Impact of graft-versus-host disease prophylaxis on outcomes after myeloablative single-unit umbilical cord blood transplantation
Copyright © 2013 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved..
Myeloablative single-unit umbilical cord blood transplantation (sUCBT) using busulfan, thiotepa, fludarabine, and antithymocyte globulin (Grupo Español de Trasplante Hematopoyético [GETH]-2005 protocol) resulted in high rates of engraftment and high antitumor activity. We designed a new graft-versus-host disease prophylaxis, substituting long-term steroids with mycophenolate mofetil together with a slight reduction of antithymocyte globulin (GETH/Gruppo Italiano Trapianto Midollo Osseo [GITMO]-2008 protocol). The results in 145 consecutive patients were compared with those obtained in 88 patients from the previous GETH-2005 trial. The cumulative incidence (CI) of myeloid engraftment at 60 days for patients in the GETH-2005 and GETH/GITMO-2008 trials was 94% and 88%, respectively, at a median time to neutrophil recovery of 19 and 23 days, respectively (P < .0001). In the multivariable analyses, platelet engraftment, acute and chronic graft-versus-host disease, nonrelapse mortality, relapse, and event-free survival were not significantly different. The 3-year event-free survival rate in the GETH/GITMO-2008 trial was 66%, 31%, and 25% for patients transplanted in early, intermediate, and advanced stages of the disease, respectively (P < .0001). This study confirms that myeloablative sUCBT using busulfan-based conditioning is a valuable strategy for patients with hematological malignancies. The use of mycophenolate mofetil apparently had an adverse effect on myeloid engraftment, and therefore a cautious use of this agent is warranted in the UCBT setting.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2013 |
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| Erschienen: |
2013 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:19 |
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| Enthalten in: |
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation - 19(2013), 9 vom: 21. Sept., Seite 1387-92 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sanz, Jaime [VerfasserIn] |
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| Links: |
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| Themen: |
Engraftment |
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| Anmerkungen: |
Date Completed 17.03.2014 Date Revised 17.03.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.bbmt.2013.07.004 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM229133134 |
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| 245 | 1 | 0 | |a Impact of graft-versus-host disease prophylaxis on outcomes after myeloablative single-unit umbilical cord blood transplantation |
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| 500 | |a Date Revised 17.03.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2013 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a Myeloablative single-unit umbilical cord blood transplantation (sUCBT) using busulfan, thiotepa, fludarabine, and antithymocyte globulin (Grupo Español de Trasplante Hematopoyético [GETH]-2005 protocol) resulted in high rates of engraftment and high antitumor activity. We designed a new graft-versus-host disease prophylaxis, substituting long-term steroids with mycophenolate mofetil together with a slight reduction of antithymocyte globulin (GETH/Gruppo Italiano Trapianto Midollo Osseo [GITMO]-2008 protocol). The results in 145 consecutive patients were compared with those obtained in 88 patients from the previous GETH-2005 trial. The cumulative incidence (CI) of myeloid engraftment at 60 days for patients in the GETH-2005 and GETH/GITMO-2008 trials was 94% and 88%, respectively, at a median time to neutrophil recovery of 19 and 23 days, respectively (P < .0001). In the multivariable analyses, platelet engraftment, acute and chronic graft-versus-host disease, nonrelapse mortality, relapse, and event-free survival were not significantly different. The 3-year event-free survival rate in the GETH/GITMO-2008 trial was 66%, 31%, and 25% for patients transplanted in early, intermediate, and advanced stages of the disease, respectively (P < .0001). This study confirms that myeloablative sUCBT using busulfan-based conditioning is a valuable strategy for patients with hematological malignancies. The use of mycophenolate mofetil apparently had an adverse effect on myeloid engraftment, and therefore a cautious use of this agent is warranted in the UCBT setting | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Engraftment | |
| 650 | 4 | |a GVHD prophylaxis | |
| 650 | 4 | |a Umbilical cord blood | |
| 700 | 1 | |a Picardi, Alessandra |e verfasserin |4 aut | |
| 700 | 1 | |a Hernández Boluda, Juan C |e verfasserin |4 aut | |
| 700 | 1 | |a Martín, Carmen |e verfasserin |4 aut | |
| 700 | 1 | |a Ferrá, Christelle |e verfasserin |4 aut | |
| 700 | 1 | |a Nozzoli, Chiara |e verfasserin |4 aut | |
| 700 | 1 | |a Gonzalez-Vicent, Marta |e verfasserin |4 aut | |
| 700 | 1 | |a Rambaldi, Alessandro |e verfasserin |4 aut | |
| 700 | 1 | |a Valcarcel, David |e verfasserin |4 aut | |
| 700 | 1 | |a Verdeguer, Amparo |e verfasserin |4 aut | |
| 700 | 1 | |a Serrano, David |e verfasserin |4 aut | |
| 700 | 1 | |a de Heredia, Cristina Díaz |e verfasserin |4 aut | |
| 700 | 1 | |a Pascual, María Jesús |e verfasserin |4 aut | |
| 700 | 1 | |a de Paz, Raquel |e verfasserin |4 aut | |
| 700 | 1 | |a Montesinos, Pau |e verfasserin |4 aut | |
| 700 | 1 | |a Bartolozzi, Benedetta |e verfasserin |4 aut | |
| 700 | 1 | |a Algarotti, Alessandra |e verfasserin |4 aut | |
| 700 | 1 | |a Sanz, Miguel A |e verfasserin |4 aut | |
| 700 | 1 | |a Arcese, William |e verfasserin |4 aut | |
| 700 | 1 | |a Sanz, Guillermo F |e verfasserin |4 aut | |
| 700 | 0 | |a GETH and GITMO |e verfasserin |4 aut | |
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