Comparison of outcomes of unrelated bone marrow and umbilical cord blood transplants in children with acute leukemia
Identifieur interne : 00BD77 ( Main/Exploration ); précédent : 00BD76; suivant : 00BD78Comparison of outcomes of unrelated bone marrow and umbilical cord blood transplants in children with acute leukemia
Auteurs : Vanderson Rocha [France, Royaume-Uni, États-Unis, Italie, Autriche, Suède, Australie, Japon, Espagne, Allemagne] ; Jacqueline Cornish ; Eric L. Sievers ; Alexandra Filipovich ; Franco Locatelli ; Cristina Peters ; Mats Remberger ; Gérard Michel ; William Arcese ; Sandro Dallorso ; Karin Tiedemann ; Alessandro Busca ; Ka-Wah Chan ; Shunichi Kato ; Juan Ortega ; Marcus Vowels ; Axel Zander ; Gérard Souillet ; Anthony Oakill ; Ann Woolfrey ; Andrea L. Pay ; Ann Green ; Federico Garnier ; Irina Lonescu ; Peter Wernet ; Girolamo Sirchia ; Pablo Rubinstein ; Sylvie Chevret ; Eliane GluckmanSource :
- Blood [ 0006-4971 ] ; 2001.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Cellule souche, Enfant.
English descriptors
- KwdEn :
Abstract
In order to compare the outcomes of unrelated umbilical cord blood transplants (UCBTs) or bone marrow transplants, 541 children with acute leukemia (AL) transplanted with umbilical cord blood (n = 99), T-cell-depleted unrelated bone marrow transplants (T-UBMT) (n = 180), or nonmanipulated (UBMT) (n = 262), were analyzed in a retrospective multicenter study. Comparisons were performed after adjustment for patient, disease, and transplant variables. The major difference between the 3 groups was the higher number in the UCBT group of HLA mismatches (defined by serology for class I and molecular typing for DRB1). The donor was HLA mismatched in 92% of UCBTs, in 18% of UBMTs, and in 43% of T-UBMTs (P <.001). Other significant differences were observed in pretransplant disease characteristics, preparative regimens, graft-versus-host disease (GVHD) prophylaxis, and number of cells infused. Nonadjusted estimates of 2-year survival and event-free survival rates were 49% and 43%, respectively, in the UBMT group, 41% and 37% in the T-UBMT group, and 35% and 31% in the UCBT group. After adjustment, differences in outcomes appeared in the first 100 days after the transplantation. Compared with UBMT recipients, UCBT recipients had delayed hematopoietic recovery (Hazard ratio [HR] = 0.37; 95% confidence interval [95CI]: 0.27-0.52; P <.001), increased 100 day transplant-related mortality (HR = 2.13; 95CI: 1.20-3.76; P <.01) and decreased acute graft-versus-host disease (aGVHD) (HR = 0.50; 95CI: 0.34-0.73; P <.001). T-UBMT recipients had decreased aGVHD (HR = 0.25; 95CI: 0.17-0.36; P <.0001) and increased risk of relapse (HR = 1.96; 95CI: 1.11-3.45; P = .02). After day 100 posttransplant, the 3 groups achieved similar results in terms of relapse. Chronic GVHD was decreased after T-UBMT (HR = 0.21; 95CI: 0.11-0.37; P <.0001) and UCBT (HR = 0.24; 95CI: 0.01-0.66; P =.002), and overall mortality was higher in T-UBMT recipients (HR = 1.39; 95CI: 0.97-1.99; P <.07). In conclusion, the use of UCBT, as a source of hematopoietic stem cells, is a reasonable option for children with AL lacking an acceptably matched unrelated marrow donor.
