Volume 6 Issue 6
Nov.  2015
Turn off MathJax
Article Contents
Article Navigation >  ORGAN TRANSPLANTATION  > 2015  >  6(6): 420-424
Sun Yanling, Li Xudong, Lin Dongjun, et al. Clinical study on treatment of high-risk acute leukemia with unrelated cord blood transplantation[J]. ORGAN TRANSPLANTATION, 2015, 6(6): 420-424. doi: 10.3969/j.issn.1674-7445.2015.06.015
Citation: Sun Yanling, Li Xudong, Lin Dongjun, et al. Clinical study on treatment of high-risk acute leukemia with unrelated cord blood transplantation[J]. ORGAN TRANSPLANTATION, 2015, 6(6): 420-424. doi: 10.3969/j.issn.1674-7445.2015.06.015
shu

Clinical study on treatment of high-risk acute leukemia with unrelated cord blood transplantation

doi: 10.3969/j.issn.1674-7445.2015.06.015

  • Department of Hematology, the Third Affiliated Hospital of Sun Yat-sen University, Institute of Hemopathy of Sun Yat-sen University, Guangzhou 510630, China

More Information
  • Corresponding author: Fang Zhigang, Email: fzg92@163.com
  • Received Date: 2015-09-20
    Available Online: 2021-01-19
  • Publish Date: 2015-11-15
    Abstract
  •   Objective  To investigate the effect of unrelated cord blood transplantation (UCBT) on the treatment of high-risk childhood and adult acute leukemia.  Methods  Ten patients with high-risk acute leukemia underwent UCBT. Among the 10 patients, 3 were children and 7 were adults with the median age of 29 years old (11-41 years old). Six patients underwent one-unit cord blood transplantation and four patients underwent two-unit cord blood transplantation. The myeloablative conditioning regimen without antithymocyte globulin (ATG) was adopted. Cytarabine (Ara-C), fludarabine (Flu) or total body irradiation (TBI) was added on the basis of busulfan(Bu) and cyclophosphamide (Cy). Ciclosporin and mycophenolate mofetil were used to prevent graft-versus-host disease (GVHD).  Results  The transplantation was successful in 8 (80%) patients. The median implant-time of leukocytes was 19 d(14-25 d)and that of platelets was 40 d(33-60 d). Three patients developed acute GVHD and no patient developed chronic GVHD. The median follow-up time was 24 months (1-29 months). Seven patients remained in disease-free survival. Both the 2-year overall survival and disease-free survival rates were 66.7%.  Conclusions  UCBT is feasible in the treatment of high-risk acute leukemia. UCBT is the preferred option for the high-risk patients without HLA-identical sibling donors, which is characterized by low incidence of GVHD and low recurrence rate. It may make patients with acute leukemia remain long-term survival.

     

