scholarly journals Similar survival, but better quality of life after myeloablative transplantation using unrelated cord blood vs matched sibling donors in adults with hematologic malignancies

2014 ◽  
Vol 49 (8) ◽  
pp. 1063-1069 ◽  
Author(s):  
H-l Liu ◽  
Z-m Sun ◽  
L-q Geng ◽  
X-b Wang ◽  
K-y Ding ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cord Blood ◽  
Hematologic Malignancies ◽  
Matched Sibling ◽  
Similar Survival ◽  
Unrelated Cord Blood

Similar Survival, but Better Quality of Life After Myeloablative Transplantation Using Unrelated Cord Blood Versus Identical Sibling Hematopoietic Cells in Adults with Hematologic Malignancies: A Single Institute Analysis.

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3134-3134
Author(s):  
Huilan Liu ◽  
Liangquan Geng ◽  
Xingbing Wang ◽  
Kaiyang Ding ◽  
Juan Tong ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cord Blood ◽  
Cumulative Incidence ◽  
Research Funding ◽  
Chronic Gvhd ◽  
Hematologic Malignancies ◽  
Hematopoietic Stem ◽  
Similar Survival ◽  
Unrelated Cord Blood

Abstract Abstract 3134 HLA-identical sibling allogeneic hematopoietic stem cell transplantation (HSCT) is the best therapeutic option for high-risk hematological disease, but it is limited by lack of availability of a suitable donor for most candidate patients. At our institution our center, unrelated cord blood transplantation (UCBT) was used as the first alternative option for patients who lack an HLA-matched related donor in the last decade. We retrospectively analyzed the clinical outcomes of UCBT versus HLA-identical sibling HSCT for adult patients with hematologic malignancies. Between April 2000 and May 2012, 194 consecutive adult patients with malignant hematological diseases received UCBT (77 patients; median age 21y, r 14–46; male 49) and related bone marrow transplantation (BMT) and/or peripheral blood stem cells transplantation (PBSCT) (117 patients; median age 30y, r 14–53; male 75). Diagnoses in two groups (UCBT/Sibling) included de novo AML (n = 23/32), ALL (n = 30/26), CML (n = 17/47), MDS/AML (n = 3/8), mixed phenotype acute leukemia (MPAL) (n = 3/1), NHL (n = 1/2), and MM (n = 0/1)). Overall rates of high-risk patients were 84.4% for UCBT recipients and 50.4% for BMT/PBSCT recipients(P<0.05). 11.6 percent of UCB grafts and 100% sibling grafts were HLA-identical (antigen level for HLA-A and B, allelic for DRB1, respectively). All patients received myeloablative conditioning regimens and CsA plus mycophenolate mofetil as GVHD prophylaxis. The median number of nucleated cells and CD34+ cells infused were 0.36 (r 0.19–0.69)×108 and 0.21(r 0.06–0.52)×106 per kilogram of the recipient's body weight for UCBT recipients, and 5.68 (r 2.02–12)×108 and 3.63(r 0.67∼14.99)×106 per kilogram for BMT/PBSCT recipients (P=0.000). The primary engraftment rate was 96.1% (UCBT) and 100% (BMT/PBSCT). The median time to 0.5×109/L ANC was 19 days (r 12–35) and 12 days(r 10–18)(P = 0.000) and the median time to 20×109/L platelets was 36 days(r 14–90)and 15 days(r 11–17)(P = 0.001); hematopoietic recovery was significantly delayed after UCBT. The cumulative incidence of total acute GVHD (47.3% vs.22.2%, P = 0.001), early transplantation-related mortality (TRM) before day +100 (13.0% vs.3.4%, P<0.05), and infection (58.4%vs. 12.0%, P<0.05) was higher in UCBT recipients. Median follow-up was 42.2 months (range, 4.5–123.2 months) for BMT/PBSCT recipients and 22.2 months (range, 3.0–110.2 months) for UCBT recipients. There was no significant difference in cumulative incidence of grades ?to ? acute GVHD (9.4% vs. 5.0% P = 0.247), relapse rate (14.3% vs. 14.5%, P=0.962), and 3 year over survival (OS) (59.6% vs. 64.1%, P=0.123). But the cumulative incidence of chronic GVHD (18.8% vs. 44.1%) and extensive chronic GVHD (0% vs. 18%) was lower in UCBT recipients (P<0.05). The estimated 9-M CI of discontinuing immunosuppressive therapy (IST) while alive was 80%, and long-term survivors of UCBT had better quality of life. Our data shows similar survival, but better quality of life after myeloablative transplantation using UCB versus identical sibling hematopoietic cells in adults with hematologic malignancies. HLA-mismatched cord blood should be considered an acceptable source of hematopoietic stem-cell grafts for adults in the absence of an HLA-matched adult donor. Disclosures: Sun: Anhui Provincial “115” Industrial Innovation Program (2009): Research Funding; the Fund of the Key Medical Project of Anhui Provincial Healthy Department (2010A005): Research Funding; Key Scientific and Technological Project of Anhui province “Twelfth Five-Year Plan” (11010402164): Research Funding.

