Engraftment kinetics and graft failure after single umbilical cord blood transplantation using a myeloablative conditioning regimen
Identifieur interne : 003986 ( Main/Exploration ); précédent : 003985; suivant : 003987Engraftment kinetics and graft failure after single umbilical cord blood transplantation using a myeloablative conditioning regimen
Auteurs : Annalisa Ruggeri [France, Italie] ; Myriam Labopin [France] ; Maria Pia Sormani [Italie] ; Guillermo Sanz [Espagne] ; Jaime Sanz [Espagne] ; Fernanda Volt [France] ; Gerard Michel [France] ; Franco Locatelli [Italie] ; Cristina Diaz De Heredia [Espagne] ; Tracey O Rien [Australie] ; William Arcese [Italie] ; Anna Paola Iori [Italie] ; Sergi Querol [Espagne] ; Gesine Kogler [Allemagne] ; Lucilla Lecchi [Italie] ; Fabienne Pouthier [France] ; Federico Garnier [France] ; Cristina Navarrete [Royaume-Uni] ; Etienne Baudoux [Belgique] ; Juliana Fernandes [France] ; Chantal Kenzey [France] ; Mary Eapen [États-Unis] ; Eliane Gluckman [France, Monaco] ; Vanderson Rocha [France, Royaume-Uni] ; Riccardo Saccardi [France, Italie]Source :
- Haematologica [ 0390-6078 ] ; 2014.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Agonistes myélo-ablatifs (usage thérapeutique), Analyse de survie, Conditionnement pour greffe (), Enfant, Enfant d'âge préscolaire, Facteurs temps, Femelle, Granulocytes neutrophiles (cytologie), Granulocytes neutrophiles (immunologie), Humains, Induction de rémission, Leucémie aigüe myéloïde (), Leucémie aigüe myéloïde (anatomopathologie), Leucémie aigüe myéloïde (immunologie), Leucémie aigüe myéloïde (mortalité), Leucémie-lymphome lymphoblastique à précurseurs B et T (), Leucémie-lymphome lymphoblastique à précurseurs B et T (anatomopathologie), Leucémie-lymphome lymphoblastique à précurseurs B et T (immunologie), Leucémie-lymphome lymphoblastique à précurseurs B et T (mortalité), Maladie du greffon contre l'hôte (), Maladie du greffon contre l'hôte (anatomopathologie), Maladie du greffon contre l'hôte (immunologie), Maladie du greffon contre l'hôte (mortalité), Mâle, Nourrisson, Rejet du greffon (immunologie), Transplantation de cellules souches de sang du cordon, Transplantation homologue, Études de suivi.
- MESH :
- anatomopathologie : Leucémie aigüe myéloïde, Leucémie-lymphome lymphoblastique à précurseurs B et T, Maladie du greffon contre l'hôte.
- cytologie : Granulocytes neutrophiles.
- immunologie : Granulocytes neutrophiles, Leucémie aigüe myéloïde, Leucémie-lymphome lymphoblastique à précurseurs B et T, Maladie du greffon contre l'hôte, Rejet du greffon.
- mortalité : Leucémie aigüe myéloïde, Leucémie-lymphome lymphoblastique à précurseurs B et T, Maladie du greffon contre l'hôte.
- usage thérapeutique : Agonistes myélo-ablatifs.
- Adolescent, Adulte, Adulte d'âge moyen, Analyse de survie, Conditionnement pour greffe, Enfant, Enfant d'âge préscolaire, Facteurs temps, Femelle, Humains, Induction de rémission, Leucémie aigüe myéloïde, Leucémie-lymphome lymphoblastique à précurseurs B et T, Maladie du greffon contre l'hôte, Mâle, Nourrisson, Transplantation de cellules souches de sang du cordon, Transplantation homologue, Études de suivi.
English descriptors
- KwdEn :
- Adolescent, Adult, Child, Child, Preschool, Cord Blood Stem Cell Transplantation, Female, Follow-Up Studies, Graft Rejection (immunology), Graft vs Host Disease (immunology), Graft vs Host Disease (mortality), Graft vs Host Disease (pathology), Graft vs Host Disease (therapy), Humans, Infant, Leukemia, Myeloid, Acute (immunology), Leukemia, Myeloid, Acute (mortality), Leukemia, Myeloid, Acute (pathology), Leukemia, Myeloid, Acute (therapy), Male, Middle Aged, Myeloablative Agonists (therapeutic use), Neutrophils (cytology), Neutrophils (immunology), Precursor Cell Lymphoblastic Leukemia-Lymphoma (immunology), Precursor Cell Lymphoblastic Leukemia-Lymphoma (mortality), Precursor Cell Lymphoblastic Leukemia-Lymphoma (pathology), Precursor Cell Lymphoblastic Leukemia-Lymphoma (therapy), Remission Induction, Survival Analysis, Time Factors, Transplantation Conditioning (methods), Transplantation, Homologous.