Affiliations:
- Allemagne, Australie, Autriche, Espagne, France, Italie, Japon, Royaume-Uni, Suède, États-Unis
- Angleterre, Auvergne-Rhône-Alpes, Catalogne, Grand Londres, Hambourg, Latium, Nouvelle-Galles du Sud, Piémont, Provence-Alpes-Côte d'Azur, Rhône-Alpes, Victoria (État), Vienne (Autriche)
- Barcelone, Hambourg, Londres, Lyon, Marseille, Melbourne, Rome, Sydney, Turin, Vienne (Autriche)
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Le document en format XML
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Sievers</name></author><author><name sortKey="Filipovich, Alexandra" sort="Filipovich, Alexandra" uniqKey="Filipovich A" first="Alexandra" last="Filipovich">Alexandra Filipovich</name></author><author><name sortKey="Locatelli, Franco" sort="Locatelli, Franco" uniqKey="Locatelli F" first="Franco" last="Locatelli">Franco Locatelli</name></author><author><name sortKey="Peters, Cristina" sort="Peters, Cristina" uniqKey="Peters C" first="Cristina" last="Peters">Cristina Peters</name></author><author><name sortKey="Remberger, Mats" sort="Remberger, Mats" uniqKey="Remberger M" first="Mats" last="Remberger">Mats Remberger</name></author><author><name sortKey="Michel, Gerard" sort="Michel, Gerard" uniqKey="Michel G" first="Gérard" last="Michel">Gérard Michel</name></author><author><name sortKey="Arcese, William" sort="Arcese, William" uniqKey="Arcese W" first="William" last="Arcese">William Arcese</name></author><author><name sortKey="Dallorso, Sandro" sort="Dallorso, Sandro" uniqKey="Dallorso S" first="Sandro" last="Dallorso">Sandro Dallorso</name></author><author><name sortKey="Tiedemann, Karin" sort="Tiedemann, Karin" uniqKey="Tiedemann K" first="Karin" last="Tiedemann">Karin Tiedemann</name></author><author><name sortKey="Busca, Alessandro" sort="Busca, Alessandro" uniqKey="Busca A" first="Alessandro" last="Busca">Alessandro Busca</name></author><author><name sortKey="Chan, Ka Wah" sort="Chan, Ka Wah" uniqKey="Chan K" first="Ka-Wah" last="Chan">Ka-Wah Chan</name></author><author><name sortKey="Kato, Shunichi" sort="Kato, Shunichi" uniqKey="Kato S" first="Shunichi" last="Kato">Shunichi Kato</name></author><author><name sortKey="Ortega, Juan" sort="Ortega, Juan" uniqKey="Ortega J" first="Juan" last="Ortega">Juan Ortega</name></author><author><name sortKey="Vowels, Marcus" sort="Vowels, Marcus" uniqKey="Vowels M" first="Marcus" last="Vowels">Marcus Vowels</name></author><author><name sortKey="Zander, Axel" sort="Zander, Axel" uniqKey="Zander A" first="Axel" last="Zander">Axel Zander</name></author><author><name sortKey="Souillet, Gerard" sort="Souillet, Gerard" uniqKey="Souillet G" first="Gérard" last="Souillet">Gérard Souillet</name></author><author><name sortKey="Oakill, Anthony" sort="Oakill, Anthony" uniqKey="Oakill A" first="Anthony" last="Oakill">Anthony Oakill</name></author><author><name sortKey="Woolfrey, Ann" sort="Woolfrey, Ann" uniqKey="Woolfrey A" first="Ann" last="Woolfrey">Ann Woolfrey</name></author><author><name sortKey="Pay, Andrea L" sort="Pay, Andrea L" uniqKey="Pay A" first="Andrea L." last="Pay">Andrea L. Pay</name></author><author><name sortKey="Green, Ann" sort="Green, Ann" uniqKey="Green A" first="Ann" last="Green">Ann Green</name></author><author><name sortKey="Garnier, Federico" sort="Garnier, Federico" uniqKey="Garnier F" first="Federico" last="Garnier">Federico Garnier</name></author><author><name sortKey="Lonescu, Irina" sort="Lonescu, Irina" uniqKey="Lonescu I" first="Irina" last="Lonescu">Irina Lonescu</name></author><author><name sortKey="Wernet, Peter" sort="Wernet, Peter" uniqKey="Wernet P" first="Peter" last="Wernet">Peter Wernet</name></author><author><name sortKey="Sirchia, Girolamo" sort="Sirchia, Girolamo" uniqKey="Sirchia G" first="Girolamo" last="Sirchia">Girolamo Sirchia</name></author><author><name