Article (Scientific journals)
Impact of detectable measurable residual disease on umbilical cord blood transplantation
Baron, Frédéric; Labopin, M.; Ruggeri, A. et al.
2020In American Journal of Hematology, 95 (9), p. 1057-1065
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Abstract :
[en] The impact of measurable residual disease (MRD) on cord blood transplantation (CBT) outcomes has remained debated. To address this issue, we assessed the impact of measurable MRD at CBT on outcomes in large cohort of patients with acute leukemia. Inclusion criteria included adult patients with acute myeloid (AML) or acute lymphoblastic leukemia (ALL), CBT as first allo-HCT in first or second complete remission (CR) at transplantation, and known MRD status at the time of CBT. Data from 506 patients were included in the analysis. Among them, 317 patients had AML and 189 had ALL. Positive MRD was reported in 169 (33%) patients while the remaining 337 patients were MRD negative at CBT. At 2 years, relapse incidence was 18% in patients with MRD negativity vs 33% in those with MRD positivity at transplantation (P <.001). Two-year leukemia-free survival (LFS) and overall survival (OS) were 57% and 60%, respectively, in MRD negative patients, vs 38% (P <.001) and 48% (P =.004), respectively, in those with MRD positivity. There was no interaction between the impact of MRD on OS and LFS and diagnosis (ie, ALL vs AML), single or double CBT, and reduced-intensity or myeloablative conditioning. On multivariate analysis, MRD positivity was associated with a higher risk of relapse (HR = 1.8, P =.003), comparable non-relapse mortality (P =.44), worse LFS (HR = 1.4, P =.008) and a trend towards worse OS (HR = 1.3, P =.065). In conclusion, these data suggest that novel strategies that are aiming to achieve MRD negativity at CBT are needed for leukemic patients with positive MRD pre-CBT. © 2020 Wiley Periodicals LLC.
Disciplines :
Hematology
Author, co-author :
Baron, Frédéric  ;  Université de Liège - ULiège > I3-Hematology
Labopin, M.;  EBMT Paris Study Office/CEREST-TC, Paris, France, Service d'Hématologie Clinique et de Thérapie cellulaire, APHP, Hôpital Saint Antoine, Paris, France, Centre de Recherche Saint-Antoine (CRSA), INSERM, Paris, France, Sorbonne Université, Paris, France
Ruggeri, A.;  Ospedale San Raffaele s.r.l., Haematology and BMT, Milan, Italy, Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France
Monacord, Centre Scientifique De Monaco;  Monaco, Monaco
Sierra, J.;  Department of Hematology, Hospital Santa Creu i Sant Pau, Barcelona, Spain
Robinson, S.;  Department of Haematology, Bristol Haematology Oncology Centre, University Hospital Bristol, Bristol, United Kingdom
Labussière-Wallet, H.;  Service Hematologie, Centre Hospitalier Lyon Sud, Lyon, France
Potter, M.;  Royal Marsden Hospital, Leukaemia Myeloma Units, London, United Kingdom
Ribera, J.-M.;  Department of Clinical Hematology, ICO-Hospital Universitari Germans Trias i Pujol Josep Carreras Research Institute, Badalona, Spain
Deconinck, E.;  Service d'Hématologie, Hopital Jean Minjoz, Besancon, France
Rambaldi, A.;  Department of Oncology and Hematology, University of Milan and Azienda Socio Sanitaria Territoriale, Papa Giovanni XXIII, Bergamo, Italy
Rohrlich, P.-S.;  CHU Nice - Hôpital de l'ARCHET I, Hematologie Clinique, Nice, France
de Revel, T.;  Department of Hematology, Hôpital Américain, Clamart, France
Gluckman, E.;  Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France
Monacord, Centre Scientifique De Monaco;  Monaco, Monaco
Nagler, A.;  EBMT Paris Study Office/CEREST-TC, Paris, France, Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
Mohty, M.;  EBMT Paris Study Office/CEREST-TC, Paris, France, Service d'Hématologie Clinique et de Thérapie cellulaire, APHP, Hôpital Saint Antoine, Paris, France, Centre de Recherche Saint-Antoine (CRSA), INSERM, Paris, France, Sorbonne Université, Paris, France
More authors (7 more) Less
Language :
English
Title :
Impact of detectable measurable residual disease on umbilical cord blood transplantation
Publication date :
September 2020
Journal title :
American Journal of Hematology
ISSN :
0361-8609
eISSN :
1096-8652
Publisher :
Wiley-Liss Inc.
Volume :
95
Issue :
9
Pages :
1057-1065
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 03 September 2020

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