Long-Term Functional Outcomes following Hematopoietic Stem Cell Transplant for Early Infantile Krabbe Disease.

dc.contributor.author

Allewelt, Heather

dc.contributor.author

Taskindoust, Mahsa

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Troy, Jesse

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Page, Kristin

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Wood, Susan

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Parikh, Suhag

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Prasad, Vinod K

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Kurtzberg, Joanne

dc.date.accessioned

2018-07-03T12:59:46Z

dc.date.available

2018-07-03T12:59:46Z

dc.date.issued

2018-06-19

dc.date.updated

2018-07-03T12:59:45Z

dc.description.abstract

Allogeneic hematopoietic stem cell transplantation (HSCT) can retard the progression of early infantile Krabbe disease (EIKD). Superior outcomes are achieved if HSCT is performed prior to the onset of symptoms, however little information is available about the long-term outcomes in surviving patients. We now describe functional outcomes in pre-symptomatic infants who underwent HSCT for EIKD at ≤2 months of life. Records of the 19 patients who underwent HSCT for EIKD at ≤2 months of age from 1996-2010 were reviewed. Long-term functional outcomes were compared between those transplanted at <30 days and ≥30 days of life. Median age at transplant was 27 days (range 19-61). Median follow-up of the cohort was 12.6 years. Overall survival at 5 and 10 years post-transplant was 84.2% (95% CI:58.7-94.6%) and 78.6% (95% CI:52.5-91.4%), respectively. More favorable outcomes were seen in patients who underwent HSCT at <30 days of age, particularly in domains of mobility (p=0.01), communication (p=0.02), and feeding (p=0.008). Improved functional outcomes were observed when HSCT was performed in the first month of life, defining a critical period for intervention. These results support the implementation of newborn screening to enable rapid diagnosis and early treatment of infants with EIKD.

dc.identifier

S1083-8791(18)30334-3

dc.identifier.issn

1083-8791

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1523-6536

dc.identifier.uri

https://hdl.handle.net/10161/17210

dc.language

eng

dc.publisher

Elsevier BV

dc.relation.ispartof

Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation

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10.1016/j.bbmt.2018.06.020

dc.subject

Krabbe disease

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umbilical cord blood transplantation

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Long-Term Functional Outcomes following Hematopoietic Stem Cell Transplant for Early Infantile Krabbe Disease.

dc.type

Journal article

duke.contributor.orcid

Troy, Jesse|0000-0001-5410-8146

duke.contributor.orcid

Page, Kristin|0000-0001-9670-8828

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Parikh, Suhag|0000-0002-6066-9852

duke.contributor.orcid

Kurtzberg, Joanne|0000-0002-3370-0703

pubs.begin-page

S97

pubs.end-page

S97

pubs.organisational-group

School of Medicine

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Duke

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Duke Cancer Institute

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Institutes and Centers

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Pathology

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Clinical Science Departments

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Pediatrics, Blood and Marrow Transplantation

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Pediatrics

pubs.publication-status

Published

pubs.volume

63

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