PMID- 19706886
OWN - NLM
STAT- MEDLINE
DCOM- 20091203
LR  - 20211020
IS  - 1528-0020 (Electronic)
IS  - 0006-4971 (Print)
IS  - 0006-4971 (Linking)
VI  - 114
IP  - 19
DP  - 2009 Nov 5
TI  - Relapse risk after umbilical cord blood transplantation: enhanced 
      graft-versus-leukemia effect in recipients of 2 units.
PG  - 4293-9
LID - 10.1182/blood-2009-05-220525 [doi]
AB  - Umbilical cord blood (UCB) transplantation is potentially curative for acute 
      leukemia. This analysis was performed to identify risk factors associated with 
      leukemia relapse following myeloablative UCB transplantation. Acute leukemia 
      patients (n = 177; 88 with acute lymphoblastic leukemia and 89 with acute myeloid 
      leukemia) were treated at a single center. Patients received a UCB graft composed 
      of either 1 (47%) or 2 (53%) partially human leukocyte antigen (HLA)-matched 
      unit(s). Conditioning was with cyclophosphamide and total body irradiation with 
      or without fludarabine. The incidence of relapse was 26% (95% confidence interval 
      [CI], 19%-33%). In multivariate analysis, relapse was higher in advanced disease 
      patients (> or = third complete remission [CR3]; relative risk [RR], 3.6; P < 
      .01), with a trend toward less relapse in recipients of 2 UCB units (RR = 0.6; P 
      = .07). However, relapse was lower for CR1-2 patients who received 2 UCB units 
      (RR 0.5; P < .03). Leukemia-free survival was 40% (95% CI, 30%-51%) and 51% (95% 
      CI, 41%-62%) for single- and double-unit recipients, respectively (P = .35). 
      Although it is known that transplantation in CR1 and CR2 is associated with less 
      relapse risk, this analysis reveals an enhanced graft-versus-leukemia effect in 
      acute leukemia patients after transplantation with 2 partially HLA-matched UCB 
      units. This trial was registered at http://clinicaltrials.gov as NCT00309842.
FAU - Verneris, Michael R
AU  - Verneris MR
AD  - Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN 
      55455, USA. verneris@umn.edu
FAU - Brunstein, Claudio G
AU  - Brunstein CG
FAU - Barker, Juliet
AU  - Barker J
FAU - MacMillan, Margaret L
AU  - MacMillan ML
FAU - DeFor, Todd
AU  - DeFor T
FAU - McKenna, David H
AU  - McKenna DH
FAU - Burke, Michael J
AU  - Burke MJ
FAU - Blazar, Bruce R
AU  - Blazar BR
FAU - Miller, Jeffrey S
AU  - Miller JS
FAU - McGlave, Philip B
AU  - McGlave PB
FAU - Weisdorf, Daniel J
AU  - Weisdorf DJ
FAU - Wagner, John E
AU  - Wagner JE
LA  - eng
SI  - ClinicalTrials.gov/NCT00309842
GR  - P01 CA065493/CA/NCI NIH HHS/United States
GR  - P01-CA65493/CA/NCI NIH HHS/United States
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20090825
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
SB  - IM
CIN - Blood. 2009 Nov 5;114(19):3980-1. PMID: 19892726
MH  - Adolescent
MH  - Adult
MH  - Child
MH  - Child, Preschool
MH  - Cord Blood Stem Cell Transplantation/adverse effects/*methods
MH  - Disease-Free Survival
MH  - Female
MH  - Graft vs Host Disease/etiology
MH  - Graft vs Leukemia Effect/*immunology
MH  - Histocompatibility Testing
MH  - Humans
MH  - Infant
MH  - Leukemia, Myeloid, Acute/immunology/therapy
MH  - Male
MH  - Middle Aged
MH  - Precursor Cell Lymphoblastic Leukemia-Lymphoma/immunology/therapy
MH  - Recurrence
MH  - Risk Factors
MH  - Survival Analysis
MH  - Young Adult
PMC - PMC2774557
EDAT- 2009/08/27 09:00
MHDA- 2009/12/16 06:00
PMCR- 2010/11/05
CRDT- 2009/08/27 09:00
PHST- 2009/08/27 09:00 [entrez]
PHST- 2009/08/27 09:00 [pubmed]
PHST- 2009/12/16 06:00 [medline]
PHST- 2010/11/05 00:00 [pmc-release]
AID - S0006-4971(20)38995-3 [pii]
AID - 2009/220525 [pii]
AID - 10.1182/blood-2009-05-220525 [doi]
PST - ppublish
SO  - Blood. 2009 Nov 5;114(19):4293-9. doi: 10.1182/blood-2009-05-220525. Epub 2009 
      Aug 25.