Cord Blood Transplantation from Unrelated Donors in Adults with High-Risk Acute Myeloid Leukemia

Jaime Sanz, Miguel A. Sanz, Silvana Saavedra, Ignacio Lorenzo, Pau Montesinos, Leonor Senent, Dolores Planelles, Luis Larrea, Guillermo Martín, Javier Palau, Isidro Jarque, Jesús Martínez (+7 others)
2010 Biology of Blood and Marrow Transplantation  
Clinical studies focused on disease-specific outcomes of cord blood transplant (CBT) from unrelated donors are limited. We analyzed the outcome and prognostic factors of 49 adults with high-risk acute myelogenous leukemia (AML) receiving single-unit CBT from unrelated donors after myeloablative (MA) conditioning at a single institution. Conditioning regimens were based on the combination of thiotepa, busulfan (Bu), cyclophospamide (Cy), or fludarabine (Flu), and antithymocyte globulin (ATG).
more » ... ulative incidence of myeloid and platelet engraftment was 96% and 73% at a median time of 20 and 62 days, respectively. Engraftment was significantly faster for patients receiving higher doses of CD34 1 cells. Confidence Interval of graft-versushost disease (GVHD), acute GVHD (aGVHD) grade II-IV, III-IV, and extensive chronic GVHD (cGVHD) were 26%, 15%, and 30%, respectively. Leukemia-free survival (LFS), nonrelapse mortality (NRM), and relapse at 2 years were 42%, 39%, and 19%, respectively. Low number of total nucleated cells (TNC) had a negative impact on NRM and LFS. Patients transplanted in first complete remission (CR1) receiving TNC above 2 Â 10 7 /kg had a 4-year LFS of 75%. These results show that CBT from unrelated donors is a curative treatment for a substantial number of patients with high-risk AML, particularly if transplant is performed with highly cellular units in patients in first CR. Biol Blood Marrow Transplant 16: 86-94 (
doi:10.1016/j.bbmt.2009.09.001 pmid:19744570 fatcat:dt5zu4oudvcjdof2vthnbkkmz4