- MESH :
- chemical , therapeutic use : Myeloablative Agonists.
- cytology : Neutrophils.
- immunology : Graft Rejection, Graft vs Host Disease, Leukemia, Myeloid, Acute, Neutrophils, Precursor Cell Lymphoblastic Leukemia-Lymphoma.
- methods : Transplantation Conditioning.
- mortality : Graft vs Host Disease, Leukemia, Myeloid, Acute, Precursor Cell Lymphoblastic Leukemia-Lymphoma.
- pathology : Graft vs Host Disease, Leukemia, Myeloid, Acute, Precursor Cell Lymphoblastic Leukemia-Lymphoma.
- therapy : Graft vs Host Disease, Leukemia, Myeloid, Acute, Precursor Cell Lymphoblastic Leukemia-Lymphoma.
- Adolescent, Adult, Child, Child, Preschool, Cord Blood Stem Cell Transplantation, Female, Follow-Up Studies, Humans, Infant, Male, Middle Aged, Remission Induction, Survival Analysis, Time Factors, Transplantation, Homologous.
Abstract
Umbilical cord blood transplant recipients are exposed to an increased risk of graft failure, a complication leading to a higher rate of transplant-related mortality. The decision and timing to offer a second transplant after graft failure is challenging. With the aim of addressing this issue, we analyzed engraftment kinetics and outcomes of 1268 patients (73% children) with acute leukemia (64% acute lymphoblastic leukemia, 36% acute myeloid leukemia) in remission who underwent single-unit umbilical cord blood transplantation after a myeloablative conditioning regimen. The median follow-up was 31 months. The overall survival rate at 3 years was 47%; the 100-day cumulative incidence of transplant-related mortality was 16%. Longer time to engraftment was associated with increased transplant-related mortality and shorter overall survival. The cumulative incidence of neutrophil engraftment at day 60 was 86%, while the median time to achieve engraftment was 24 days. Probability density analysis showed that the likelihood of engraftment after umbilical cord blood transplantation increased after day 10, peaked on day 21 and slowly decreased to 21% by day 31. Beyond day 31, the probability of engraftment dropped rapidly, and the residual probability of engrafting after day 42 was 5%. Graft failure was reported in 166 patients, and 66 of them received a second graft (allogeneic, n=45). Rescue actions, such as the search for another graft, should be considered starting after day 21. A diagnosis of graft failure can be established in patients who have not achieved neutrophil recovery by day 42. Moreover, subsequent transplants should not be postponed after day 42.
Url:
DOI: 10.3324/haematol.2014.109280
PubMed: 24972767
PubMed Central: 4562541
Affiliations:
- Allemagne, Australie, Belgique, Espagne, France, Italie, Monaco, Royaume-Uni, États-Unis
- Angleterre, Bourgogne-Franche-Comté, Catalogne, Franche-Comté, Grand Londres, Latium, Lombardie, Nouvelle-Galles du Sud, Provence-Alpes-Côte d'Azur, Province de Liège, Région wallonne, Wisconsin, Île-de-France
- Barcelone, Besançon, Liège, Londres, Marseille, Milan, Paris, Rome, Sydney
- University College de Londres, Université de Liège, Université de Rome « La Sapienza »
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Le document en format XML
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Biotecnologie Cellulari ed Ematologia, Rome, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Università La Sapienza, Dip. 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University of Dusseldorf, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Dusseldorf Cord Blood Bank, University of Dusseldorf</wicri:regionArea><wicri:noRegion>University of Dusseldorf</wicri:noRegion><wicri:noRegion>University of Dusseldorf</wicri:noRegion><wicri:noRegion>University of Dusseldorf</wicri:noRegion></affiliation></author><author><name sortKey="Lecchi, Lucilla" sort="Lecchi, Lucilla" uniqKey="Lecchi L" first="Lucilla" last="Lecchi">Lucilla Lecchi</name><affiliation wicri:level="3"><nlm:aff id="af14-0991509">Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Pouthier, Fabienne" sort="Pouthier, Fabienne" uniqKey="Pouthier F" first="Fabienne" last="Pouthier">Fabienne Pouthier</name><affiliation wicri:level="3"><nlm:aff id="af15-0991509">Besançon Cord Blood Bank of the Etablissement Français du Sang, Besançon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Besançon Cord Blood Bank of the Etablissement Français du Sang, Besançon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Franche-Comté</region><settlement type="city">Besançon</settlement></placeName></affiliation></author><author><name sortKey="Garnier, Federico" sort="Garnier, Federico" uniqKey="Garnier F" first="Federico" last="Garnier">Federico Garnier</name><affiliation wicri:level="3"><nlm:aff id="af16-0991509">Agence de la Biomedecine, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Agence de la Biomedecine, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Navarrete, Cristina" sort="Navarrete, Cristina" uniqKey="Navarrete