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Cord Blood Stem Cells

Single-unit umbilical cord blood transplantation from unrelated donors in patients with hematological malignancy using busulfan, thiotepa, fludarabine and ATG as myeloablative conditioning regimen

Bone Marrow Transplantation volume 47, pages 1287–1293 (2012)Cite this article

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Abstract

Attempts to optimize outcomes in cord blood transplantation (CBT) by using new conditioning regimens and standardization of cord blood unit selection are warranted. In all, 88 patients (18 children and 70 adults) with hematological malignancy from nine Spanish institutions underwent a single-unit CBT after an i.v. BU-based myeloablative conditioning regimen. All evaluable patients except one engrafted. The overall cumulative incidence (CI) of myeloid engraftment was 94% at a median time of 19 days. In multivariate analysis, nonadvanced disease stage was the only factor with a favorable impact on myeloid engraftment. The CI of acute GVHD grades II–IV and chronic extensive GVHD were 24% each. The CI of nonrelapse mortality at 100 days, 180 days and 5 years was 14, 23 and 44%, respectively. The 5-year CI of relapse was 18%, whereas disease-free survival (DFS) was 46%, 39% and 11% for patients transplanted in early, intermediate and advanced stages of the disease, respectively. Our study shows high rates of engraftment with fast neutrophil recovery in patients undergoing single-unit CBT using a BU-based conditioning regimen. Long-term DFS can be achieved in a substantial number of patients with high-risk hematological malignancies, particularly when transplanted in an early stage of the disease.

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Acknowledgements

We thank David Pellicer for data collection and management. This study was supported by a Pierre Fabre Ibérica unrestricted research grant.

Author Contributions: JS and GFS conceived the study and interpreted the data; JS, MAS and GFS wrote the paper; JS performed the statistical analyses; JCHB, CM, MG, CF, DS, CDH, CB, AMM and CS reviewed the manuscript and contributed to the final draft.

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Authors and Affiliations

  1. Department of Hematology, Hospital Universitario La Fe, Valencia, Spain

    J Sanz, M A Sanz & G F Sanz

  2. Hospital Clínico Universitario, Valencia, Spain

    J C H Boluda & C Solano

  3. Hospital Reina Sofía, Córdoba, Spain

    C Martín

  4. Hospital Niño Jesús, Madrid, Spain

    M González

  5. Hospital Universitari Germans Trias I Pujol, Barcelona, Spain

    C Ferrá

  6. Hospital Gregorio Marañón, Madrid, Spain

    D Serrano

  7. Hospital Infantil Vall D’Hebron, Barcelona, Spain

    C D de Heredia

  8. Hospital Universitari Vall D’Hebron, Barcelona, Spain

    C Barrenetxea

  9. Hospital La Paz infantil, Madrid, Spain

    A M Martinez

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on behalf of Grupo Español de Trasplante Hematopoyético y Terapia Celular (GETH)

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Correspondence to J Sanz.

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Sanz, J., Boluda, J., Martín, C. et al. Single-unit umbilical cord blood transplantation from unrelated donors in patients with hematological malignancy using busulfan, thiotepa, fludarabine and ATG as myeloablative conditioning regimen. Bone Marrow Transplant 47, 1287–1293 (2012). https://doi.org/10.1038/bmt.2012.13

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