title: Salvaged single-unit cord blood transplantation for 26 patients with hematologic malignancies not in remission.
abstract: Treatments for patients with hematologic malignancies not in remission are limited, but a few clinical studies have investigated the effects of salvaged unrelated cord blood transplantation (CBT). We retrospectively studied 19 patients with acute leukemia, 5 with myelodysplastic syndrome (MDS with refractory anemia with excess blasts [RAEB]), and 2 with non-Hodgkin's lymphoma who received 1 CBT unit ≤ 2 loci human leukocyte antigen (HLA)-mismatched after undergoing myeloablative conditioning regimens between July 2005 and July 2014. All of them were in non-remission before transplantation. The infused total nucleated cell (TNC) dose was 4.07 (range 2.76-6.02) × 10⁷/kg and that of CD34⁺ stem cells was 2.08 (range 0.99-8.65) × 10⁵/kg. All patients were engrafted with neutrophils that exceeded 0.5 × 10⁹/L on median day +17 (range 14-37 days) and had platelet counts of >20 × 10⁹/L on median day +35 (range 17-70 days). Sixteen patients (61.5%) experienced pre-engraftment syndrome (PES), and six (23.1%) patients progressed to acute graft-versus-host disease (GVHD). The cumulative incidence rates of II-IV acute GVHD and chronic GVHD were 50% and 26.9%, respectively. After a median follow-up of 27 months (range 5-74), 14 patients survived and 3 relapsed. The estimated 2-year overall survival (OS), disease-free survival (DFS), and non-relapse mortality (NRM) rates were 50.5%, 40.3%, and 35.2%, respectively. Salvaged CBT might be a promising modality for treating hematologic malignancies, even in patients with a high leukemia burden.
authors.affiliation: School of Medicine, Shandong University, Jinan, CN.
authors.forename: W
authors.initials: W
authors.lastname: Yao
authors.affiliation: Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, CN.
authors.forename: C C
authors.initials: CC
authors.lastname: Zheng
authors.affiliation: Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, CN.
authors.forename: H L
authors.initials: HL
authors.lastname: Liu
authors.affiliation: Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, CN.
authors.forename: L Q
authors.initials: LQ
authors.lastname: Geng
authors.affiliation: Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, CN.
authors.forename: B L
authors.initials: BL
authors.lastname: Tang
authors.affiliation: Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, CN.
authors.forename: J
authors.initials: J
authors.lastname: Tong
authors.affiliation: Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, CN.
authors.forename: X Y
authors.initials: XY
authors.lastname: Zhu
authors.affiliation: Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, CN.
authors.forename: K D
authors.initials: KD
authors.lastname: Song
authors.affiliation: Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, CN.
authors.forename: P
authors.initials: P
authors.lastname: Qiang
authors.affiliation: School of Medicine, Shandong University, Jinan, CN.
authors.forename: Z M
authors.initials: ZM
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts; D000754:Anemia, Refractory, with Excess of Blasts / Q000401:mortality / Q000628:therapy*; D002648:Child; D036101:Cord Blood Stem Cell Transplantation / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000401:mortality; D019337:Hematologic Neoplasms / Q000401:mortality / Q000628:therapy; D006801:Humans; D007938:Leukemia / Q000401:mortality / Q000628:therapy; D015456:Leukemia, Biphenotypic, Acute / Q000401:mortality / Q000628:therapy*; D007945:Leukemia, Lymphoid / Q000401:mortality / Q000628:therapy; D007951:Leukemia, Myeloid / Q000401:mortality / Q000628:therapy; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000628:therapy*; D008297:Male; D009190:Myelodysplastic Syndromes / Q000401:mortality / Q000628:therapy; D012074:Remission Induction / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult