title: Unrelated cord blood transplantation for childhood acute myeloid leukemia: a Eurocord Group analysis.
abstract: Results of unrelated cord blood transplantation (UCBT) in childhood acute myeloid leukemia (AML) have not been previously reported. We analyzed 95 children receiving UCB transplants for AML (20 in first complete remission [CR1], 47 in CR2, and 28 in more advanced stage). Poor prognosis cytogenetic abnormalities were identified in 29 cases. Most patients received a 1 or 2 HLA antigens-mismatched UCB transplants. The median number of collected nucleated cells (NCs) was 5.2 x 107/kg. Cumulative incidence (CI) of neutrophil recovery was 78% +/- 4%, acute graft-versus-host disease (GVHD) was 35% +/- 5%, and 100-day transplantation-related mortality (TRM) was 20% +/- 4%. In multivariable analysis, a collected NC dose higher than 5.2 x 107/kg was associated with a lower 100-day TRM. The 2-year CI of relapse was 29% +/- 5% and was associated with disease status. The 2-year leukemia-free survival (LFS) was 42% +/- 5% (59% +/- 11% in CR1, 50% +/- 8% in CR2, and 21% +/- 9% for children not in CR). Children with poor prognosis cytogenetic features had similar LFS compared with other patients (44% +/- 11% vs 40% +/- 8%). In CR2, LFS was not influenced by the length of CR1 (53% +/- 11% in CR1 < 9.5 months compared with 50% +/- 12% in later relapses). We conclude that UCBT is a therapeutic option for children with very poor-prognosis AML and who lack an HLA-identical sibling.
authors.affiliation: Eurocord Registry-Hospital Saint Louis AP/HP, Department of Hematology and Bone Marrow Transplantation and Clinical Research Laboratory on Cell Therapy, Paris University 7, 1 Ave Claude Vellefaux, 75010 Paris, France.
authors.forename: Gerard
authors.initials: G
authors.lastname: Michel
authors.forename: Vanderson
authors.initials: V
authors.lastname: Rocha
authors.forename: Sylvie
authors.initials: S
authors.lastname: Chevret
authors.forename: William
authors.initials: W
authors.lastname: Arcese
authors.forename: Kah-Wah
authors.initials: KW
authors.lastname: Chan
authors.forename: Alexandra
authors.initials: A
authors.lastname: Filipovich
authors.forename: Tsuneo A
authors.initials: TA
authors.lastname: Takahashi
authors.forename: Marcus
authors.initials: M
authors.lastname: Vowels
authors.forename: Juan
authors.initials: J
authors.lastname: Ortega
authors.forename: Pierre
authors.initials: P
authors.lastname: Bordigoni
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Shaw
authors.forename: Isaac
authors.initials: I
authors.lastname: Yaniv
authors.forename: Alexandra
authors.initials: A
authors.lastname: Machado
authors.forename: Pedro
authors.initials: P
authors.lastname: Pimentel
authors.forename: Franca
authors.initials: F
authors.lastname: Fagioli
authors.forename: Amparo
authors.initials: A
authors.lastname: Verdeguer
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Jouet
authors.forename: Blanca
authors.initials: B
authors.lastname: Diez
authors.forename: Euripedes
authors.initials: E
authors.lastname: Ferreira
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pasquini
authors.forename: Joseph
authors.initials: J
authors.lastname: Rosenthal
authors.forename: Eric
authors.initials: E
authors.lastname: Sievers
authors.forename: Chiara
authors.initials: C
authors.lastname: Messina
authors.forename: Anna Paola
authors.initials: AP
authors.lastname: Iori
authors.forename: Federico
authors.initials: F
authors.lastname: Garnier
authors.forename: Irina
authors.initials: I
authors.lastname: Ionescu
authors.forename: Franco
authors.initials: F
authors.lastname: Locatelli
authors.forename: Eliane
authors.initials: E
authors.lastname: Gluckman
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001772:Blood Cell Count; D001782:Blood Donors; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D036101:Cord Blood Stem Cell Transplantation / Q000401:mortality; D005060:Europe / Q000453:epidemiology; D005260:Female; D006086:Graft vs Host Disease / Q000401:mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007951:Leukemia, Myeloid / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D012042:Registries / Q000706:statistics & numerical data; D012074:Remission Induction; D012189:Retrospective Studies; D016019:Survival Analysis