C" first="Cristina" last="Navarrete">Cristina Navarrete</name><affiliation wicri:level="4"><nlm:aff id="af17-0991509">NHS-Cord Blood Bank, NHSBT, Colindale Ave, and University College London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>NHS-Cord Blood Bank, NHSBT, Colindale Ave, and University College London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName type="university">University College de Londres</orgName></affiliation></author><author><name sortKey="Baudoux, Etienne" sort="Baudoux, Etienne" uniqKey="Baudoux E" first="Etienne" last="Baudoux">Etienne Baudoux</name><affiliation wicri:level="4"><nlm:aff id="af18-0991509">Liege Cord Blood Bank, University of Liege, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Liege Cord Blood Bank, University of Liege</wicri:regionArea><placeName><settlement type="city">Liège</settlement><region type="region" nuts="1">Région wallonne</region><region type="province" nuts="1">Province de Liège</region></placeName><orgName type="university">Université de Liège</orgName></affiliation></author><author><name sortKey="Fernandes, Juliana" sort="Fernandes, Juliana" uniqKey="Fernandes J" first="Juliana" last="Fernandes">Juliana Fernandes</name><affiliation wicri:level="1"><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII</wicri:regionArea><wicri:noRegion>and IUH University Paris VII</wicri:noRegion><wicri:noRegion>and IUH University Paris VII</wicri:noRegion></affiliation></author><author><name sortKey="Kenzey, Chantal" sort="Kenzey, Chantal" uniqKey="Kenzey C" first="Chantal" last="Kenzey">Chantal Kenzey</name><affiliation wicri:level="1"><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII</wicri:regionArea><wicri:noRegion>and IUH University Paris VII</wicri:noRegion><wicri:noRegion>and IUH University Paris VII</wicri:noRegion></affiliation></author><author><name sortKey="Eapen, Mary" sort="Eapen, Mary" uniqKey="Eapen M" first="Mary" last="Eapen">Mary Eapen</name><affiliation wicri:level="2"><nlm:aff id="af19-0991509">Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, Medical College of Wisconsin, Milwaukee, WI</wicri:regionArea><placeName><region type="state">Wisconsin</region></placeName></affiliation></author><author><name sortKey="Gluckman, Eliane" sort="Gluckman, Eliane" uniqKey="Gluckman E" first="Eliane" last="Gluckman">Eliane Gluckman</name><affiliation wicri:level="1"><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII</wicri:regionArea><wicri:noRegion>and IUH University Paris VII</wicri:noRegion><wicri:noRegion>and IUH University Paris VII</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af20-0991509">Monacord, Centre Scientifique de Monaco, Monaco</nlm:aff><country xml:lang="fr">Monaco</country><wicri:regionArea>Monacord, Centre Scientifique de Monaco</wicri:regionArea><wicri:noRegion>Centre Scientifique de Monaco</wicri:noRegion></affiliation></author><author><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name><affiliation wicri:level="1"><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII</wicri:regionArea><wicri:noRegion>and IUH University Paris VII</wicri:noRegion><wicri:noRegion>and IUH University Paris VII</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af21-0991509">Churchill Hospital, Oxford University Hospitals, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Churchill Hospital, Oxford University Hospitals</wicri:regionArea><wicri:noRegion>Oxford University Hospitals</wicri:noRegion></affiliation></author><author><name sortKey="Saccardi, Riccardo" sort="Saccardi, Riccardo" uniqKey="Saccardi R" first="Riccardo" last="Saccardi">Riccardo Saccardi</name><affiliation wicri:level="1"><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII</wicri:regionArea><wicri:noRegion>and IUH University Paris VII</wicri:noRegion><wicri:noRegion>and IUH University Paris VII</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af22-0991509">Careggi University Hospital, Florence, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Careggi University Hospital, Florence</wicri:regionArea><wicri:noRegion>Florence</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24972767</idno><idno type="pmc">4562541</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562541</idno><idno type="RBID">PMC:4562541</idno><idno 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type="wicri:Area/Ncbi/Merge">001B73</idno><idno type="wicri:Area/Ncbi/Curation">001B73</idno><idno type="wicri:Area/Ncbi/Checkpoint">001B73</idno><idno type="wicri:doubleKey">0390-6078:2014:Ruggeri A:engraftment:kinetics:and</idno><idno type="wicri:Area/Main/Merge">003A26</idno><idno type="wicri:Area/Main/Curation">003986</idno><idno type="wicri:Area/Main/Exploration">003986</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Engraftment kinetics and graft failure after single umbilical cord
