title: Comparison of outcomes after single or double cord blood transplantation in adults with acute leukemia using different types of myeloablative conditioning regimen, a retrospective study on behalf of Eurocord and the Acute Leukemia Working Party of EBMT.
abstract: We report outcomes after single (s) and double (d) umbilical cord blood transplantation (UCBT) after myeloablative conditioning (MAC) regimen for 239 patients transplanted for acute leukemia in first complete remission (CR1). All sUCBT patients received a total nucleated cell dose >2.5 × 10(7)/kg. Conditioning regimen for sUCBT was total body irradiation (TBI)12 Gy- or busulfan (BU)-based ± fludarabine (Flu) (n=68, group 1), thiotepa+BU+Flu (TBF) (n=88, group 2), and for dUCBT it was TBI12 Gy+cyclophosphamide ± Flu (n=83, group 3). dUCBT recipients were younger, received higher cell dose and less frequently antithymocyte globulin. In multivariate analysis, we found similar neutrophil recovery among the three groups; however, acute graft-versus-host disease II-IV was higher in dUCBT compared with others. Non-relapse mortality and relapse incidence were not statistically different among the three groups. Leukemia-free survival was 30% for sUCBT using TBI- or BU-based MAC compared with 48% for sUCBT TBF and 48% for dUCBT (P=0.02 and P=0.03, respectively), and it was not statistically different between sUCBT with TBF and dUCBT. In conclusion, use of sUCBT with adequate cell dose (>2.5 × 10(7)/kg) and a specific conditioning regimen in the MAC setting results in similar outcomes as dUCBT. The choice of TBF conditioning regimen for sUCBT may improve results, and whether this regimen may be effective in dUCBT should be further analyzed.
authors.affiliation: 1] Eurocord, Hôpital Saint Louis, AP-HP, and IUH University Paris VII, Paris, France [2] Rome Transplant Network, University Tor Vergata, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ruggeri
authors.affiliation: Hospital Universitario La Fe, Valencia, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Sanz
authors.affiliation: CHU Sainte-Justine, Montreal, QC, Canada.
authors.forename: H
authors.initials: H
authors.lastname: Bittencourt
authors.affiliation: Hospital Universitario La Fe, Valencia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Sanz
authors.affiliation: Ospedali Riuniti di Bergamo, Bergamo, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Rambaldi
authors.affiliation: Eurocord, Hôpital Saint Louis, AP-HP, and IUH University Paris VII, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Volt
authors.affiliation: Hôpital Claude Huriez, Lille, France.
authors.forename: I
authors.initials: I
authors.lastname: Yakoub-Agha
authors.affiliation: ICO-Hospital Universitari Germans Trias i Pujol, Jose Carreras Research Institute, Badalona, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Ribera
authors.affiliation: Hôpital l'Archet, Nice, France.
authors.forename: L
authors.initials: L
authors.lastname: Mannone
authors.affiliation: Hospital Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Sierra
authors.affiliation: Hospital Saint Antoine, Service d'Hématologie et Thérapie Cellulaire, AP-HP, UPMC Univ Paris 06, UMR-S 938, CEREST-TC EBMT, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Mohty
authors.affiliation: Hospital Clínico Universitario, Valencia, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Solano
authors.affiliation: Eurocord, Hôpital Saint Louis, AP-HP, and IUH University Paris VII, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Nabhan
authors.affiliation: Rome Transplant Network, University Tor Vergata, Rome, Italy.
authors.forename: W
authors.initials: W
authors.lastname: Arcese
authors.affiliation: Eurocord, Hôpital Saint Louis, AP-HP, and IUH University Paris VII, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Gluckman
authors.affiliation: Hospital Saint Antoine, Service d'Hématologie et Thérapie Cellulaire, AP-HP, UPMC Univ Paris 06, UMR-S 938, CEREST-TC EBMT, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Labopin
authors.affiliation: 1] Eurocord, Hôpital Saint Louis, AP-HP, and IUH University Paris VII, Paris, France [2] Churchill Hospital, Oxford University Hospitals, Oxford, UK.
authors.forename: V
authors.initials: V
authors.lastname: Rocha
mesh_terms: D000293:Adolescent; D000328:Adult; D018952:Antigens, CD34 / Q000032:analysis; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D019172:Transplantation Conditioning; D016896:Treatment Outcome
chemical_list: D018952:Antigens, CD34