sortKey="Rubinstein, Pablo" sort="Rubinstein, Pablo" uniqKey="Rubinstein P" first="Pablo" last="Rubinstein">Pablo Rubinstein</name></author><author><name sortKey="Chevret, Sylvie" sort="Chevret, Sylvie" uniqKey="Chevret S" first="Sylvie" last="Chevret">Sylvie Chevret</name></author><author><name sortKey="Gluckman, Eliane" sort="Gluckman, Eliane" uniqKey="Gluckman E" first="Eliane" last="Gluckman">Eliane Gluckman</name></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">01-0362875</idno><date when="2001">2001</date><idno type="stanalyst">PASCAL 01-0362875 INIST</idno><idno type="RBID">Pascal:01-0362875</idno><idno type="wicri:Area/PascalFrancis/Corpus">005B32</idno><idno type="wicri:Area/PascalFrancis/Curation">000625</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">005932</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">005932</idno><idno type="wicri:doubleKey">0006-4971:2001:Rocha V:comparison:of:outcomes</idno><idno type="wicri:Area/Main/Merge">00CC77</idno><idno type="wicri:Area/Main/Curation">00BD77</idno><idno type="wicri:Area/Main/Exploration">00BD77</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Comparison of outcomes of unrelated bone marrow and umbilical cord blood transplants in children with acute leukemia</title><author><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Eurocord-Cord Blood Transplant Group (CBTG) and Biostatistics Department, Saint Louis Hospital AP-HP, University of Paris 7</s1><s3>FRA</s3></inist:fA14><country>France</country><wicri:noRegion>University of Paris 7</wicri:noRegion><wicri:noRegion>Eurocord-Cord Blood Transplant Group (CBTG) and Biostatistics Department, Saint Louis Hospital AP-HP, University of Paris 7</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Hospital for Sick Children</s1><s2>Bristol</s2><s3>GBR</s3></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Hospital for Sick Children</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Fred Hutchinson Cancer Research Center</s1><s2>Seattle, WA</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><wicri:noRegion>Fred Hutchinson Cancer Research Center</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Children's Hospital Medical Center</s1><s2>Cincinnati, OH</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><wicri:noRegion>Children's Hospital Medical Center</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Clinica Pediatrica, IRCCS Policlinico San Matteo</s1><s2>Pavia</s2><s3>ITA</s3></inist:fA14><country>Italie</country><wicri:noRegion>Pavia</wicri:noRegion></affiliation><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>St Anna Kinderspital</s1><s2>Vienna</s2><s3>AUT</s3></inist:fA14><country>Autriche</country><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Huddinge University Hospital</s1><s2>Huddinge</s2><s3>SWE</s3></inist:fA14><country>Suède</country><wicri:noRegion>Huddinge University Hospital</wicri:noRegion></affiliation><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Hospital La Timone</s1><s2>Marseille</s2><s3>FRA</s3></inist:fA14><country>France</country><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><affiliation wicri:level="3"><inist:fA14 i1="09"><s1>University La Sapienza</s1><s2>Rome</s2><s3>ITA</s3></inist:fA14><country>Italie</country><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Institute G. Gaslini</s1><s2>Genoa</s2><s3>ITA</s3></inist:fA14><country>Italie</country><wicri:noRegion>Institute G. Gaslini</wicri:noRegion></affiliation><affiliation wicri:level="3"><inist:fA14 i1="11"><s1>Royal Children's Hospital</s1><s2>Melbourne</s2><s3>AUS</s3></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="12"><s1>Ospedale Regina Margherita</s1><s2>Turin</s2><s3>ITA</s3></inist:fA14><country>Italie</country><placeName><settlement type="city">Turin</settlement><region