blood transplantation using a myeloablative conditioning regimen</title><author><name sortKey="Ruggeri, Annalisa" sort="Ruggeri, Annalisa" uniqKey="Ruggeri A" first="Annalisa" last="Ruggeri">Annalisa Ruggeri</name><affiliation wicri:level="1"><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII</wicri:regionArea><wicri:noRegion>and IUH University Paris VII</wicri:noRegion><wicri:noRegion>and IUH University Paris VII</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af2-0991509">Hospital Saint Antoine, Service d’Hématologie et Thérapie Cellulaire, AP-HP, UPMC University of Paris 06, UMR-S 938, CEREST-TC EBMT, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Hospital Saint Antoine, Service d’Hématologie et Thérapie Cellulaire, AP-HP, UPMC University of Paris 06, UMR-S 938, CEREST-TC EBMT</wicri:regionArea><wicri:noRegion>CEREST-TC EBMT</wicri:noRegion><wicri:noRegion>CEREST-TC EBMT</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af3-0991509">Cord Blood Committee EBMT, University of Genova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Cord Blood Committee EBMT, University of Genova</wicri:regionArea><wicri:noRegion>University of Genova</wicri:noRegion></affiliation></author><author><name sortKey="Labopin, Myriam" sort="Labopin, Myriam" uniqKey="Labopin M" first="Myriam" last="Labopin">Myriam Labopin</name><affiliation wicri:level="1"><nlm:aff id="af2-0991509">Hospital Saint Antoine, Service d’Hématologie et Thérapie Cellulaire, AP-HP, UPMC University of Paris 06, UMR-S 938, CEREST-TC EBMT, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Hospital Saint Antoine, Service d’Hématologie et Thérapie Cellulaire, AP-HP, UPMC University of Paris 06, UMR-S 938, CEREST-TC EBMT</wicri:regionArea><wicri:noRegion>CEREST-TC EBMT</wicri:noRegion><wicri:noRegion>CEREST-TC EBMT</wicri:noRegion></affiliation></author><author><name sortKey="Sormani, Maria Pia" sort="Sormani, Maria Pia" uniqKey="Sormani M" first="Maria Pia" last="Sormani">Maria Pia Sormani</name><affiliation wicri:level="1"><nlm:aff id="af4-0991509">Biostatistics Unit, Department of Health Sciences (DISSAL), University of Genova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Biostatistics Unit, Department of Health Sciences (DISSAL), University of Genova</wicri:regionArea><wicri:noRegion>University of Genova</wicri:noRegion></affiliation></author><author><name sortKey="Sanz, Guillermo" sort="Sanz, Guillermo" uniqKey="Sanz G" first="Guillermo" last="Sanz">Guillermo Sanz</name><affiliation wicri:level="1"><nlm:aff id="af5-0991509">Hospital Universitario y Politécnico La Fe, Valencia, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital Universitario y Politécnico La Fe, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Sanz, Jaime" sort="Sanz, Jaime" uniqKey="Sanz J" first="Jaime" last="Sanz">Jaime Sanz</name><affiliation wicri:level="1"><nlm:aff id="af5-0991509">Hospital Universitario y Politécnico La Fe, Valencia, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital Universitario y Politécnico La Fe, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Volt, Fernanda" sort="Volt, Fernanda" uniqKey="Volt F" first="Fernanda" last="Volt">Fernanda Volt</name><affiliation wicri:level="1"><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII</wicri:regionArea><wicri:noRegion>and IUH University Paris VII</wicri:noRegion><wicri:noRegion>and IUH University Paris VII</wicri:noRegion></affiliation></author><author><name sortKey="Michel, Gerard" sort="Michel, Gerard" uniqKey="Michel G" first="Gerard" last="Michel">Gerard Michel</name><affiliation wicri:level="3"><nlm:aff id="af6-0991509">Hôpital d’Enfants de la Timone, Marseille, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Hôpital d’Enfants de la Timone, Marseille</wicri:regionArea><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement></placeName></affiliation></author><author><name sortKey="Locatelli, Franco" sort="Locatelli, Franco" uniqKey="Locatelli F" first="Franco" last="Locatelli">Franco Locatelli</name><affiliation wicri:level="1"><nlm:aff id="af7-0991509">Dipartimento di Oncoematologia Pediatrica, Ospedale Bambino Gesù, IRCSS, Rome/University of Pavia, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Dipartimento di Oncoematologia Pediatrica, Ospedale Bambino Gesù, IRCSS, Rome/University of Pavia</wicri:regionArea><wicri:noRegion>Rome/University of Pavia</wicri:noRegion></affiliation></author><author><name sortKey="De Heredia, Cristina Diaz" sort="De Heredia, Cristina Diaz" uniqKey="De Heredia C" first="Cristina Diaz" last="De Heredia">Cristina Diaz De Heredia</name><affiliation wicri:level="3"><nlm:aff id="af8-0991509">Servicio de Hematologia y Oncologia Pediátricas, Hospital Universitario Vall d’Hebron, Barcelona, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Servicio de Hematologia y Oncologia Pediátricas, Hospital Universitario Vall d’Hebron, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="O Rien, Tracey" sort="O Rien, Tracey" uniqKey="O Rien T" first="Tracey" last="O Rien">Tracey O Rien</name><affiliation wicri:level="3"><nlm:aff