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Unrelated cord blood transplantation in adult and pediatric acute lymphoblastic leukemia: effect of minimal residual disease on relapse and survival. Biol Blood Marrow Transplant 2012 Jun;18(6):963-8

Date

03/21/2012

Pubmed ID

22430088

Pubmed Central ID

PMC3631589

DOI

10.1016/j.bbmt.2012.02.012

Scopus ID

2-s2.0-84860796306   26 Citations

Abstract

Data on pretransplantation minimal residual disease (MRD) and outcomes of umbilical cord blood transplantation (UCBT) are limited. Out of the 143 patients with acute lymphoblastic leukemia (ALL) who underwent UCBT at the University of Minnesota between 2004 and 2010, we evaluated 86 patients with available MRD assessment data by 4- and 8-color flow cytometry analysis immediately before transplantation. Ten patients (11.6%) were MRD-positive, and 76 were MRD-negative (88.4%). Most of the patients (82%) received myeloablative conditioning. GVHD prophylaxis consisted of cyclosporine and mycophenolate mofetil. In multivariate analysis, age, disease status (complete remission [CR] 1 versus CR2/CR3), disease group (precursor B cell ALL versus Philadelphia chromosome-positive ALL versus T cell ALL), and time to transplantation had no impact on relapse. Patients with MRD before UCBT had a greater incidence of relapse at 2 years (relapse rate, 30%; 95% confidence interval [CI], 4%-56%) and lower 3-year disease-free survival (30%; 95% CI, 7%-58%) compared with those without MRD (relapse rate, 16%; 95% CI, 8%-25%; P = .05; disease-free survival, 55%; 95% CI, 43%-66%; P = .02). Our data suggest that in patients with ALL, achieving an MRD-negative state before UCBT improves outcomes.

Author List

Bachanova V, Burke MJ, Yohe S, Cao Q, Sandhu K, Singleton TP, Brunstein CG, Wagner JE, Verneris MR, Weisdorf DJ

Author

Michael James Burke MD Professor in the Pediatrics department at Medical College of Wisconsin




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

Adolescent
Adult
Age Factors
Antineoplastic Agents
Child
Child, Preschool
Cord Blood Stem Cell Transplantation
Cyclosporine
Disease-Free Survival
Female
Fetal Blood
Graft vs Host Disease
Humans
Infant
Male
Middle Aged
Mycophenolic Acid
Neoplasm, Residual
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Secondary Prevention
Transplantation Conditioning
Transplantation, Homologous
Treatment Outcome
Unrelated Donors
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a