PMID- 21933579
OWN - NLM
STAT- MEDLINE
DCOM- 20120427
LR  - 20110921
IS  - 2542-5641 (Electronic)
IS  - 0366-6999 (Linking)
VI  - 124
IP  - 16
DP  - 2011 Aug
TI  - Long-term outcomes in adults with leukemia treated with transplantation of two 
      unrelated umbilical cord blood units.
PG  - 2411-6
AB  - BACKGROUND: Wide application of umbilical cord blood transplantation (UCBT) in 
      adult patients is limited by low cell-dose available in one umbilical cord blood 
      (UCB) unit. The aim of this study was to investigate the safety and long-term 
      outcomes of UCBT from unrelated donors in adult and adolescent patients with 
      leukemia. METHODS: Thirteen patients with leukemia received double-unit UCBT with 
      human leukocyte antigen (HLA) mismatched at 0 - 2 loci. We analyzed the 
      engraftment, graft-versus-host disease (GVHD) and survival. RESULTS: Twelve 
      evaluable patients (92.3%) had neutrophil and platelet engraftment at a median of 
      21 days (range, 16-38 days) and 34 days (range, 25 - 51 days), respectively. At 
      day 30, engraftment was derived from one donor in 8 patients (66.7%, 95%CI 40.0% 
      - 93.4%), and from both donors in 4 patients (33.3%, 95%CI 6.7% - 60.0%) with 1 
      unit predominated. Unit with larger nucleated cell (NC) dose would predominate in 
      engraftment (P = 0.039), whereas CD34(+) cell dose or HLA-match failed to 
      demonstrate any relationship with unit predominance. Only one patient developed 
      grade II acute graft-versus-host disease (aGVHD). Chronic GVHD (cGVHD) was 
      observed in 2 of 11 patients who survived more than 100 days, and both were 
      limited. The median follow-up after transplantation for the 13 patients was 45 
      months (range 1.5 - 121.0 months) and 72 months (range 41.0 - 121.0 months) for 
      the 8 alive and with full donor chimerism. The 5-year cumulative disease free 
      survival (DFS) was (61.5 +/- 13.5)%. Of the 13 patients, 5 patients died in 1 year 
      and 1-year transplantation related mortality (TRM) was 23.1% (95%CI 0.2% - 
      46.0%). CONCLUSION: Double-unit UCBT from unrelated donors with HLA-mismatched at 
      0-2 loci may overcome the cell-dose barrier and be feasible for adults and 
      adolescents with leukemia.
FAU - Yin, Yue
AU  - Yin Y
AD  - Department of Hematology, Peking University First Hospital, Beijing 100034, 
      China.
FAU - Ren, Han-Yun
AU  - Ren HY
FAU - Cen, Xin-An
AU  - Cen XA
FAU - Qiu, Zhi-Xiang
AU  - Qiu ZX
FAU - Ou, Jin-Ping
AU  - Ou JP
FAU - Wang, Wen-Sheng
AU  - Wang WS
FAU - Wang, Mang-Ju
AU  - Wang MJ
FAU - Xu, Wei-Lin
AU  - Xu WL
FAU - Wang, Li-Hong
AU  - Wang LH
FAU - Li, Yuan
AU  - Li Y
FAU - Dong, Yu-Jun
AU  - Dong YJ
LA  - eng
PT  - Journal Article
PL  - China
TA  - Chin Med J (Engl)
JT  - Chinese medical journal
JID - 7513795
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Cord Blood Stem Cell Transplantation/adverse effects/*methods
MH  - Disease-Free Survival
MH  - Female
MH  - Graft vs Host Disease/etiology
MH  - Humans
MH  - Leukemia/immunology/mortality/*therapy
MH  - Male
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2011/09/22 06:00
MHDA- 2012/04/28 06:00
CRDT- 2011/09/22 06:00
PHST- 2011/09/22 06:00 [entrez]
PHST- 2011/09/22 06:00 [pubmed]
PHST- 2012/04/28 06:00 [medline]
PST - ppublish
SO  - Chin Med J (Engl). 2011 Aug;124(16):2411-6.