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Factors affecting mortality following myeloablative cord blood transplantation in adults: a pooled analysis of three international registries. Bone Marrow Transplant 2011 Jan;46(1):70-6 PMID: 20436518 PMCID: PMC3366187

Pubmed ID

20436518

Abstract

A retrospective analysis was conducted to examine factors affecting early mortality after myeloablative, single-unit cord blood transplantation (CBT) for hematological malignancies in adolescents and adults. Data were collected from the three main CBT registries pooling 514 records of unrelated, single, unmanipulated, first myeloablative allogeneic CBTs conducted in North America or Europe from 1995 to 2005, with an HLA match ≥ 4/6 loci, in patients aged 12-55. Overall 100-day, 180-day and 1-year survival (Kaplan-Meier method) were 56, 46 and 37%, respectively, with no significant heterogeneity across registries. Multivariate analysis showed cell dose < 2.5 × 10⁷/kg (odds ratio (OR) 2.76, P < 0.0001), older age (P = 0.002), advanced disease (P = 0.02), positive CMV sero-status (OR 1.37 P = 0.11), female gender (OR 1.43, P = 0.07) and limited CBT center experience (< 10 records contributed, OR 2.08, P = 0.0003) to be associated with higher 100-day mortality. A multivariate model predictive of 1-year mortality included similar prognostic factors except female gender. Transplant year did not appear as a significant independent predictor. This is the first analysis to pool records from three major CBT registries in the United States and Europe. In spite of some differences in practice patterns, survival was remarkably homogeneous. The resulting model may contribute to better understanding factors affecting CBT outcomes.

Author List

Cohen YC, Scaradavou A, Stevens CE, Rubinstein P, Gluckman E, Rocha V, Horowitz MM, Eapen M, Nagler A, Shpall EJ, Laughlin MJ, Daniely Y, Pacheco D, Barishev R, Olmer L, Freedman LS

Authors

Mary Eapen MBBS, DCh, MRCPI, MS Professor in the Medicine department at Medical College of Wisconsin
Mary M. Horowitz MD, MS Center Director, Professor in the Medicine department at Medical College of Wisconsin




Scopus

2-s2.0-78651378621   49 Citations

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aging
Child
Cord Blood Stem Cell Transplantation
Cytomegalovirus Infections
Europe
Female
Hematologic Neoplasms
Humans
Male
Middle Aged
Myeloablative Agonists
Neoplasm Staging
North America
Prognosis
Registries
Reproducibility of Results
Retrospective Studies
Survival Analysis
Transplantation Conditioning
Young Adult
jenkins-FCD Prod-300 626508253d14e4184314fb9f66322a03a5906796