Factors with an impact on chimerism development and long-term survival after umbilical cord blood transplantation
BACKGROUND: Umbilical cord blood transplantation (UCBT) is increasingly used and produces similar results to matched unrelated donor transplantation.
METHODS: We performed a retrospective single-center analysis of 50 umbilical cord blood transplantations UCBTs performed from 2001 to 2010, including 37 single and 13 double umbilical cord blood transplantations UCBTs.
RESULTS: The rate of engraftment of neutrophils was 88% at a median time of 29 days (range, 3-79). Complete donor chimerism (DC) within the CD19, CD3, and CD33 cell lineages was seen in 74%, 72%, and 76% of the patients, respectively. DC was associated with acute graft-versus-host disease (GVHD) grades II to IV for the CD3 cell lineage (P=0.01) and, in multivariate analysis, with total body irradiation for all lineages (P<0.01). Overall survival (OS) at 1 and 5 years was 55% and 43%. Nonmalignant diseases were associated with better 5-year OS (72%) than malignancies (28%; P=0.026). In multivariate analysis, a negative correlation was seen between OS and age (hazard ratio [HR], 1.04; 95% confidence interval [95% CI], 1.02-1.06; P<0.001), acute GVHD grades III and IV (HR, 3.43; 95% CI, 1.95-6.02; P<0.001), and mesenchymal stem cell treatment (HR, 2.66; 95% CI, 1.11-6.35; P=0.027). Transplant-related mortality at 100 days and 1 year was 16% and 30%. The incidence of acute GVHD grades II to IV was 34%. Acute GVHD grades III and IV was associated with ABO incompatibility (HR, 2.61; P=0.05) and myeloablative conditioning (HR, 4.17; P=0.047).
CONCLUSIONS: The outcome in patients with nonmalignant diseases was acceptable, but transplant-related mortality in the whole group remains high. A significantly higher rate of DC was associated with total body irradiation-based conditioning and with acute GVHD grades II and IV.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2012 |
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| Erschienen: |
2012 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:94 |
|---|---|
| Enthalten in: |
Transplantation - 94(2012), 10 vom: 27. Nov., Seite 1066-74 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Berglund, Sofia [VerfasserIn] |
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| Links: |
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| Themen: |
Antigens, CD19 |
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| Anmerkungen: |
Date Completed 01.04.2013 Date Revised 16.11.2017 published: Print Citation Status MEDLINE |
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| doi: |
10.1097/TP.0b013e31826c39b2 |
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| funding: |
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|---|---|
| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM221913068 |
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| 100 | 1 | |a Berglund, Sofia |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Factors with an impact on chimerism development and long-term survival after umbilical cord blood transplantation |
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| 500 | |a Date Revised 16.11.2017 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Umbilical cord blood transplantation (UCBT) is increasingly used and produces similar results to matched unrelated donor transplantation | ||
| 520 | |a METHODS: We performed a retrospective single-center analysis of 50 umbilical cord blood transplantations UCBTs performed from 2001 to 2010, including 37 single and 13 double umbilical cord blood transplantations UCBTs | ||
| 520 | |a RESULTS: The rate of engraftment of neutrophils was 88% at a median time of 29 days (range, 3-79). Complete donor chimerism (DC) within the CD19, CD3, and CD33 cell lineages was seen in 74%, 72%, and 76% of the patients, respectively. DC was associated with acute graft-versus-host disease (GVHD) grades II to IV for the CD3 cell lineage (P=0.01) and, in multivariate analysis, with total body irradiation for all lineages (P<0.01). Overall survival (OS) at 1 and 5 years was 55% and 43%. Nonmalignant diseases were associated with better 5-year OS (72%) than malignancies (28%; P=0.026). In multivariate analysis, a negative correlation was seen between OS and age (hazard ratio [HR], 1.04; 95% confidence interval [95% CI], 1.02-1.06; P<0.001), acute GVHD grades III and IV (HR, 3.43; 95% CI, 1.95-6.02; P<0.001), and mesenchymal stem cell treatment (HR, 2.66; 95% CI, 1.11-6.35; P=0.027). Transplant-related mortality at 100 days and 1 year was 16% and 30%. The incidence of acute GVHD grades II to IV was 34%. Acute GVHD grades III and IV was associated with ABO incompatibility (HR, 2.61; P=0.05) and myeloablative conditioning (HR, 4.17; P=0.047) | ||
| 520 | |a CONCLUSIONS: The outcome in patients with nonmalignant diseases was acceptable, but transplant-related mortality in the whole group remains high. A significantly higher rate of DC was associated with total body irradiation-based conditioning and with acute GVHD grades II and IV | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
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| 700 | 1 | |a Le Blanc, Katarina |e verfasserin |4 aut | |
| 700 | 1 | |a Remberger, Mats |e verfasserin |4 aut | |
| 700 | 1 | |a Gertow, Jens |e verfasserin |4 aut | |
| 700 | 1 | |a Uzunel, Mehmet |e verfasserin |4 aut | |
| 700 | 1 | |a Svenberg, Petter |e verfasserin |4 aut | |
| 700 | 1 | |a Winiarski, Jacek |e verfasserin |4 aut | |
| 700 | 1 | |a Ljungman, Per |e verfasserin |4 aut | |
| 700 | 1 | |a Ringdén, Olle |e verfasserin |4 aut | |
| 700 | 1 | |a Uhlin, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Mattsson, Jonas |e verfasserin |4 aut | |
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