especially important for minority patients. The relapse incidence was low but strategies to ameliorate TRM are needed.

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Published In

Br J Haematol

DOI

EISSN

1365-2141

Publication Date

February 2015

Volume

168

Issue

3

Start / End Page

405 / 412

Location

England

Related Subject Headings

  • Young Adult
  • Transplantation Conditioning
  • Recurrence
  • Prospective Studies
  • Neutrophils
  • Myelodysplastic Syndromes
  • Middle Aged
  • Lymphocyte Count
  • Leukemia
  • Kaplan-Meier Estimate
 

Citation

APA
Chicago
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Barker, J. N., Fei, M., Karanes, C., Horwitz, M., Devine, S., Kindwall-Keller, T. L., … RCI BMT 05-DCB Protocol Team, . (2015). Results of a prospective multicentre myeloablative double-unit cord blood transplantation trial in adult patients with acute leukaemia and myelodysplasia. Br J Haematol, 168(3), 405–412. https://doi.org/10.1111/bjh.13136
Barker, Juliet N., Mingwei Fei, Chatchada Karanes, Mitchell Horwitz, Steven Devine, Tamila L. Kindwall-Keller, Jennifer Holter, et al. “Results of a prospective multicentre myeloablative double-unit cord blood transplantation trial in adult patients with acute leukaemia and myelodysplasia.Br J Haematol 168, no. 3 (February 2015): 405–12. https://doi.org/10.1111/bjh.13136.
Barker JN, Fei M, Karanes C, Horwitz M, Devine S, Kindwall-Keller TL, et al. Results of a prospective multicentre myeloablative double-unit cord blood transplantation trial in adult patients with acute leukaemia and myelodysplasia. Br J Haematol. 2015 Feb;168(3):405–12.
Barker, Juliet N., et al. “Results of a prospective multicentre myeloablative double-unit cord blood transplantation trial in adult patients with acute leukaemia and myelodysplasia.Br J Haematol, vol. 168, no. 3, Feb. 2015, pp. 405–12. Pubmed, doi:10.1111/bjh.13136.
Barker JN, Fei M, Karanes C, Horwitz M, Devine S, Kindwall-Keller TL, Holter J, Adams A, Logan B, Navarro WH, Riches M, RCI BMT 05-DCB Protocol Team. Results of a prospective multicentre myeloablative double-unit cord blood transplantation trial in adult patients with acute leukaemia and myelodysplasia. Br J Haematol. 2015 Feb;168(3):405–412.
Journal cover image

Published In

Br J Haematol

DOI

EISSN

1365-2141

Publication Date

February 2015

Volume

168

Issue

3

Start / End Page

405 / 412

Location

England

Related Subject Headings

  • Young Adult
  • Transplantation Conditioning
  • Recurrence
  • Prospective Studies
  • Neutrophils
  • Myelodysplastic Syndromes
  • Middle Aged
  • Lymphocyte Count
  • Leukemia
  • Kaplan-Meier Estimate