Umbilical cord blood versus unrelated donor transplantation in adults with primary refractory or relapsed acute myeloid leukemia: a report from Eurocord, the Acute Leukemia Working Party and the Cord Blood Committee of the Cellular Therapy and Immunobiology Working Party of the EBMT.,Blood Cancer Journal

当前位置： X-MOL 学术 › Blood Cancer J. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Umbilical cord blood versus unrelated donor transplantation in adults with primary refractory or relapsed acute myeloid leukemia: a report from Eurocord, the Acute Leukemia Working Party and the Cord Blood Committee of the Cellular Therapy and Immunobiology Working Party of the EBMT.
Blood Cancer Journal ( IF 12.9 ) Pub Date : 2019-04-12 , DOI: 10.1038/s41408-019-0204-x
Frédéric Baron ₁ , Myriam Labopin _{2,

3,

4,

5} , Annalisa Ruggeri _{2,

6,

7} , Gerhard Ehninger ₈ , Fransesca Bonifazi ₉ , Matthias Stelljes ₁₀ , Jaime Sanz ₁₁ , Gernot Stuhler ₁₂ , Alberto Bosi ₁₃ , Nicolaus Kröger ₁₄ , Maria Teresa Van Lint ₁₅ , Arnold Ganser ₁₆ , Edouard Forcade ₁₇ , Mohamad Mohty _{2,

3,

4,

5} , Eliane Gluckman ₆ , Arnon Nagler _{3,

18}

Affiliation

GIGA and CHU of Liege, University of Liege, Liege, Belgium.
Department of Haematology, Saint Antoine Hospital, Paris, France.
EBMT Paris Study Office/CEREST-TC, Paris, France.
INSERM UMR 938, Paris, France.
Sorbonne University, Paris, France.
Eurocord, Saint Louis Hospital, Paris, France.
Dipartimento di Oncoematologia e terapie cellulari, Ospedale Pediatrico Bambino Gesù, Roma, Italy.
Universitaetsklinikum Dresden, Medizinische Klinik und Poliklinik I, Dresden, Germany.
S.Orsola-Malpighi Hospital, Institute of Hematology and Medical Oncology, Bologna University, Bologna, Italy.
Department of Hematology/Oncology, University of Münster, Münster, Germany.
Hematology Department, University Hospital La Fe, Valencia, Spain.
Deutsche Klinik für Diagnostik, KMT Zentrum, Wiesbaden, Germany.
Department of Hematology, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy.
Bone Marrow Transplantation Centre, University Hospital Eppendorf, Hamburg, Germany.
Department of Haematology II, Ospedale San Martino, Genova, Italy.
Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.
CHU Bordeaux, Service d'hematologie et therapie cellulaire, F-33000, Bordeaux, France.
Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.

The role of umbilical cord blood transplantation (CBT) in acute myeloid leukemia (AML) patients with active disease at allogeneic hematopoietic cell transplantation (allo-HCT) remains poorly investigated. In this study, we compared transplantation outcomes of 2963 patients with primary refractory or relapsed AML given CBT, 10/10 HLA-matched UD, or 9/10 HLA-matched UD allo-HCT from 2004 to 2015 at EBMT-affiliated centers. Neutrophil engraftment and complete remission rates in CBT, UD 10/10, and UD 9/10 recipients were 75 and 48%, 93 and 69%, and 93 and 70%, respectively. In multivariate Cox analyses, in comparison with CBT (n = 285), UD 10/10 recipients (n = 2001) had a lower incidence of relapse (HR = 0.7, P = 0.001), a lower incidence of non relapse mortality (HR = 0.6, P < 0.001), better GVHD-free and leukemia-free survival (GRFS, HR = 0.8, P < 0.001) and better survival (HR = 0.6, P < 0.001). Further, in comparison with CBT, 9/10 UD recipients (n = 677) also had a lower incidence of relapse (HR = 0.8, P = 0.02), a lower incidence of nonrelapse mortality (HR = 0.7, P = 0.008), better GRFS (HR = 0.8, P = 0.01) and better survival (HR = 0.7, P < 0.001). In summary, these data suggest that in AML patients with active disease at transplantation, allo-HCT with UD results in better transplantation outcomes than CBT.

中文翻译：

成人原发性难治性或复发性急性髓性白血病的脐带血与无关的供体移植：Eurocord，急性白血病工作组和EBMT细胞治疗和免疫生物学工作组的脐带血委员会的报告。

在同种异体造血细胞移植（allo-HCT）中患有活动性疾病的急性髓性白血病（AML）患者中，脐带血移植（CBT）的作用仍然缺乏研究。在这项研究中，我们比较了2004年至2015年在EBMT附属中心接受CBT，10/10 HLA匹配UD或9/10 HLA匹配UD allo-HCT的2963例原发性难治或复发性AML患者的移植结局。CBT，UD 10/10和UD 9/10接受者中性粒细胞的植入率和完全缓解率分别为75％和48％，93％和69％，以及93％和70％。在多变量Cox分析中，与CBT（n = 285）相比，UD 10/10接受者（n = 2001）的复发率较低（HR = 0.7，P = 0.001），非复发死亡率（HR）较低= 0.6，P <0.001），更好的无GVHD和无白血病生存率（GRFS，HR = 0.8，P <0.001）和更好的生存率（HR = 0.6，P <0.001）。此外，与CBT相比，9/10名UD接受者（n = 677）的复发率也较低（HR = 0.8，P = 0.02），非复发性死亡率也较低（HR = 0.7，P = 0.008），更好的GRFS（HR = 0.8，P = 0.01）和更好的生存率（HR = 0.7，P <0.001）。总之，这些数据表明，在移植时患有活动性疾病的AML患者中，同种异体HCT与UD相比，移植效果要好于CBT。

更新日期：2019-11-18

点击分享查看原文

点击收藏

公开下载

阅读更多本刊最新论文