Outcomes of graft failure after umbilical cord blood transplantation in acute leukemia: a study from Eurocord and the Acute Leukemia Working Party of the EBMT.
[en] Graft failure has remained a limitation of umbilical cord blood transplantation (CBT). Here, we assessed the outcomes of patients who experienced graft failure after CBT. Inclusion criteria were patients (age ≥ 18 years) experiencing graft failure after unrelated CBT (single or double) between 2005 and 2016, for acute myelogenous leukemia (AML) or acute lymphoblastic leukemia (ALL), no prior allogeneic or autologous transplantation, no other stem cell product. The study included 87 patients. At 1-year, cumulative incidence of relapse and nonrelapse mortality (NRM) was 35% and 37%, respectively. One-year overall survival (OS) and progression-free survival (PFS) was 40% and 29%, respectively. Forty-six patients underwent a salvage second transplantation with 1-year and 2-year OS and PFS from second transplantation 41% and 34% for OS, and 37% and 34% for PFS, respectively. In multivariate analysis, complete remission (CR) at CBT (HR = 0.45, 95% CI 0.25-0.83, P = 0.01) and reduced-intensity conditioning (HR = 0.51, 95% CI 0.29-0.91, P = 0.023) were associated with better OS. In conclusion, in this retrospective study, we observed that approximately one-quarter of patients experiencing graft failure after CBT remained alive without relapse 2 years later.
Disciplines :
Hematology
Author, co-author :
Baron, Frédéric ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'hématologie clinique
Ruggeri, Annalisa ; Eurocord, Saint Louis Hospital, Paris, France and Centre scientifique de Monaco, Paris, Monaco ; IRCCS San Raffaele Scientific Institute,department of Hematologogy and BMT, Milano, Italy
Peczynski, Christophe ; Department of Haematology, Saint Antoine Hospital, Paris, France ; EBMT Paris study office/CEREST-TC, Paris, France ; INSERM UMR 938, Paris, France ; Sorbonne university, Paris, France
Labopin, Myriam ; Department of Haematology, Saint Antoine Hospital, Paris, France ; EBMT Paris study office/CEREST-TC, Paris, France ; INSERM UMR 938, Paris, France ; Sorbonne university, Paris, France
Bourhis, Jean-Henri; Gustave Roussy, institut de cancérologie, BMT Service, Division of Hematology, Villejuif, France
Michallet, Mauricette; Service d'Hématologie du Centre de lutte contre le Cancer Léon Bérard, Lyon, France
Chevallier, Patrice ; CHU Nantes, Dept. D'Hematologie, Nantes, France
Sanz, Jaime ; University Hospital La Fe, Hematology Department, Valencia, Spain
Forcade, Edouard ; Service d'Hématologie Clinique et Thérapie Cellulaire, CHU Bordeaux, F-33000, Bordeaux, France
Saccardi, Riccardo; Azienda Ospedaliera Universitaria Careggi, Cell Therapy and Transfusion Medicine Unit, Firenze, Italy
Potter, Victoria; Kings College Hospital, London, UK
Gluckman, Eliane; Eurocord, Saint Louis Hospital, Paris, France and Centre scientifique de Monaco, Paris, Monaco
Nagler, Arnon ; Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel and the EBMT Paris Office, Hospital Saint Antoine, Paris, France
Mohty, Mohamad ; Department of Haematology, Saint Antoine Hospital, Paris, France ; EBMT Paris study office/CEREST-TC, Paris, France ; INSERM UMR 938, Paris, France ; Sorbonne university, Paris, France
Outcomes of graft failure after umbilical cord blood transplantation in acute leukemia: a study from Eurocord and the Acute Leukemia Working Party of the EBMT.
We thank Emmanuelle Polge and Audrey Mailhol from the office of the ALWP of the EBMT. FB is Senior Research Associate at the National Fund for Scientific Research (FNRS) Belgium.
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