Successful allogeneic engraftment of mismatched unrelated cord blood following a nonmyeloablative preparative regimen

Blood ◽  
2001 ◽  
Vol 98 (12) ◽  
pp. 3486-3488 ◽  
Author(s):  
David A. Rizzieri ◽  
Gwynn D. Long ◽  
James J. Vredenburgh ◽  
Christina Gasparetto ◽  
Ashley Morris ◽  
...  
Keyword(s):  
Cord Blood ◽  
Allogeneic Transplantation ◽  
Hematologic Malignancies ◽  
Unrelated Donor ◽  
Preparative Regimen ◽  
Unrelated Donors ◽  
Alternative Donor ◽  
Matched Sibling ◽  
Cord Blood Cells ◽  
Unrelated Cord Blood

Abstract Reduction in the toxicity of allogeneic transplantation with nonmyeloablative induction regimens has expanded the scope of practice to older and more debilitated patients. However, the limited availability of matched sibling donors requires that alternative donor sources be investigated. Reported here are 2 cases of patients with advanced hematologic malignancies without matched siblings, partially matched family members, or matched unrelated donors who successfully underwent nonmyeloablative conditioning therapy followed by infusion of partially matched, unrelated-donor cord blood cells. The patients are in remission and remain 100% donor as assessed by short tandem repeat analysis of the marrow 6 and 12 months following transplantation.

scholarly journals Correction to: An Evaluation of Adjuvant Psychological Therapy (APT) Effectiveness on the Quality of Life of Patients with Hematologic Malignancies

2018 ◽  
Vol 38 (6) ◽  
pp. 1736-1736
Author(s):  
Masoome Barani ◽  
Maryam Bakhtiari ◽  
Vahid Sadeghi Firoozabadi ◽  
Mahshid Mehdizadeh ◽  
Akram Sadeghi
Keyword(s):  
Quality Of Life ◽  
Hematologic Malignancies ◽  
Psychological Therapy

An Evaluation of Adjuvant Psychological Therapy (APT) Effectiveness on the Quality of Life of Patients with Hematologic Malignancies

2017 ◽  
Vol 38 (6) ◽  
pp. 1728-1735
Author(s):  
Masoome Barani ◽  
Maryam Bakhtiari ◽  
Vahid Sadeghi Firoozabadi ◽  
Mahshid Mehdizadeh ◽  
Akram Sadeghi
Keyword(s):  
Quality Of Life ◽  
Hematologic Malignancies ◽  
Psychological Therapy

Quality of Life of Young Adult Survivors of Hematologic Malignancies

2013 ◽  
Vol 36 (2) ◽  
pp. E1-E7 ◽  
Author(s):  
Marlana R. Mattson ◽  
Regan K. Demshar ◽  
Barbara J. Daly
Keyword(s):  
Quality Of Life ◽  
Young Adult ◽  
Adult Survivors ◽  
Hematologic Malignancies ◽  
Young Adult Survivors

scholarly journals HLA mismatch direction in cord blood transplantation: impact on outcome and implications for cord blood unit selection

