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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">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><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff>
</affiliation>
<affiliation><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>
</affiliation>
<affiliation><nlm:aff id="af3-0991509">Cord Blood Committee EBMT, University of Genova, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Labopin, Myriam" sort="Labopin, Myriam" uniqKey="Labopin M" first="Myriam" last="Labopin">Myriam Labopin</name>
<affiliation><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>
</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><nlm:aff id="af4-0991509">Biostatistics Unit, Department of Health Sciences (DISSAL), University of Genova, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sanz, Guillermo" sort="Sanz, Guillermo" uniqKey="Sanz G" first="Guillermo" last="Sanz">Guillermo Sanz</name>
<affiliation><nlm:aff id="af5-0991509">Hospital Universitario y Politécnico La Fe, Valencia, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sanz, Jaime" sort="Sanz, Jaime" uniqKey="Sanz J" first="Jaime" last="Sanz">Jaime Sanz</name>
<affiliation><nlm:aff id="af5-0991509">Hospital Universitario y Politécnico La Fe, Valencia, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Volt, Fernanda" sort="Volt, Fernanda" uniqKey="Volt F" first="Fernanda" last="Volt">Fernanda Volt</name>
<affiliation><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Michel, Gerard" sort="Michel, Gerard" uniqKey="Michel G" first="Gerard" last="Michel">Gerard Michel</name>
<affiliation><nlm:aff id="af6-0991509">Hôpital d’Enfants de la Timone, Marseille, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Locatelli, Franco" sort="Locatelli, Franco" uniqKey="Locatelli F" first="Franco" last="Locatelli">Franco Locatelli</name>
<affiliation><nlm:aff id="af7-0991509">Dipartimento di Oncoematologia Pediatrica, Ospedale Bambino Gesù, IRCSS, Rome/University of Pavia, Italy</nlm:aff>
</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><nlm:aff id="af8-0991509">Servicio de Hematologia y Oncologia Pediátricas, Hospital Universitario Vall d’Hebron, Barcelona, Spain</nlm:aff>
</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><nlm:aff id="af9-0991509">Sydney Children’s Hospital, Sydney, Australia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Arcese, William" sort="Arcese, William" uniqKey="Arcese W" first="William" last="Arcese">William Arcese</name>
<affiliation><nlm:aff id="af10-0991509">Rome Transplant Network, University Tor Vergata, Rome, Italy</nlm:aff>
</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><nlm:aff id="af11-0991509">Università La Sapienza, Dip. Biotecnologie Cellulari ed Ematologia, Rome, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Querol, Sergi" sort="Querol, Sergi" uniqKey="Querol S" first="Sergi" last="Querol">Sergi Querol</name>
<affiliation><nlm:aff id="af12-0991509">Barcelona Cord Blood Bank, Barcelona, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kogler, Gesine" sort="Kogler, Gesine" uniqKey="Kogler G" first="Gesine" last="Kogler">Gesine Kogler</name>
<affiliation><nlm:aff id="af13-0991509">Dusseldorf Cord Blood Bank, University of Dusseldorf, Germany</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lecchi, Lucilla" sort="Lecchi, Lucilla" uniqKey="Lecchi L" first="Lucilla" last="Lecchi">Lucilla Lecchi</name>
<affiliation><nlm:aff id="af14-0991509">Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Pouthier, Fabienne" sort="Pouthier, Fabienne" uniqKey="Pouthier F" first="Fabienne" last="Pouthier">Fabienne Pouthier</name>
<affiliation><nlm:aff id="af15-0991509">Besançon Cord Blood Bank of the Etablissement Français du Sang, Besançon, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Garnier, Federico" sort="Garnier, Federico" uniqKey="Garnier F" first="Federico" last="Garnier">Federico Garnier</name>
<affiliation><nlm:aff id="af16-0991509">Agence de la Biomedecine, Paris, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Navarrete, Cristina" sort="Navarrete, Cristina" uniqKey="Navarrete C" first="Cristina" last="Navarrete">Cristina Navarrete</name>
<affiliation><nlm:aff id="af17-0991509">NHS-Cord Blood Bank, NHSBT, Colindale Ave, and University College London, UK</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Baudoux, Etienne" sort="Baudoux, Etienne" uniqKey="Baudoux E" first="Etienne" last="Baudoux">Etienne Baudoux</name>
<affiliation><nlm:aff id="af18-0991509">Liege Cord Blood Bank, University of Liege, Belgium</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Fernandes, Juliana" sort="Fernandes, Juliana" uniqKey="Fernandes J" first="Juliana" last="Fernandes">Juliana Fernandes</name>
<affiliation><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kenzey, Chantal" sort="Kenzey, Chantal" uniqKey="Kenzey C" first="Chantal" last="Kenzey">Chantal Kenzey</name>
<affiliation><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Eapen, Mary" sort="Eapen, Mary" uniqKey="Eapen M" first="Mary" last="Eapen">Mary Eapen</name>
<affiliation><nlm:aff id="af19-0991509">Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gluckman, Eliane" sort="Gluckman, Eliane" uniqKey="Gluckman E" first="Eliane" last="Gluckman">Eliane Gluckman</name>
<affiliation><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af20-0991509">Monacord, Centre Scientifique de Monaco, Monaco</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name>
<affiliation><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af21-0991509">Churchill Hospital, Oxford University Hospitals, UK</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Saccardi, Riccardo" sort="Saccardi, Riccardo" uniqKey="Saccardi R" first="Riccardo" last="Saccardi">Riccardo Saccardi</name>
<affiliation><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af22-0991509">Careggi University Hospital, Florence, Italy</nlm:aff>
</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 type="doi">10.3324/haematol.2014.109280</idno>
<date when="2014">2014</date>
<idno type="wicri:Area/Pmc/Corpus">000188</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000188</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><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff>
</affiliation>
<affiliation><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>
</affiliation>
<affiliation><nlm:aff id="af3-0991509">Cord Blood Committee EBMT, University of Genova, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Labopin, Myriam" sort="Labopin, Myriam" uniqKey="Labopin M" first="Myriam" last="Labopin">Myriam Labopin</name>
<affiliation><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>
</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><nlm:aff id="af4-0991509">Biostatistics Unit, Department of Health Sciences (DISSAL), University of Genova, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sanz, Guillermo" sort="Sanz, Guillermo" uniqKey="Sanz G" first="Guillermo" last="Sanz">Guillermo Sanz</name>
<affiliation><nlm:aff id="af5-0991509">Hospital Universitario y Politécnico La Fe, Valencia, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sanz, Jaime" sort="Sanz, Jaime" uniqKey="Sanz J" first="Jaime" last="Sanz">Jaime Sanz</name>
<affiliation><nlm:aff id="af5-0991509">Hospital Universitario y Politécnico La Fe, Valencia, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Volt, Fernanda" sort="Volt, Fernanda" uniqKey="Volt F" first="Fernanda" last="Volt">Fernanda Volt</name>
<affiliation><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Michel, Gerard" sort="Michel, Gerard" uniqKey="Michel G" first="Gerard" last="Michel">Gerard Michel</name>
<affiliation><nlm:aff id="af6-0991509">Hôpital d’Enfants de la Timone, Marseille, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Locatelli, Franco" sort="Locatelli, Franco" uniqKey="Locatelli F" first="Franco" last="Locatelli">Franco Locatelli</name>
<affiliation><nlm:aff id="af7-0991509">Dipartimento di Oncoematologia Pediatrica, Ospedale Bambino Gesù, IRCSS, Rome/University of Pavia, Italy</nlm:aff>
</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><nlm:aff id="af8-0991509">Servicio de Hematologia y Oncologia Pediátricas, Hospital Universitario Vall d’Hebron, Barcelona, Spain</nlm:aff>
</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><nlm:aff id="af9-0991509">Sydney Children’s Hospital, Sydney, Australia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Arcese, William" sort="Arcese, William" uniqKey="Arcese W" first="William" last="Arcese">William Arcese</name>
<affiliation><nlm:aff id="af10-0991509">Rome Transplant Network, University Tor Vergata, Rome, Italy</nlm:aff>
</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><nlm:aff id="af11-0991509">Università La Sapienza, Dip. Biotecnologie Cellulari ed Ematologia, Rome, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Querol, Sergi" sort="Querol, Sergi" uniqKey="Querol S" first="Sergi" last="Querol">Sergi Querol</name>
<affiliation><nlm:aff id="af12-0991509">Barcelona Cord Blood Bank, Barcelona, Spain</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kogler, Gesine" sort="Kogler, Gesine" uniqKey="Kogler G" first="Gesine" last="Kogler">Gesine Kogler</name>
<affiliation><nlm:aff id="af13-0991509">Dusseldorf Cord Blood Bank, University of Dusseldorf, Germany</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lecchi, Lucilla" sort="Lecchi, Lucilla" uniqKey="Lecchi L" first="Lucilla" last="Lecchi">Lucilla Lecchi</name>
<affiliation><nlm:aff id="af14-0991509">Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Pouthier, Fabienne" sort="Pouthier, Fabienne" uniqKey="Pouthier F" first="Fabienne" last="Pouthier">Fabienne Pouthier</name>
<affiliation><nlm:aff id="af15-0991509">Besançon Cord Blood Bank of the Etablissement Français du Sang, Besançon, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Garnier, Federico" sort="Garnier, Federico" uniqKey="Garnier F" first="Federico" last="Garnier">Federico Garnier</name>
<affiliation><nlm:aff id="af16-0991509">Agence de la Biomedecine, Paris, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Navarrete, Cristina" sort="Navarrete, Cristina" uniqKey="Navarrete C" first="Cristina" last="Navarrete">Cristina Navarrete</name>
<affiliation><nlm:aff id="af17-0991509">NHS-Cord Blood Bank, NHSBT, Colindale Ave, and University College London, UK</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Baudoux, Etienne" sort="Baudoux, Etienne" uniqKey="Baudoux E" first="Etienne" last="Baudoux">Etienne Baudoux</name>
<affiliation><nlm:aff id="af18-0991509">Liege Cord Blood Bank, University of Liege, Belgium</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Fernandes, Juliana" sort="Fernandes, Juliana" uniqKey="Fernandes J" first="Juliana" last="Fernandes">Juliana Fernandes</name>
<affiliation><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kenzey, Chantal" sort="Kenzey, Chantal" uniqKey="Kenzey C" first="Chantal" last="Kenzey">Chantal Kenzey</name>
<affiliation><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Eapen, Mary" sort="Eapen, Mary" uniqKey="Eapen M" first="Mary" last="Eapen">Mary Eapen</name>
<affiliation><nlm:aff id="af19-0991509">Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gluckman, Eliane" sort="Gluckman, Eliane" uniqKey="Gluckman E" first="Eliane" last="Gluckman">Eliane Gluckman</name>
<affiliation><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af20-0991509">Monacord, Centre Scientifique de Monaco, Monaco</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name>
<affiliation><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af21-0991509">Churchill Hospital, Oxford University Hospitals, UK</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Saccardi, Riccardo" sort="Saccardi, Riccardo" uniqKey="Saccardi R" first="Riccardo" last="Saccardi">Riccardo Saccardi</name>
<affiliation><nlm:aff id="af1-0991509">Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af22-0991509">Careggi University Hospital, Florence, Italy</nlm:aff>
</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></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>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
  <front><journal-meta><journal-id journal-id-type="nlm-ta">Haematologica</journal-id>
<journal-id journal-id-type="iso-abbrev">Haematologica</journal-id>
<journal-id journal-id-type="hwp">haematol</journal-id>
<journal-id journal-id-type="publisher-id">Haematologica</journal-id>
<journal-title-group><journal-title>Haematologica</journal-title>
</journal-title-group>
<issn pub-type="ppub">0390-6078</issn>
<issn pub-type="epub">1592-8721</issn>
<publisher><publisher-name>Ferrata Storti Foundation</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24972767</article-id>
<article-id pub-id-type="pmc">4562541</article-id>
<article-id pub-id-type="doi">10.3324/haematol.2014.109280</article-id>
<article-id pub-id-type="publisher-id">0991509</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Articles</subject>
<subj-group subj-group-type="heading"><subject>Stem Cell Transplantation</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group><article-title>Engraftment kinetics and graft failure after single umbilical cord
blood transplantation using a myeloablative conditioning regimen</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Ruggeri</surname>
<given-names>Annalisa</given-names>
</name>
<xref ref-type="aff" rid="af1-0991509">1</xref>
<xref ref-type="aff" rid="af2-0991509">2</xref>
<xref ref-type="aff" rid="af3-0991509">3</xref>
<xref ref-type="corresp" rid="c1-0991509"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Labopin</surname>
<given-names>Myriam</given-names>
</name>
<xref ref-type="aff" rid="af2-0991509">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sormani</surname>
<given-names>Maria Pia</given-names>
</name>
<xref ref-type="aff" rid="af4-0991509">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sanz</surname>
<given-names>Guillermo</given-names>
</name>
<xref ref-type="aff" rid="af5-0991509">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sanz</surname>
<given-names>Jaime</given-names>
</name>
<xref ref-type="aff" rid="af5-0991509">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Volt</surname>