id="af9-0991509">Sydney Children’s Hospital, Sydney, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Sydney Children’s Hospital, Sydney</wicri:regionArea><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Arcese, William" sort="Arcese, William" uniqKey="Arcese W" first="William" last="Arcese">William Arcese</name><affiliation wicri:level="3"><nlm:aff id="af10-0991509">Rome Transplant Network, University Tor Vergata, Rome, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Rome Transplant Network, University Tor Vergata, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Iori, Anna Paola" sort="Iori, Anna Paola" uniqKey="Iori A" first="Anna Paola" last="Iori">Anna Paola Iori</name><affiliation wicri:level="4"><nlm:aff id="af11-0991509">Università La Sapienza, Dip. Biotecnologie Cellulari ed Ematologia, Rome, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Università La Sapienza, Dip. Biotecnologie Cellulari ed Ematologia, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region><settlement type="city">Rome</settlement></placeName><orgName type="university">Université de Rome « La Sapienza »</orgName></affiliation></author><author><name sortKey="Querol, Sergi" sort="Querol, Sergi" uniqKey="Querol S" first="Sergi" last="Querol">Sergi Querol</name><affiliation wicri:level="3"><nlm:aff id="af12-0991509">Barcelona Cord Blood Bank, Barcelona, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Barcelona Cord Blood Bank, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Kogler, Gesine" sort="Kogler, Gesine" uniqKey="Kogler G" first="Gesine" last="Kogler">Gesine Kogler</name><affiliation wicri:level="1"><nlm:aff id="af13-0991509">Dusseldorf Cord Blood Bank, University of Dusseldorf, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Dusseldorf Cord Blood Bank, University of Dusseldorf</wicri:regionArea><wicri:noRegion>University of Dusseldorf</wicri:noRegion><wicri:noRegion>University of Dusseldorf</wicri:noRegion><wicri:noRegion>University of Dusseldorf</wicri:noRegion></affiliation></author><author><name sortKey="Lecchi, Lucilla" sort="Lecchi, Lucilla" uniqKey="Lecchi L" first="Lucilla" last="Lecchi">Lucilla Lecchi</name><affiliation wicri:level="3"><nlm:aff id="af14-0991509">Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Pouthier, Fabienne" sort="Pouthier, Fabienne" uniqKey="Pouthier F" first="Fabienne" last="Pouthier">Fabienne Pouthier</name><affiliation wicri:level="3"><nlm:aff id="af15-0991509">Besançon Cord Blood Bank of the Etablissement Français du Sang, Besançon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Besançon Cord Blood Bank of the Etablissement Français du Sang, Besançon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Franche-Comté</region><settlement type="city">Besançon</settlement></placeName></affiliation></author><author><name sortKey="Garnier, Federico" sort="Garnier, Federico" uniqKey="Garnier F" first="Federico" last="Garnier">Federico Garnier</name><affiliation wicri:level="3"><nlm:aff id="af16-0991509">Agence de la Biomedecine, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Agence de la Biomedecine, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Navarrete, Cristina" sort="Navarrete, Cristina" uniqKey="Navarrete C" first="Cristina" last="Navarrete">Cristina Navarrete</name><affiliation wicri:level="4"><nlm:aff id="af17-0991509">NHS-Cord Blood Bank, NHSBT, Colindale Ave, and University College London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>NHS-Cord Blood Bank, NHSBT, Colindale Ave, and University College London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName type="university">University College de Londres</orgName></affiliation></author><author><name sortKey="Baudoux, Etienne" sort="Baudoux, Etienne" uniqKey="Baudoux E" first="Etienne" last="Baudoux">Etienne Baudoux</name><affiliation wicri:level="4"><nlm:aff id="af18-0991509">Liege Cord Blood Bank, University of Liege, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Liege Cord Blood Bank, University of Liege</wicri:regionArea><placeName><settlement type="city">Liège</settlement><region type="region" nuts="1">Région wallonne</region><region type="province" nuts="1">Province de Liège</region></placeName><orgName type="university">Université de Liège</orgName></affiliation></author><author><name sortKey="Fernandes, Juliana" sort="Fernandes, Juliana" uniqKey="Fernandes J" first="Juliana" last="Fernandes">Juliana Fernandes</name><affiliation wicri:level="1"><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII</wicri:regionArea><wicri:noRegion>and IUH University Paris VII</wicri:noRegion><wicri:noRegion>and IUH University Paris VII</wicri:noRegion></affiliation></author><author><name sortKey="Kenzey, Chantal" sort="Kenzey, Chantal" uniqKey="Kenzey C" first="Chantal" last="Kenzey">Chantal Kenzey</name><affiliation wicri:level="1"><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII</wicri:regionArea><wicri:noRegion>and