Blood ◽  
2011 ◽  
Vol 118 (14) ◽  
pp. 3969-3978 ◽  
Author(s):  
Cladd E. Stevens ◽  
Carmelita Carrier ◽  
Carol Carpenter ◽  
Dorothy Sung ◽  
Andromachi Scaradavou
Keyword(s):  
New York ◽  
Human Leukocyte Antigen ◽  
Cord Blood ◽  
Cord Blood Transplantation ◽  
Human Leukocyte ◽  
Hematologic Malignancies ◽  
Leukocyte Antigen ◽  
Blood Transplantation ◽  
Cord Blood Unit ◽  
Unrelated Cord Blood

AbstractDonor-recipient human leukocyte antigen mismatch level affects the outcome of unrelated cord blood (CB) transplantation. To identify possible “permissive” mismatches, we examined the relationship between direction of human leukocyte antigen mismatch (“vector”) and transplantation outcomes in 1202 recipients of single CB units from the New York Blood Center National Cord Blood Program treated in United States Centers from 1993-2006. Altogether, 98 donor/patient pairs had only unidirectional mismatches: 58 in the graft-versus-host (GVH) direction only (GVH-O) and 40 in the host-versus-graft or rejection direction only (R-O). Engraftment was faster in patients with GVH-O mismatches compared with those with 1 bidirectional mismatch (hazard ratio [HR] = 1.6, P = .003). In addition, patients with hematologic malignancies given GVH-O grafts had lower transplantation-related mortality (HR = 0.5, P = .062), overall mortality (HR = 0.5, P = .019), and treatment failure (HR = 0.5, P = .016), resulting in outcomes similar to those of matched CB grafts. In contrast, R-O mismatches had slower engraftment, higher graft failure, and higher relapse rates (HR = 2.4, P = .010). Based on our findings, CB search algorithms should be modified to identify unidirectional mismatches. We recommend that transplant centers give priority to GVH-O-mismatched units over other mismatches and avoid selecting R-O mismatches, if possible.

scholarly journals Sequential Transplantation of Haploidentical Stem Cell and Unrelated Cord Blood With Using ATG/PTCY Increases Survival of Relapsed/Refractory Hematologic Malignancies

2021 ◽  
Vol 12 ◽  
Author(s):  
Hua Li ◽  
Xiaofan Li ◽  
Yiling Chen ◽  
Duihong Li ◽  
Xianling Chen ◽  
...  
Keyword(s):  
Cord Blood ◽  
Cord Blood Transplantation ◽  
Chronic Gvhd ◽  
Disease Free Survival ◽  
Hematologic Malignancies ◽  
Post Transplantation ◽  
Blood Transplantation ◽  
Gvhd Prophylaxis ◽  
Unrelated Donors ◽  
Unrelated Cord Blood

Allogeneic haploidentical HSCT (haplo-HSCT) and unrelated umbilical cord blood transplantation(UCBT)are used in patients lacking HLA-identical sibling or unrelated donors. With myeloablative condition and GVHD prophylaxis of using low-dose ATG and post-transplantation cyclophosphamide (PTCY), we conducted a prospective clinical trial. Of eligible 122 patients from February 2015 to December 2019 in the study, 113 patients were involved. Forty-eight patients were in the group of sequential haplo-cord transplantation (haplo-cord HSCT), and 65 patients were in the group of single UCBT. The primary endpoint of 2-year disease-free survival (DFS) was no statistical difference between groups (64.1 vs. 56.5%), p&gt;0.05. The analysis of subgroup patients with relapsed/refractory showed haplo-cord HSCT was associated with better OS (HR 0.348, 95% CI, 0.175–0.691; p=0.0025), DFS (HR 0.402, 95% CI, 0.208–0.779; p=0.0069), and GRFS (HR 0.235, 95% CI, 0.120–0.457, p&lt;0.0001) compared to the single cord group. The 2-year’s probability in OS, DFS, and GRFS was 64.9 vs. 31.6%, 64.5 vs. 31.6%, and 60.8 vs. 15.0% in the haplo-cord group and single cord group, respectively. III-IV acute GVHD 8.3 vs. 6.2%, chronic GVHD 25.8 vs. 13.7%, and extensive chronic GVHD 5.3 vs. 1.8% were shown in corresponding group, p&gt;0.05. The patients engrafted persistently with UCB showed better survival outcomes. Our sequential Haplo-cord HSCT with ATG/PTCY improved the survival of patients and might be an alternative transplantation approach for patients with relapsed/refractory hematologic malignancies.

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