title: Double umbilical cord blood transplantation for hematological malignancies: a long-term analysis from the SFGM-TC registry.
abstract: Allogeneic hematopoietic stem cell (HSC) transplantation is a curative treatment for many hematologic malignancies for which umbilical cord blood (UCB) represents an alternative source of HSCs. To overcome the low cellularity of one UCB unit, double UCB transplantation (dUCBT) has been developed in adults. We have analyzed the outcome of 136 patients who underwent dUCBT reported to the SFGM-TC registry between 2005 and 2007. Forty-six patients received myeloablative regimens, and 90 patients received reduced-intensity conditioning regimens. There were 84 cases of leukemia, 17 cases of non-Hodgkin lymphoma, 11 cases of myeloma, and 24 other hematologic malignancies. At transplantation, 40 (29%) patients were in complete remission. At day 60 after transplantation, the cumulative incidence of neutrophil recovery was 91%. We observed one UCB unit domination in 88% of cases. The cumulative incidence of day 100 acute graft-versus-host disease, chronic graft-versus-host disease, transplant-related mortality, and relapse at 2 years were 36%, 23%, 27%, and 28% respectively. After a median follow-up of 49.5 months, the 3-year probabilities of overall and progression-free survival were 41% and 35%, respectively, with a significant overall survival advantage when male cord engrafted male recipients. We obtained a long-term plateau among patients in complete remission, which makes dUCBT a promising treatment strategy for these patients.
authors.affiliation: Centre Hospitalier Lyon Sud, Hématologie 1G, Hospices Civils de Lyon, Pierre Bénite, France.
authors.forename: Hélène Labussière
authors.initials: HL
authors.lastname: Wallet
authors.forename: Mohamad
authors.initials: M
authors.lastname: Sobh
authors.forename: Stéphane
authors.initials: S
authors.lastname: Morisset
authors.forename: Marie
authors.initials: M
authors.lastname: Robin
authors.forename: Nathalie
authors.initials: N
authors.lastname: Fegueux
authors.forename: Sabine
authors.initials: S
authors.lastname: Fürst
authors.forename: Mohamad
authors.initials: M
authors.lastname: Mohty
authors.forename: Eric
authors.initials: E
authors.lastname: Deconinck
authors.forename: Loïc
authors.initials: L
authors.lastname: Fouillard
authors.forename: Pierre
authors.initials: P
authors.lastname: Bordigoni
authors.forename: Bernard
authors.initials: B
authors.lastname: Rio
authors.forename: Anne
authors.initials: A
authors.lastname: Sirvent
authors.forename: Marc
authors.initials: M
authors.lastname: Renaud
authors.forename: Nathalie
authors.initials: N
authors.lastname: Dhedin
authors.forename: Reza
authors.initials: R
authors.lastname: Tabrizi
authors.forename: Sébastien
authors.initials: S
authors.lastname: Maury
authors.forename: Agnès
authors.initials: A
authors.lastname: Buzyn
authors.forename: Gérard
authors.initials: G
authors.lastname: Michel
authors.forename: Natacha
authors.initials: N
authors.lastname: Maillard
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Cahn
authors.forename: Jacques-Olivier
authors.initials: JO
authors.lastname: Bay
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yakoub-Agha
authors.forename: Anne
authors.initials: A
authors.lastname: Huynh
authors.forename: Aline
authors.initials: A
authors.lastname: Schmidt-Tanguy
authors.forename: Thierry
authors.initials: T
authors.lastname: Lamy
authors.forename: Bruno
authors.initials: B
authors.lastname: Lioure
authors.forename: Nicole
authors.initials: N
authors.lastname: Raus
authors.forename: Evelyne
authors.initials: E
authors.lastname: Marry
authors.forename: Federico
authors.initials: F
authors.lastname: Garnier
authors.forename: Marie-Lorraine
authors.initials: ML
authors.lastname: Balère
authors.forename: Eliane
authors.initials: E
authors.lastname: Gluckman
authors.forename: Vanderson
authors.initials: V
authors.lastname: Rocha
authors.forename: Gérard
authors.initials: G
authors.lastname: Socié
authors.forename: Didier
authors.initials: D
authors.lastname: Blaise
authors.forename: Noël
authors.initials: N
authors.lastname: Milpied
authors.forename: Mauricette
authors.initials: M
authors.lastname: Michallet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology / Q000401:mortality; D019337:Hematologic Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012042:Registries / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult