Influence of nucleated cell dose on overall survival of unrelated cord blood transplantation for patients with severe acquired aplastic anemia: a study by eurocord and the aplastic anemia working party of the European group for blood and marrow transplantation.

Abstract

Information is scarce on outcomes after unrelated cord blood transplantation (UCBT) for patients with severe aplastic anemia (SAA). We retrospectively analyzed 71 patients (median age, 13 years; 28 adults) with SAA (9 with paroxysmal nocturnal hemoglobinuria [PNH]) who received a single-unit (n = 57; 79%) or double-unit UCBT (n = 14; 19%) in 32 centers between 1996 and 2009. A reduced-intensity conditioning regimen was provided in 68% of the patients. The cumulative incidence (CI) of neutrophil recovery was 51% ± 6% at day 60, with significantly better engraftment seen in recipients of higher prefreezing total nucleated cell (TNC) dose (>3.9 10(7)/kg; hazard ratio [HR], 1.5; P = .05). The CI of platelet engraftment at day 180 posttransplantation was 37% ± 7%, that of grade II-IV acute GVHD was 20% ± 5%, and that of chronic GVHD at 3 years was 18% ± 5%. At a median follow-up of 35 months (range, 3-83 months), the estimated probability of 3-year overall survival (OS) was 38% ± 6%. Significantly improved OS was seen in recipients of >3.9 10(7) TNCs/kg prefreezing (45%, compared with 18% for recipients of ≤ 3.9 10(7) TNC/kg; HR, 0.4; P = .007). These results highlight the fundamental role of cell dose for both engraftment and OS in patients with SAA undergoing UCBT.

Type

Journal article

Department

Description

Provenance

Subjects

Humans, Anemia, Aplastic, Graft vs Host Disease, Platelet Count, Cord Blood Stem Cell Transplantation, Cell Count, Survival Rate, Retrospective Studies, Graft Survival, Adolescent, Young Adult

Citation

Published Version (Please cite this version)

10.1016/j.bbmt.2010.06.011

Publication Info

Peffault de Latour, Regis, Duncan Purtill, Annalisa Ruggeri, Guillermo Sanz, Gerard Michel, Virginie Gandemer, Sebastien Maury, Joanne Kurtzberg, et al. (2011). Influence of nucleated cell dose on overall survival of unrelated cord blood transplantation for patients with severe acquired aplastic anemia: a study by eurocord and the aplastic anemia working party of the European group for blood and marrow transplantation. Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 17(1). pp. 78–85. 10.1016/j.bbmt.2010.06.011 Retrieved from https://hdl.handle.net/10161/24638.

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