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Umbilical cord blood transplantation in adults with advanced hodgkin's disease: high incidence of post-transplant lymphoproliferative disease.
- Source :
-
European journal of haematology [Eur J Haematol] 2016 Feb; Vol. 96 (2), pp. 128-35. Date of Electronic Publication: 2015 Apr 18. - Publication Year :
- 2016
-
Abstract
- We report the outcome of 30 consecutive patients with Hodgkin disease (HD) who underwent single-unit UCBT. Most (90%) patients had failed previous autologous hematopoietic stem cell transplantation. The conditioning regimens were based on combinations of thiotepa, busulfan, cyclophosphamide or fludarabine, and antithymocyte globulin. The cumulative incidence (CI) of myeloid engraftment was 90% [95% confidence interval (C.I.), 74-98%] with a median of 18 d (range, 10-48). CI of acute graft-versus-host disease (GvHD) grades II-IV was 30% (95% C.I., 17-44%), while the incidence of chronic GVHD was 42% (95% C.I., 23-77%). The non-relapse mortality (NRM) at 100 d and 4 yr was 30% (95% C.I., 13-46%) and 47% (95% C.I., 29-65%), respectively. EBV-related post-transplant lymphoproliferative disease (EBV-PTLD) accounted for more than one-third of transplant-related death, with an estimate incidence of 26% (95% C.I., 9-44). The incidence of relapse at 4 yr was 25% (95% C.I., 9-42%). Four-year event-free survival (EFS) and overall survival (OS) were 28% and 30%, respectively. Despite a high NRM and an unexpected high incidence of EBV-PTLD, UCBT in heavily pretreated HD patients is an option for patients lacking a suitable adult donor, provided the disease is not in refractory relapse.<br /> (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Subjects :
- Acute Disease
Adult
Antilymphocyte Serum therapeutic use
Busulfan therapeutic use
Chronic Disease
Cyclophosphamide therapeutic use
Female
Graft Survival
Graft vs Host Disease immunology
Graft vs Host Disease mortality
Graft vs Host Disease pathology
Graft vs Host Disease prevention & control
Herpesvirus 4, Human pathogenicity
Hodgkin Disease immunology
Hodgkin Disease mortality
Hodgkin Disease pathology
Humans
Infectious Mononucleosis immunology
Infectious Mononucleosis mortality
Infectious Mononucleosis pathology
Male
Middle Aged
Recurrence
Survival Analysis
Thiotepa therapeutic use
Vidarabine analogs & derivatives
Vidarabine therapeutic use
Cord Blood Stem Cell Transplantation adverse effects
Hodgkin Disease therapy
Infectious Mononucleosis etiology
Myeloablative Agonists therapeutic use
Transplantation Conditioning
Subjects
Details
- Language :
- English
- ISSN :
- 1600-0609
- Volume :
- 96
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- European journal of haematology
- Publication Type :
- Academic Journal
- Accession number :
- 25845981
- Full Text :
- https://doi.org/10.1111/ejh.12557