Faculty Collaboration Database

Analysis of risk factors influencing outcome in children with myelodysplastic syndrome after unrelated cord blood transplantation. Leukemia 2011 Mar;25(3):449-54

Date

12/08/2010

Pubmed ID

21135856

Pubmed Central ID

PMC3365546

DOI

10.1038/leu.2010.285

Scopus ID

2-s2.0-79952445223 (requires institutional sign-in at Scopus site)   34 Citations

Abstract

We describe 70 children with myelodysplastic syndrome (MDS) (refractory cytopenia (n=31) and refractory anemia with excess blasts (n=30) or blasts in transformation (n=9)) who received umbilical cord blood (UCB) transplantation with a single UCB unit and a myeloablative conditioning regimen. Approximately 20% of children had secondary MDS. Median age at transplantation was 7 years and the median follow-up was 3 years. The day-60 probability of neutrophil recovery was 76%; recovery was faster after transplantation of matched or 1-locus mismatched UCB, irradiation-containing conditioning regimen, cell dose >6 × 10(7)/kg and monosomy 7. Risks of treatment failure (recurrent disease or death) were lower in patients with monosomy 7 and transplantations after 2001. The 3-year disease-free survival (DFS) was 50% for transplantations after 2001 compared with 27% for the earlier period (P=0.018). Transplantations after 2001 occurred within 6 months after diagnosis and used UCB units with higher cell dose. DFS was highest in patients with monosomy 7 (61%) compared with other karyotypes (30%), P=0.017. These data suggest that transplantation of mismatched UCB graft is an acceptable alternative for children without a matched sibling or suitably matched unrelated adult donor.

Author List

Madureira AB, Eapen M, Locatelli F, Teira P, Zhang MJ, Davies SM, Picardi A, Woolfrey A, Chan KW, Socié G, Vora A, Bertrand Y, Sales-Bonfim CM, Gluckman E, Niemeyer C, Rocha V, Eurocord-European Blood and Marrow Transplant Group, Center of International Blood and Marrow Transplant Registry, European Working Group on childhood MDS

Authors

Mary Eapen MBBS, DCh, MRCPI, MS Professor in the Medicine department at Medical College of Wisconsin
Mei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin

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

Adolescent
Child
Child, Preschool
Cord Blood Stem Cell Transplantation
Disease-Free Survival
Graft vs Host Disease
Humans
Infant
Infant, Newborn
Myelodysplastic Syndromes
Recurrence
Risk Factors
Treatment Outcome