type="région" nuts="2">Piémont</region></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>MD Anderson Cancer Center</s1><s2>Houston, TX</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><wicri:noRegion>MD Anderson Cancer Center</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="14"><s1>Tokai University School of Medicine</s1><s2>Isehara</s2><s3>JPN</s3></inist:fA14><country>Japon</country><wicri:noRegion>Tokai University School of Medicine</wicri:noRegion></affiliation><affiliation wicri:level="3"><inist:fA14 i1="15"><s1>Hospital Infantil Vall d'Hebron</s1><s2>Barcelona</s2><s3>ESP</s3></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="16"><s1>Sydney Children's Hospital</s1><s2>Sydney</s2><s3>AUS</s3></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="17"><s1>University Hospital Eppendort</s1><s2>Hamburg</s2><s3>DEU</s3></inist:fA14><country>Allemagne</country><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="18"><s1>Hospital Debrousse</s1><s2>Lyon</s2><s3>FRA</s3></inist:fA14><country>France</country><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="19"><s1>Anthony Nolan Bone Marrow Trust Registry</s1><s2>London</s2><s3>GBR</s3></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="20"><s1>National Blood Service</s1><s2>Bristol</s2><s3>GBR</s3></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>National Blood Service</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="21"><s1>Duesseldorf Cord Blood Bank</s1><s2>Duesseldorf</s2><s3>DEU</s3></inist:fA14><country>Allemagne</country><wicri:noRegion>Duesseldorf</wicri:noRegion><wicri:noRegion>Duesseldorf Cord Blood Bank</wicri:noRegion><wicri:noRegion>Duesseldorf Cord Blood Bank</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="22"><s1>Milano Cord Blood Bank</s1><s2>Milano</s2><s3>ITA</s3></inist:fA14><country>Italie</country><wicri:noRegion>Milano Cord Blood Bank</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="23"><s1>New York Cord Blood Bank</s1><s2>New York, NY</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><wicri:noRegion>New York Cord Blood Bank</wicri:noRegion></affiliation></author><author><name sortKey="Cornish, Jacqueline" sort="Cornish, Jacqueline" uniqKey="Cornish J" first="Jacqueline" last="Cornish">Jacqueline Cornish</name></author><author><name sortKey="Sievers, Eric L" sort="Sievers, Eric L" uniqKey="Sievers E" first="Eric L." last="Sievers">Eric L. Sievers</name></author><author><name sortKey="Filipovich, Alexandra" sort="Filipovich, Alexandra" uniqKey="Filipovich A" first="Alexandra" last="Filipovich">Alexandra Filipovich</name></author><author><name sortKey="Locatelli, Franco" sort="Locatelli, Franco" uniqKey="Locatelli F" first="Franco" last="Locatelli">Franco Locatelli</name></author><author><name sortKey="Peters, Cristina" sort="Peters, Cristina" uniqKey="Peters C" first="Cristina" last="Peters">Cristina Peters</name></author><author><name sortKey="Remberger, Mats" sort="Remberger, Mats" uniqKey="Remberger M" first="Mats" last="Remberger">Mats Remberger</name></author><author><name sortKey="Michel, Gerard" sort="Michel, Gerard" uniqKey="Michel G" first="Gérard" last="Michel">Gérard Michel</name></author><author><name sortKey="Arcese, William" sort="Arcese, William" uniqKey="Arcese W" first="William" last="Arcese">William Arcese</name></author><author><name sortKey="Dallorso, Sandro" sort="Dallorso, Sandro" uniqKey="Dallorso S" first="Sandro" last="Dallorso">Sandro Dallorso</name></author><author><name sortKey="Tiedemann, Karin" sort="Tiedemann, Karin" uniqKey="Tiedemann K" first="Karin" last="Tiedemann">Karin Tiedemann</name></author><author><name sortKey="Busca, Alessandro" sort="Busca, Alessandro" uniqKey="Busca A" first="Alessandro" last="Busca">Alessandro Busca</name></author><author><name sortKey="Chan, Ka