IUH University Paris VII</wicri:noRegion><wicri:noRegion>and IUH University Paris VII</wicri:noRegion></affiliation></author><author><name sortKey="Eapen, Mary" sort="Eapen, Mary" uniqKey="Eapen M" first="Mary" last="Eapen">Mary Eapen</name><affiliation wicri:level="2"><nlm:aff id="af19-0991509">Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, Medical College of Wisconsin, Milwaukee, WI</wicri:regionArea><placeName><region type="state">Wisconsin</region></placeName></affiliation></author><author><name sortKey="Gluckman, Eliane" sort="Gluckman, Eliane" uniqKey="Gluckman E" first="Eliane" last="Gluckman">Eliane Gluckman</name><affiliation wicri:level="1"><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII</wicri:regionArea><wicri:noRegion>and IUH University Paris VII</wicri:noRegion><wicri:noRegion>and IUH University Paris VII</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af20-0991509">Monacord, Centre Scientifique de Monaco, Monaco</nlm:aff><country xml:lang="fr">Monaco</country><wicri:regionArea>Monacord, Centre Scientifique de Monaco</wicri:regionArea><wicri:noRegion>Centre Scientifique de Monaco</wicri:noRegion></affiliation></author><author><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name><affiliation wicri:level="1"><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII</wicri:regionArea><wicri:noRegion>and IUH University Paris VII</wicri:noRegion><wicri:noRegion>and IUH University Paris VII</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af21-0991509">Churchill Hospital, Oxford University Hospitals, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Churchill Hospital, Oxford University Hospitals</wicri:regionArea><wicri:noRegion>Oxford University Hospitals</wicri:noRegion></affiliation></author><author><name sortKey="Saccardi, Riccardo" sort="Saccardi, Riccardo" uniqKey="Saccardi R" first="Riccardo" last="Saccardi">Riccardo Saccardi</name><affiliation wicri:level="1"><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII</wicri:regionArea><wicri:noRegion>and IUH University Paris VII</wicri:noRegion><wicri:noRegion>and IUH University Paris VII</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af22-0991509">Careggi University Hospital, Florence, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Careggi University Hospital, Florence</wicri:regionArea><wicri:noRegion>Florence</wicri:noRegion></affiliation></author></analytic><series><title level="j">Haematologica</title><idno type="ISSN">0390-6078</idno><idno type="eISSN">1592-8721</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Child</term><term>Child, Preschool</term><term>Cord Blood Stem Cell Transplantation</term><term>Female</term><term>Follow-Up Studies</term><term>Graft Rejection (immunology)</term><term>Graft vs Host Disease (immunology)</term><term>Graft vs Host Disease (mortality)</term><term>Graft vs Host Disease (pathology)</term><term>Graft vs Host Disease (therapy)</term><term>Humans</term><term>Infant</term><term>Leukemia, Myeloid, Acute (immunology)</term><term>Leukemia, Myeloid, Acute (mortality)</term><term>Leukemia, Myeloid, Acute (pathology)</term><term>Leukemia, Myeloid, Acute (therapy)</term><term>Male</term><term>Middle Aged</term><term>Myeloablative Agonists (therapeutic use)</term><term>Neutrophils (cytology)</term><term>Neutrophils (immunology)</term><term>Precursor Cell Lymphoblastic Leukemia-Lymphoma (immunology)</term><term>Precursor Cell Lymphoblastic Leukemia-Lymphoma (mortality)</term><term>Precursor Cell Lymphoblastic Leukemia-Lymphoma (pathology)</term><term>Precursor Cell Lymphoblastic Leukemia-Lymphoma (therapy)</term><term>Remission Induction</term><term>Survival Analysis</term><term>Time Factors</term><term>Transplantation Conditioning (methods)</term><term>Transplantation, Homologous</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Agonistes myélo-ablatifs (usage thérapeutique)</term><term>Analyse de survie</term><term>Conditionnement pour greffe ()</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Facteurs temps</term><term>Femelle</term><term>Granulocytes neutrophiles (cytologie)</term><term>Granulocytes neutrophiles (immunologie)</term><term>Humains</term><term>Induction de rémission</term><term>Leucémie aigüe myéloïde ()</term><term>Leucémie aigüe myéloïde (anatomopathologie)</term><term>Leucémie aigüe myéloïde (immunologie)</term><term>Leucémie aigüe myéloïde (mortalité)</term><term>Leucémie-lymphome lymphoblastique à précurseurs B et T ()</term><term>Leucémie-lymphome lymphoblastique à précurseurs B et T (anatomopathologie)</term><term>Leucémie-lymphome lymphoblastique à précurseurs B et T (immunologie)</term><term>Leucémie-lymphome lymphoblastique à précurseurs B et T (mortalité)</term><term>Maladie du greffon contre l'hôte ()</term><term>Maladie du greffon contre l'hôte (anatomopathologie)</term><term>Maladie du greffon contre l'hôte (immunologie)</term><term>Maladie du greffon contre l'hôte (mortalité)</term><term>Mâle</term><term>Nourrisson</term><term>Rejet du greffon (immunologie)</term><term>Transplantation de cellules souches de sang du cordon</term><term>Transplantation homologue</term><term>Études de suivi</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Myeloablative Agonists</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Leucémie aigüe myéloïde</term><term>Leucémie-lymphome lymphoblastique à précurseurs B et T</term><term>Maladie du greffon contre l'hôte</term></keywords><keywords scheme="MESH" qualifier="cytologie" xml:lang="fr"><term>Granulocytes neutrophiles</term></keywords><keywords scheme="MESH" qualifier="cytology" xml:lang="en"><term>Neutrophils</term></keywords><keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Granulocytes neutrophiles</term><term>Leucémie aigüe myéloïde</term><term>Leucémie-lymphome lymphoblastique à précurseurs B et T</term><term>Maladie du greffon contre l'hôte</term><term>Rejet du greffon</term></keywords><keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>Graft Rejection</term><term>Graft vs Host Disease</term><term>Leukemia, Myeloid, Acute</term><term>Neutrophils</term><term>Precursor Cell Lymphoblastic Leukemia-Lymphoma</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Transplantation Conditioning</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Graft vs Host Disease</term><term>Leukemia, Myeloid, Acute</term><term>Precursor Cell Lymphoblastic Leukemia-Lymphoma</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Leucémie aigüe myéloïde</term><term>Leucémie-lymphome lymphoblastique à précurseurs B et T</term><term>Maladie du greffon contre l'hôte</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Graft vs Host Disease</term><term>Leukemia, Myeloid, Acute</term><term>Precursor Cell Lymphoblastic Leukemia-Lymphoma</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Graft vs Host Disease</term><term>Leukemia, Myeloid, Acute</term><term>Precursor Cell Lymphoblastic Leukemia-Lymphoma</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Agonistes myélo-ablatifs</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Child</term><term>Child, Preschool</term><term>Cord Blood Stem Cell Transplantation</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Infant</term><term>Male</term><term>Middle Aged</term><term>Remission Induction</term><term>Survival Analysis</term><term>Time Factors</term><term>Transplantation, Homologous</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Analyse de survie</term><term>Conditionnement pour greffe</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Facteurs temps</term><term>Femelle</term><term>Humains</term><term>Induction de rémission</term><term>Leucémie aigüe myéloïde</term><term>Leucémie-lymphome lymphoblastique à précurseurs B et T</term><term>Maladie du greffon contre l'hôte</term><term>Mâle</term><term>Nourrisson</term><term>Transplantation de cellules souches de sang du cordon</term><term>Transplantation homologue</term><term>Études de suivi</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Umbilical cord blood transplant recipients are exposed to an increased risk of
graft failure, a complication leading to a higher rate of transplant-related
mortality. The decision and timing to offer a second transplant after graft
failure is challenging. With the aim of addressing this issue, we analyzed
engraftment kinetics and outcomes of 1268 patients (73% children) with
acute leukemia (64% acute lymphoblastic leukemia, 36% acute
myeloid leukemia) in remission who underwent single-unit umbilical cord blood
transplantation after a myeloablative conditioning regimen. The median follow-up
was 31 months. The overall survival rate at 3 years was 47%; the 100-day
cumulative incidence of transplant-related mortality was 16%. Longer
time to engraftment was associated with increased transplant-related mortality
and shorter overall survival. The cumulative incidence of neutrophil engraftment
at day 60 was 86%, while the median time to achieve engraftment was 24
days. Probability density analysis showed that the likelihood of engraftment
after umbilical cord blood transplantation increased after day 10, peaked on day
21 and slowly decreased to 21% by day 31. Beyond day 31, the probability
of engraftment dropped rapidly, and the residual probability of engrafting after
day 42 was 5%. Graft failure was reported in 166 patients, and 66 of
them received a second graft (allogeneic, n=45). Rescue actions, such as the
search for another graft, should be considered starting after day 21. A
diagnosis of graft failure can be established in patients who have not achieved
neutrophil recovery by day 42. Moreover, subsequent transplants should not be