    • FullText(HTML)
  • loading
    • References(17)
  • [1]
    Solh M. Haploidentical vs cord blood transplantation for adults with acute myelogenous leukemia[J]. World J Stem Cells, 2014, 6(4):371-379. doi: 10.4252/wjsc.v6.i4.371
    [2]
    Eapen M, Wagner JE. Transplant outcomes in acute leukemia.I.[J]. Semin Hematol, 2010, 47(1):46-50. doi: 10.1053/j.seminhematol.2009.10.007
    [3]
    Piñana JL, Sanz J, Esquirol A, et al. Umbilical cord blood transplantation in adults with advanced hodgkin's disease:high incidence of post-transplant lymphoproliferative disease[J]. Eur J Haematol, 2015, DOI:10.1111/ejh.12557[Epub ahead of print].
    [4]
    Tucunduva L, Ruggeri A, Sanz G, et al. Risk factors for outcomes after unrelated cord blood transplantation for adults with acute lymphoblastic leukemia:a report on behalf of Eurocord and the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation[J]. Bone Marrow Transplant, 2014, 49(7):887-894. doi: 10.1038/bmt.2014.72
    [5]
    Marks DI, Woo KA, Zhong X, et al. Unrelated umbilical cord blood transplant for adult acute lymphoblastic leukemia in first and second completeremission:a comparison with allografts from adult unrelated donors[J]. Haematologica, 2014, 99(2):322-328. doi: 10.3324/haematol.2013.094193
    [6]
    Ruqqeri A, Labopin M, Sanz G, et al. Comparison of outcomes after unrelated cord blood and unmanipulated haploidentical stem cell transplantationin adults with acute leukemia[J]. Leukemia, 2015, 29(9):1891-1900. doi: 10.1038/leu.2015.98
    [7]
    Robin M, Ruggeri A, Labopin M, et al. Comparison of unrelated cord blood and peripheral blood stem cell transplantation in adults with myelodysplastic syndrome after reduced-intensity conditioning regimen:a collaborative study from Eurocord (Cord Blood Committee of Cellular Therapy & Immunobiology Working Party of EBMT) and Chronic Malignancies Working Party[J]. Biol Blood Marrow Transplant, 2015, 21(3):489-495. doi: 10.1016/j.bbmt.2014.11.675
    [8]
    Sanz J, Boluda JC, Martin 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[J].Bone Marrow Transplant, 2012, 47(10):1287-1293. doi: 10.1038/bmt.2012.13
    [9]
    Scaradavou A, Brunstein CG, Eapen M, et al. Double unit grafts successfully extend the application of umbilical cord blood transplantation in adults with acute leukemia[J]. Blood, 2013, 121(5):752-758. doi: 10.1182/blood-2012-08-449108
    [10]
    Glucksberg H, Storb R, Fefer A, et al. Clinical manifestations of graft-versus-host disease in human recipients of marrow from HLA-matched sibling donors[J]. Transplantation, 1974, 18(4):295-304. doi: 10.1097/00007890-197410000-00001
    [11]
    Fernandes JF, Rocha V, Labopin M, et al. Transplantation in patients with SCID:mismatched related stem cells or unrelated cord blood?[J]. Blood, 2012, 119(12):2949-2955. doi: 10.1182/blood-2011-06-363572
    [12]
    Danby R, Rocha V. Improving engraftment and immune reconstitution in umbilical cord blood transplantation[J]. Front Immunol, 2014, 5:68. http://cn.bing.com/academic/profile?id=2112888327&encoded=0&v=paper_preview&mkt=zh-cn
    [13]
    Delaney C, Heimfeld S, Brashem-Stein C, et al. Notch-mediated expansion of human cord blood progenitor cells capable of rapid myeloid reconstitution[J]. Nat Med, 2010, 16(2):232-236. doi: 10.1038/nm.2080
    [14]
    de Lima M, McNiece I, Robinson SN, et al. Cord-blood engraftment with ex vivo mesenchymal-cell coculture[J]. N Engl J Med, 2012, 367(24):2305-2315. doi: 10.1056/NEJMoa1207285
    [15]
    Zheng C, Zhu X, Tang B, et al. Comparative analysis of unrelated cord blood transplantation and HLA-matched sibling hematopoietic stem cell transplantation in children with high-risk or advanced acute leukemia[J].Ann Hematol, 2015, 94(3):473-480. doi: 10.1007/s00277-014-2213-y
    [16]
    Eapen M, Rocha V, Sanz G, et al. Effect of graft source on unrelated donor haemopoietic stem-cell transplantation in adults with acute leukaemia:a retrospective analysis[J]. Lancet Oncol, 2010, 11(7):653-660. doi: 10.1016/S1470-2045(10)70127-3
    [17]
    Zheng C, Tang B, Tong J, et al. Unrelated cord blood transplantation for central nervous system relapse in high-risk childhood acute lymphoblastic leukemia[J]. Ann Hematol, 2013, 92(12):1665-1673. doi: 10.1007/s00277-013-1820-3
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (79) PDF downloads(5) Cited by()
    Proportional views
    Related

    WeChat Subscription Account

    Wechat Service Account

    Contact Us
    • Tel：020-38736410
    • Email: organtranspl@163.com
    • Address：The Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Road, Tianhe District, Guangzhou
    • Editorial Office of Organ Transplantation  粤ICP备2021030844号
    Links

    Supported by: Beijing Renhe Information Technology Co. Ltd    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return