Wah" sort="Chan, Ka Wah" uniqKey="Chan K" first="Ka-Wah" last="Chan">Ka-Wah Chan</name></author><author><name sortKey="Kato, Shunichi" sort="Kato, Shunichi" uniqKey="Kato S" first="Shunichi" last="Kato">Shunichi Kato</name></author><author><name sortKey="Ortega, Juan" sort="Ortega, Juan" uniqKey="Ortega J" first="Juan" last="Ortega">Juan Ortega</name></author><author><name sortKey="Vowels, Marcus" sort="Vowels, Marcus" uniqKey="Vowels M" first="Marcus" last="Vowels">Marcus Vowels</name></author><author><name sortKey="Zander, Axel" sort="Zander, Axel" uniqKey="Zander A" first="Axel" last="Zander">Axel Zander</name></author><author><name sortKey="Souillet, Gerard" sort="Souillet, Gerard" uniqKey="Souillet G" first="Gérard" last="Souillet">Gérard Souillet</name></author><author><name sortKey="Oakill, Anthony" sort="Oakill, Anthony" uniqKey="Oakill A" first="Anthony" last="Oakill">Anthony Oakill</name></author><author><name sortKey="Woolfrey, Ann" sort="Woolfrey, Ann" uniqKey="Woolfrey A" first="Ann" last="Woolfrey">Ann Woolfrey</name></author><author><name sortKey="Pay, Andrea L" sort="Pay, Andrea L" uniqKey="Pay A" first="Andrea L." last="Pay">Andrea L. Pay</name></author><author><name sortKey="Green, Ann" sort="Green, Ann" uniqKey="Green A" first="Ann" last="Green">Ann Green</name></author><author><name sortKey="Garnier, Federico" sort="Garnier, Federico" uniqKey="Garnier F" first="Federico" last="Garnier">Federico Garnier</name></author><author><name sortKey="Lonescu, Irina" sort="Lonescu, Irina" uniqKey="Lonescu I" first="Irina" last="Lonescu">Irina Lonescu</name></author><author><name sortKey="Wernet, Peter" sort="Wernet, Peter" uniqKey="Wernet P" first="Peter" last="Wernet">Peter Wernet</name></author><author><name sortKey="Sirchia, Girolamo" sort="Sirchia, Girolamo" uniqKey="Sirchia G" first="Girolamo" last="Sirchia">Girolamo Sirchia</name></author><author><name sortKey="Rubinstein, Pablo" sort="Rubinstein, Pablo" uniqKey="Rubinstein P" first="Pablo" last="Rubinstein">Pablo Rubinstein</name></author><author><name sortKey="Chevret, Sylvie" sort="Chevret, Sylvie" uniqKey="Chevret S" first="Sylvie" last="Chevret">Sylvie Chevret</name></author><author><name sortKey="Gluckman, Eliane" sort="Gluckman, Eliane" uniqKey="Gluckman E" first="Eliane" last="Gluckman">Eliane Gluckman</name></author></analytic><series><title level="j" type="main">Blood</title><title level="j" type="abbreviated">Blood</title><idno type="ISSN">0006-4971</idno><imprint><date when="2001">2001</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Blood</title><title level="j" type="abbreviated">Blood</title><idno type="ISSN">0006-4971</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acute</term><term>Acute lymphocytic leukemia</term><term>Acute myelocytic leukemia</term><term>Blood</term><term>Bone marrow</term><term>Child</term><term>Comparative study</term><term>Depletion</term><term>Graft versus host reaction</term><term>Hematopoietic cell</term><term>Homograft</term><term>Prognosis</term><term>Stem cell</term><term>T-Lymphocyte</term><term>Treatment</term><term>Umbilical cord</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Leucémie lymphoblastique</term><term>Leucémie myéloblastique</term><term>Traitement</term><term>Homogreffe</term><term>Cellule hématopoïétique</term><term>Cellule souche</term><term>Cordon ombilical</term><term>Sang</term><term>Moelle osseuse</term><term>Etude comparative</term><term>Pronostic</term><term>Maladie greffon hôte</term><term>Lymphocyte T</term><term>Déplétion</term><term>Enfant</term><term>Aigu</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Cellule souche</term><term>Enfant</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In order to compare the outcomes of unrelated umbilical cord blood transplants (UCBTs) or bone marrow