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Human herpesvirus 6 reactivation before engraftment is strongly predictive of graft failure after double umbilical cord blood allogeneic stem cell transplantation in adults.
- Source :
-
Experimental Hematology . Nov2014, Vol. 42 Issue 11, p945-954. 10p. - Publication Year :
- 2014
-
Abstract
- Our main objective was to determine new factors associated with engraftment and single-unit predominance after double umbilical cord blood (UCB) allogeneic stem-cell transplantation. Engraftment occurred in 78% of cases in this retrospective study including 77 adult patients. Three-year overall survival, disease-free survival, relapse incidence, and nonrelapse mortality were 55 ± 6%, 44 ± 6%, 33 ± 5%, and 23 ± 4%, respectively. In multivariate analysis, Human herpesvirus 6 reactivation during aplasia (hazard ratio [HR] = 2.63; 95% confidence interval [CI]: 1.64–4.17; p < 0.001), younger recipient age (<53 years) (HR = 1.97; 95% CI: 1.16–3.35; p = 0.012), and lower human leukocyte antigen matching between the two units (3 of 6 or 4 of 6) (HR = 2.09; 95% confidence interval: 1.22–3.59; p = 0.013) were the three factors independently associated with graft failure. Also, factors independently predicting the losing UCB unit were younger age of the UCB unit (odds ratio [OR] = 1.01; 95% CI: 1–1.02; p = 0.035), lower CD34 + cell dose contained in the UCB unit (≤0.8 × 10 5 /kg) (OR = 2.55; 95% CI: 1.05–6.16; p = 0.04), and presence of an ABO incompatibility between the UCB unit and the recipient (OR = 2.53; 95% CI: 1.15–5.53; p = 0.02). Thus, Human herpesvirus 6 reactivation during aplasia, lower unit-unit human leukocyte antigen matching, and younger UCB unit age, as new unfavorable predictive factors, may represent new parameters to take into account after double UCB allogeneic stem-cell transplantation in adults. These results need to be confirmed prospectively, as they may influence unit selections and patient outcomes. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 0301472X
- Volume :
- 42
- Issue :
- 11
- Database :
- Academic Search Index
- Journal :
- Experimental Hematology
- Publication Type :
- Academic Journal
- Accession number :
- 99511195
- Full Text :
- https://doi.org/10.1016/j.exphem.2014.07.264