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Adult dual umbilical cord blood transplantation using myeloablative total body irradiation (1350 cGy) and fludarabine conditioning.

Publication ,  Journal Article
Kanda, J; Rizzieri, DA; Gasparetto, C; Long, GD; Chute, JP; Sullivan, KM; Morris, A; Smith, CA; Hogge, DE; Nitta, J; Song, K; Niedzwiecki, D ...
Published in: Biol Blood Marrow Transplant
June 2011

High treatment-related mortality (TRM) and high graft failure rate are serious concerns in HLA-mismatched umbilical cord blood (UCB) transplantation with myeloablative conditioning. We conducted a prospective trial of dual UCB transplantation using modified myeloablation consisting of total-body irradiation (TBI; 1350 cGy) and fludarabine (Flu) (160 mg/m(2)). Twenty-seven patients (median age, 33 years; range: 20-58 years) with hematologic malignancies were enrolled. The median combined cryopreserved total nucleated cell (TNC) dose was 4.3 × 10(7)/kg (range: 3.2-7.7 × 10(7)/kg). The cumulative incidences of neutrophil (≥500/μL) and platelet (≥50,000/μL) engraftment were 80% (95% confidence interval [CI], 58%-91%) and 68% (95% CI, 46%-83%), respectively. Among engrafted patients, a single cord blood unit was predominant by 100 days posttransplantation. A higher cryopreserved and infused TNC dose and infused CD3(+) cell dose were significant factors associated with the predominant UCB unit (P = .032, .020, and .042, respectively). TRM and relapse rates at 2 years were 28% (95% CI, 12%-47%) and 20% (95% CI, 7%-37%), respectively. Cumulative incidences of grades II-IV and grades III-IV acute graft-versus-host disease (aGVHD) were 37% (95% CI, 20%-55%) and 11% (95% CI, 3%-26%), respectively, and that of chronic GVHD was 31% (95% CI, 15%-49%). With a median follow-up of 23 months, overall survival and disease-free survival rates at 2 years were 58% (95% CI, 34%-75%) and 52% (95% CI, 29%-70%), respectively. This study supports the use of TBI 1350 cGy/Flu as an alternative to conventional myeloablative conditioning for dual UCB transplantation.

Duke Scholars

Published In

Biol Blood Marrow Transplant

DOI

EISSN

1523-6536

Publication Date

June 2011

Volume

17

Issue

6

Start / End Page

867 / 874

Location

United States

Related Subject Headings

  • Whole-Body Irradiation
  • Vidarabine
  • Treatment Outcome
  • Transplantation Conditioning
  • Recurrence
  • Prospective Studies
  • Middle Aged
  • Male
  • Lymphocyte Count
  • Immunology
 

Citation

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Kanda, J., Rizzieri, D. A., Gasparetto, C., Long, G. D., Chute, J. P., Sullivan, K. M., … Horwitz, M. E. (2011). Adult dual umbilical cord blood transplantation using myeloablative total body irradiation (1350 cGy) and fludarabine conditioning. Biol Blood Marrow Transplant, 17(6), 867–874. https://doi.org/10.1016/j.bbmt.2010.09.009
Kanda, Junya, David A. Rizzieri, Cristina Gasparetto, Gwynn D. Long, John P. Chute, Keith M. Sullivan, Ashley Morris, et al. “Adult dual umbilical cord blood transplantation using myeloablative total body irradiation (1350 cGy) and fludarabine conditioning.Biol Blood Marrow Transplant 17, no. 6 (June 2011): 867–74. https://doi.org/10.1016/j.bbmt.2010.09.009.
Kanda J, Rizzieri DA, Gasparetto C, Long GD, Chute JP, Sullivan KM, et al. Adult dual umbilical cord blood transplantation using myeloablative total body irradiation (1350 cGy) and fludarabine conditioning. Biol Blood Marrow Transplant. 2011 Jun;17(6):867–74.
Kanda, Junya, et al. “Adult dual umbilical cord blood transplantation using myeloablative total body irradiation (1350 cGy) and fludarabine conditioning.Biol Blood Marrow Transplant, vol. 17, no. 6, June 2011, pp. 867–74. Pubmed, doi:10.1016/j.bbmt.2010.09.009.
Kanda J, Rizzieri DA, Gasparetto C, Long GD, Chute JP, Sullivan KM, Morris A, Smith CA, Hogge DE, Nitta J, Song K, Niedzwiecki D, Chao NJ, Horwitz ME. Adult dual umbilical cord blood transplantation using myeloablative total body irradiation (1350 cGy) and fludarabine conditioning. Biol Blood Marrow Transplant. 2011 Jun;17(6):867–874.
Journal cover image

Published In

Biol Blood Marrow Transplant

DOI

EISSN

1523-6536

Publication Date

June 2011

Volume

17

Issue

6

Start / End Page

867 / 874

Location

United States

Related Subject Headings

  • Whole-Body Irradiation
  • Vidarabine
  • Treatment Outcome
  • Transplantation Conditioning
  • Recurrence
  • Prospective Studies
  • Middle Aged
  • Male
  • Lymphocyte Count
  • Immunology