transplants, 541 children with acute leukemia (AL) transplanted with umbilical cord blood (n = 99), T-cell-depleted unrelated bone marrow transplants (T-UBMT) (n = 180), or nonmanipulated (UBMT) (n = 262), were analyzed in a retrospective multicenter study. Comparisons were performed after adjustment for patient, disease, and transplant variables. The major difference between the 3 groups was the higher number in the UCBT group of HLA mismatches (defined by serology for class I and molecular typing for DRB1). The donor was HLA mismatched in 92% of UCBTs, in 18% of UBMTs, and in 43% of T-UBMTs (P <.001). Other significant differences were observed in pretransplant disease characteristics, preparative regimens, graft-versus-host disease (GVHD) prophylaxis, and number of cells infused. Nonadjusted estimates of 2-year survival and event-free survival rates were 49% and 43%, respectively, in the UBMT group, 41% and 37% in the T-UBMT group, and 35% and 31% in the UCBT group. After adjustment, differences in outcomes appeared in the first 100 days after the transplantation. Compared with UBMT recipients, UCBT recipients had delayed hematopoietic recovery (Hazard ratio [HR] = 0.37; 95% confidence interval [95CI]: 0.27-0.52; P <.001), increased 100 day transplant-related mortality (HR = 2.13; 95CI: 1.20-3.76; P <.01) and decreased acute graft-versus-host disease (aGVHD) (HR = 0.50; 95CI: 0.34-0.73; P <.001). T-UBMT recipients had decreased aGVHD (HR = 0.25; 95CI: 0.17-0.36; P <.0001) and increased risk of relapse (HR = 1.96; 95CI: 1.11-3.45; P = .02). After day 100 posttransplant, the 3 groups achieved similar results in terms of relapse. Chronic GVHD was decreased after T-UBMT (HR = 0.21; 95CI: 0.11-0.37; P <.0001) and UCBT (HR = 0.24; 95CI: 0.01-0.66; P =.002), and overall mortality was higher in T-UBMT recipients (HR = 1.39; 95CI: 0.97-1.99; P <.07). In conclusion, the use of UCBT, as a source of hematopoietic stem cells, is a reasonable option for children with AL lacking an acceptably matched unrelated marrow donor.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Autriche</li><li>Espagne</li><li>France</li><li>Italie</li><li>Japon</li><li>Royaume-Uni</li><li>Suède</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Auvergne-Rhône-Alpes</li><li>Catalogne</li><li>Grand Londres</li><li>Hambourg</li><li>Latium</li><li>Nouvelle-Galles du Sud</li><li>Piémont</li><li>Provence-Alpes-Côte d'Azur</li><li>Rhône-Alpes</li><li>Victoria (État)</li><li>Vienne (Autriche)</li></region><settlement><li>Barcelone</li><li>Hambourg</li><li>Londres</li><li>Lyon</li><li>Marseille</li><li>Melbourne</li><li>Rome</li><li>Sydney</li><li>Turin</li><li>Vienne (Autriche)</li></settlement></list><tree><noCountry><name sortKey="Arcese, William" sort="Arcese, William" uniqKey="Arcese W" first="William" last="Arcese">William Arcese</name><name sortKey="Busca, Alessandro" sort="Busca, Alessandro" uniqKey="Busca A" first="Alessandro" last="Busca">Alessandro Busca</name><name sortKey="Chan, Ka Wah" sort="Chan, Ka Wah" uniqKey="Chan K" first="Ka-Wah" last="Chan">Ka-Wah Chan</name><name sortKey="Chevret, Sylvie" sort="Chevret, Sylvie" uniqKey="Chevret S" first="Sylvie" last="Chevret">Sylvie Chevret</name><name sortKey="Cornish, Jacqueline" sort="Cornish, Jacqueline" uniqKey="Cornish J" first="Jacqueline" last="Cornish">Jacqueline Cornish</name><name sortKey="Dallorso, Sandro" sort="Dallorso, Sandro" uniqKey="Dallorso S" first="Sandro" last="Dallorso">Sandro Dallorso</name><name sortKey="Filipovich, Alexandra" sort="Filipovich, Alexandra" uniqKey="Filipovich A" first="Alexandra" last="Filipovich">Alexandra Filipovich</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="Green, Ann" sort="Green, Ann" uniqKey="Green A" first="Ann" last="Green">Ann Green</name><name