Cord blood transplant in childhood ALL

被引:13
作者
Sawczyn, KK
Quinones, R
Malcolm, J
Foreman, N
Garrington, T
Gore, L
Gao, DX
Giller, R
机构
[1] Univ Colorado, Sch Med, Denver, CO 80202 USA
[2] Childrens Hosp, Denver, CO 80218 USA
关键词
acute lymphoblastic leukemia (ALL); cord blood; bone marrow transplant (BMT); transplantation;
D O I
10.1002/pbc.20414
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background. Optimal therapy for high risk and relapsed acute lymphoblastic leukemia (ALL) remains uncertain. Wider availability of cord blood from related and unrelated donors has prompted studies of its use for hematopoeitic stem cell transplant (HSCT). Procedure. We evaluated 26 consecutive cord blood transplants (CBT) for ALL performed at our center from 1996 to 2002 on studies using consistent conditioning therapy and graft-versus-host disease (GVHD) prophylaxis. Median patient age was 8.5 years (range, 0.5-24 year). Cord blood (CB) was from unrelated donors in 25/26 cases. Median CB nucleated cell dose was 3.26e7/kg (range, 0.8 - 12.9). Results. With median follow-up of 548 days, 16/26 patients (62%) are event-free survivors. Acute GVHD developed in 14/24 evaluable patients, reaching grade III-IV in 7 patients. Chronic GVHD occurred in 10/22 evaluable patients. Multivariate analysis showed higher total nucleated cell dose per kilogram to be the strongest predictor of event-free survival. Conclusions. We conclude that CBT can effectively treat ALL in children with high risk features and following relapse.
引用
收藏
页码:964 / 970
页数:7
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