postponed after day 42.</p></div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Belgique</li><li>Espagne</li><li>France</li><li>Italie</li><li>Monaco</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Bourgogne-Franche-Comté</li><li>Catalogne</li><li>Franche-Comté</li><li>Grand Londres</li><li>Latium</li><li>Lombardie</li><li>Nouvelle-Galles du Sud</li><li>Provence-Alpes-Côte d'Azur</li><li>Province de Liège</li><li>Région wallonne</li><li>Wisconsin</li><li>Île-de-France</li></region><settlement><li>Barcelone</li><li>Besançon</li><li>Liège</li><li>Londres</li><li>Marseille</li><li>Milan</li><li>Paris</li><li>Rome</li><li>Sydney</li></settlement><orgName><li>University College de Londres</li><li>Université de Liège</li><li>Université de Rome « La Sapienza »</li></orgName></list><tree><country name="France"><noRegion><name sortKey="Ruggeri, Annalisa" sort="Ruggeri, Annalisa" uniqKey="Ruggeri A" first="Annalisa" last="Ruggeri">Annalisa Ruggeri</name></noRegion><name sortKey="Fernandes, Juliana" sort="Fernandes, Juliana" uniqKey="Fernandes J" first="Juliana" last="Fernandes">Juliana Fernandes</name><name sortKey="Garnier, Federico" sort="Garnier, Federico" uniqKey="Garnier F" first="Federico" last="Garnier">Federico Garnier</name><name sortKey="Gluckman, Eliane" sort="Gluckman, Eliane" uniqKey="Gluckman E" first="Eliane" last="Gluckman">Eliane Gluckman</name><name sortKey="Kenzey, Chantal" sort="Kenzey, Chantal" uniqKey="Kenzey C" first="Chantal" last="Kenzey">Chantal Kenzey</name><name sortKey="Labopin, Myriam" sort="Labopin, Myriam" uniqKey="Labopin M" first="Myriam" last="Labopin">Myriam Labopin</name><name sortKey="Michel, Gerard" sort="Michel, Gerard" uniqKey="Michel G" first="Gerard" last="Michel">Gerard Michel</name><name sortKey="Pouthier, Fabienne" sort="Pouthier, Fabienne" uniqKey="Pouthier F" first="Fabienne" last="Pouthier">Fabienne Pouthier</name><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name><name sortKey="Ruggeri, Annalisa" sort="Ruggeri, Annalisa" uniqKey="Ruggeri A" first="Annalisa" last="Ruggeri">Annalisa Ruggeri</name><name sortKey="Saccardi, Riccardo" sort="Saccardi, Riccardo" uniqKey="Saccardi R" first="Riccardo" last="Saccardi">Riccardo Saccardi</name><name sortKey="Volt, Fernanda" sort="Volt, Fernanda" uniqKey="Volt F" first="Fernanda" last="Volt">Fernanda Volt</name></country><country name="Italie"><noRegion><name sortKey="Ruggeri, Annalisa" sort="Ruggeri, Annalisa" uniqKey="Ruggeri A" first="Annalisa" last="Ruggeri">Annalisa Ruggeri</name></noRegion><name sortKey="Arcese, William" sort="Arcese, William" uniqKey="Arcese W" first="William" last="Arcese">William Arcese</name><name sortKey="Iori, Anna Paola" sort="Iori, Anna Paola" uniqKey="Iori A" first="Anna Paola" last="Iori">Anna Paola Iori</name><name sortKey="Lecchi, Lucilla" sort="Lecchi, Lucilla" uniqKey="Lecchi L" first="Lucilla" last="Lecchi">Lucilla Lecchi</name><name sortKey="Locatelli, Franco" sort="Locatelli, Franco" uniqKey="Locatelli F" first="Franco" last="Locatelli">Franco Locatelli</name><name sortKey="Saccardi, Riccardo" sort="Saccardi, Riccardo" uniqKey="Saccardi R" first="Riccardo" last="Saccardi">Riccardo Saccardi</name><name sortKey="Sormani, Maria Pia" sort="Sormani, Maria Pia" uniqKey="Sormani M" first="Maria Pia" last="Sormani">Maria Pia Sormani</name></country><country name="Espagne"><noRegion><name sortKey="Sanz, Guillermo" sort="Sanz, Guillermo" uniqKey="Sanz G" first="Guillermo" last="Sanz">Guillermo Sanz</name></noRegion><name sortKey="De Heredia, Cristina Diaz" sort="De Heredia, Cristina Diaz" uniqKey="De Heredia C" first="Cristina Diaz" last="De Heredia">Cristina Diaz De Heredia</name><name sortKey="Querol, Sergi" sort="Querol, Sergi" uniqKey="Querol S" first="Sergi" last="Querol">Sergi Querol</name><name sortKey="Sanz, Jaime" sort="Sanz, Jaime" uniqKey="Sanz J" first="Jaime" last="Sanz">Jaime Sanz</name></country><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="O Rien, Tracey" sort="O Rien, Tracey" uniqKey="O Rien T" first="Tracey" last="O Rien">Tracey O Rien</name></region></country><country name="Allemagne"><noRegion><name sortKey="Kogler, Gesine" sort="Kogler, Gesine" uniqKey="Kogler G" first="Gesine" last="Kogler">Gesine Kogler</name></noRegion></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Navarrete, Cristina" sort="Navarrete, Cristina" uniqKey="Navarrete C" first="Cristina" last="Navarrete">Cristina Navarrete</name></region><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name></country><country name="Belgique"><region name="Région wallonne"><name sortKey="Baudoux, Etienne" sort="Baudoux, Etienne" uniqKey="Baudoux E" first="Etienne" last="Baudoux">Etienne Baudoux</name></region></country><country name="États-Unis"><region name="Wisconsin"><name sortKey="Eapen, Mary" sort="Eapen, Mary" uniqKey="Eapen M" first="Mary" last="Eapen">Mary Eapen</name></region></country><country name="Monaco"><noRegion><name sortKey="Gluckman, Eliane" sort="Gluckman, Eliane" uniqKey="Gluckman E" first="Eliane" last="Gluckman">Eliane Gluckman</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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