sortKey="Kato, Shunichi" sort="Kato, Shunichi" uniqKey="Kato S" first="Shunichi" last="Kato">Shunichi Kato</name><name sortKey="Locatelli, Franco" sort="Locatelli, Franco" uniqKey="Locatelli F" first="Franco" last="Locatelli">Franco Locatelli</name><name sortKey="Lonescu, Irina" sort="Lonescu, Irina" uniqKey="Lonescu I" first="Irina" last="Lonescu">Irina Lonescu</name><name sortKey="Michel, Gerard" sort="Michel, Gerard" uniqKey="Michel G" first="Gérard" last="Michel">Gérard Michel</name><name sortKey="Oakill, Anthony" sort="Oakill, Anthony" uniqKey="Oakill A" first="Anthony" last="Oakill">Anthony Oakill</name><name sortKey="Ortega, Juan" sort="Ortega, Juan" uniqKey="Ortega J" first="Juan" last="Ortega">Juan Ortega</name><name sortKey="Pay, Andrea L" sort="Pay, Andrea L" uniqKey="Pay A" first="Andrea L." last="Pay">Andrea L. Pay</name><name sortKey="Peters, Cristina" sort="Peters, Cristina" uniqKey="Peters C" first="Cristina" last="Peters">Cristina Peters</name><name sortKey="Remberger, Mats" sort="Remberger, Mats" uniqKey="Remberger M" first="Mats" last="Remberger">Mats Remberger</name><name sortKey="Rubinstein, Pablo" sort="Rubinstein, Pablo" uniqKey="Rubinstein P" first="Pablo" last="Rubinstein">Pablo Rubinstein</name><name sortKey="Sievers, Eric L" sort="Sievers, Eric L" uniqKey="Sievers E" first="Eric L." last="Sievers">Eric L. Sievers</name><name sortKey="Sirchia, Girolamo" sort="Sirchia, Girolamo" uniqKey="Sirchia G" first="Girolamo" last="Sirchia">Girolamo Sirchia</name><name sortKey="Souillet, Gerard" sort="Souillet, Gerard" uniqKey="Souillet G" first="Gérard" last="Souillet">Gérard Souillet</name><name sortKey="Tiedemann, Karin" sort="Tiedemann, Karin" uniqKey="Tiedemann K" first="Karin" last="Tiedemann">Karin Tiedemann</name><name sortKey="Vowels, Marcus" sort="Vowels, Marcus" uniqKey="Vowels M" first="Marcus" last="Vowels">Marcus Vowels</name><name sortKey="Wernet, Peter" sort="Wernet, Peter" uniqKey="Wernet P" first="Peter" last="Wernet">Peter Wernet</name><name sortKey="Woolfrey, Ann" sort="Woolfrey, Ann" uniqKey="Woolfrey A" first="Ann" last="Woolfrey">Ann Woolfrey</name><name sortKey="Zander, Axel" sort="Zander, Axel" uniqKey="Zander A" first="Axel" last="Zander">Axel Zander</name></noCountry><country name="France"><noRegion><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name></noRegion><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name></country><country name="Royaume-Uni"><noRegion><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name></noRegion><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name></country><country name="États-Unis"><noRegion><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name></noRegion><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name></country><country name="Italie"><noRegion><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name></noRegion><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name></country><country name="Autriche"><region name="Vienne (Autriche)"><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name></region></country><country name="Suède"><noRegion><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name></noRegion></country><country name="Australie"><region name="Victoria (État)"><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name></region><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name></country><country name="Japon"><noRegion><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name></noRegion></country><country name="Espagne"><region name="Catalogne"><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name></region></country><country name="Allemagne"><region name="Hambourg"><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name></region><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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