Faculty Collaboration Database

Double unit grafts successfully extend the application of umbilical cord blood transplantation in adults with acute leukemia. Blood 2013 Jan 31;121(5):752-8

Date

12/12/2012

Pubmed ID

23223509

Pubmed Central ID

PMC3563363

DOI

10.1182/blood-2012-08-449108

Scopus ID

2-s2.0-84873542634 (requires institutional sign-in at Scopus site)   152 Citations

Abstract

UNLABELLED: Cell dose is a major limitation for umbilical cord blood (UCB) transplantation because units containing a minimum of 2.5 x 10(7) total nucleated cells (TNC)/kilogram patient body weight are frequently not available. The transplantation of 2 partially HLA-matched UCB units has been adopted as a simple approach for increasing the TNC.We sought to determine whether the relative safety and efficacy of this approach was comparable with a single UCB transplantation. Included are adults with acute leukemia who received transplants with 1 (n =106) or 2 (n =303) UCB units. All UCB units for single UCB transplantations contained TNC ≥ 2.5 x 10(7)/kg. For double UCB transplantations, the total TNC for units 1 and 2 were > 2.5 x 10(7)/kg but in approximately half of these transplantations, 1 of the 2 units contained < 2.5 x 10(7) TNC/kg. Adjusting for factors associated with outcomes, risks of neutrophil recovery (odds ratio 0.83, P =.59), transplantation-related mortality (hazard ratio [HR] 0.91, P= .63), relapse (HR 0.90, P= .64), and overall mortality (HR 0.93, P= .62) was similar after double UCB and adequate dose single UCB transplantations. These data support double UCB unit transplantation for acute leukemia when an adequately dosed single UCB unit is not available thereby extending access to nearly all patients.

KEY POINTS: Efficacy of transplanting adequately dosed 1- or 2-cord blood units.

Author List

Scaradavou A, Brunstein CG, Eapen M, Le-Rademacher J, Barker JN, Chao N, Cutler C, Delaney C, Kan F, Isola L, Karanes C, Laughlin MJ, Wagner JE, Shpall EJ

Author

Mary Eapen MBBS, DCh, MRCPI, MS Professor in the Medicine department at Medical College of Wisconsin

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

Acute Disease
Adolescent
Adult
Aged
Cord Blood Stem Cell Transplantation
Disease-Free Survival
Female
Histocompatibility Testing
Humans
Leukemia
Male
Middle Aged
Survival Rate
Transplantation, Homologous