title: Phase II trial of parathyroid hormone after double umbilical cord blood transplantation.
abstract: Transplantation of 1 or 2 umbilical cord blood products is a useful alternative stem cell source. However, the limited number of stem cells in each infusion results in slow engraftment. In mouse models, administration of parathyroid hormone (PTH) is an effective way to enhance the ability of limited numbers of hematopoietic stem cells to support hematopoiesis. In this study, patients received either a myeloablative or a reduced-intensity double umbilical cord blood transplantation, followed by PTH at 100 μg/day for 28 days. Thirteen patients (median age, 42 years) were enrolled. All patients engrafted; the median time to neutrophil and platelet engraftment of >20 × 10(9) cells/L was 30 days and 61 days, respectively. The incidence of grade II-IV acute GVHD was 38.5% at day 100. Four deaths occurred before day 100, prompting early study closure. No patient who received a myeloablative regimen relapsed. Overall survival at 6 months after transplantation was 62%, and disease-free survival at 2 years was 39%. At the dose and schedule studied, there was no evidence that PTH influenced blood count recovery.
authors: Hematology/Oncology Division, Department of Medicine, Massachusetts General Hospital, Boston, USA. kballen@partners.org
authors: Karen
authors: K
authors: Ballen
authors: Adam M
authors: AM
authors: Mendizabal
authors: Corey
authors: C
authors: Cutler
authors: Ioannis
authors: I
authors: Politikos
authors: Katarzyna
authors: K
authors: Jamieson
authors: Elizabeth J
authors: EJ
authors: Shpall
authors: Bimalangshu R
authors: BR
authors: Dey
authors: Eyal
authors: E
authors: Attar
authors: Steven
authors: S
authors: McAfee
authors: Colleen
authors: C
authors: Delaney
authors: Philip
authors: P
authors: McCarthy
authors: Edward D
authors: ED
authors: Ball
authors: Ram
authors: R
authors: Kamble
authors: David
authors: D
authors: Avigan
authors: Richard T
authors: RT
authors: Maziarz
authors: Vincent T
authors: VT
authors: Ho
authors: John
authors: J
authors: Koreth
authors: Edwin
authors: E
authors: Alyea
authors: Robert
authors: R
authors: Soiffer
authors: John R
authors: JR
authors: Wingard
authors: Vicki
authors: V
authors: Boussiotis
authors: Thomas R
authors: TR
authors: Spitzer
authors: Joseph H
authors: JH
authors: Antin
mesh_terms: D000328:Adult; D000368:Aged; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D018572:Disease-Free Survival; D006085:Graft Survival / Q000276:immunology / Q000502:physiology; D006402:Hematologic Diseases / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000008:administration & dosage* / Q000009:adverse effects; D015996:Survival Rate; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods; D055815:Young Adult
chemical_list: D010281:Parathyroid Hormone