<given-names>Fernanda</given-names>
</name>
<xref ref-type="aff" rid="af1-0991509">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Michel</surname>
<given-names>Gerard</given-names>
</name>
<xref ref-type="aff" rid="af6-0991509">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Locatelli</surname>
<given-names>Franco</given-names>
</name>
<xref ref-type="aff" rid="af7-0991509">7</xref>
</contrib>
<contrib contrib-type="author"><name><surname>De Heredia</surname>
<given-names>Cristina Diaz</given-names>
</name>
<xref ref-type="aff" rid="af8-0991509">8</xref>
</contrib>
<contrib contrib-type="author"><name><surname>O’Brien</surname>
<given-names>Tracey</given-names>
</name>
<xref ref-type="aff" rid="af9-0991509">9</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Arcese</surname>
<given-names>William</given-names>
</name>
<xref ref-type="aff" rid="af10-0991509">10</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Iori</surname>
<given-names>Anna Paola</given-names>
</name>
<xref ref-type="aff" rid="af11-0991509">11</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Querol</surname>
<given-names>Sergi</given-names>
</name>
<xref ref-type="aff" rid="af12-0991509">12</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kogler</surname>
<given-names>Gesine</given-names>
</name>
<xref ref-type="aff" rid="af13-0991509">13</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lecchi</surname>
<given-names>Lucilla</given-names>
</name>
<xref ref-type="aff" rid="af14-0991509">14</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pouthier</surname>
<given-names>Fabienne</given-names>
</name>
<xref ref-type="aff" rid="af15-0991509">15</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Garnier</surname>
<given-names>Federico</given-names>
</name>
<xref ref-type="aff" rid="af16-0991509">16</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Navarrete</surname>
<given-names>Cristina</given-names>
</name>
<xref ref-type="aff" rid="af17-0991509">17</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Baudoux</surname>
<given-names>Etienne</given-names>
</name>
<xref ref-type="aff" rid="af18-0991509">18</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fernandes</surname>
<given-names>Juliana</given-names>
</name>
<xref ref-type="aff" rid="af1-0991509">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kenzey</surname>
<given-names>Chantal</given-names>
</name>
<xref ref-type="aff" rid="af1-0991509">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Eapen</surname>
<given-names>Mary</given-names>
</name>
<xref ref-type="aff" rid="af19-0991509">19</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gluckman</surname>
<given-names>Eliane</given-names>
</name>
<xref ref-type="aff" rid="af1-0991509">1</xref>
<xref ref-type="aff" rid="af20-0991509">20</xref>
<xref ref-type="author-notes" rid="fn1-0991509">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rocha</surname>
<given-names>Vanderson</given-names>
</name>
<xref ref-type="aff" rid="af1-0991509">1</xref>
<xref ref-type="aff" rid="af21-0991509">21</xref>
<xref ref-type="author-notes" rid="fn1-0991509">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Saccardi</surname>
<given-names>Riccardo</given-names>
</name>
<xref ref-type="aff" rid="af1-0991509">1</xref>
<xref ref-type="aff" rid="af22-0991509">22</xref>
<xref ref-type="author-notes" rid="fn1-0991509">*</xref>
</contrib>
<on-behalf-of>on behalf of Eurocord, Cord Blood Committee EBMT and
Netcord</on-behalf-of>
</contrib-group>
<aff id="af1-0991509"><label>1</label>
Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France</aff>
<aff id="af2-0991509"><label>2</label>
Hospital Saint Antoine, Service d’Hématologie et Thérapie Cellulaire, AP-HP, UPMC University of Paris 06, UMR-S 938, CEREST-TC EBMT, France</aff>
<aff id="af3-0991509"><label>3</label>
Cord Blood Committee EBMT, University of Genova, Italy</aff>
<aff id="af4-0991509"><label>4</label>
Biostatistics Unit, Department of Health Sciences (DISSAL), University of Genova, Italy</aff>
<aff id="af5-0991509"><label>5</label>
Hospital Universitario y Politécnico La Fe, Valencia, Spain</aff>
<aff id="af6-0991509"><label>6</label>
Hôpital d’Enfants de la Timone, Marseille, France</aff>
<aff id="af7-0991509"><label>7</label>
Dipartimento di Oncoematologia Pediatrica, Ospedale Bambino Gesù, IRCSS, Rome/University of Pavia, Italy</aff>
<aff id="af8-0991509"><label>8</label>
Servicio de Hematologia y Oncologia Pediátricas, Hospital Universitario Vall d’Hebron, Barcelona, Spain</aff>
<aff id="af9-0991509"><label>9</label>
Sydney Children’s Hospital, Sydney, Australia</aff>
<aff id="af10-0991509"><label>10</label>
Rome Transplant Network, University Tor Vergata, Rome, Italy</aff>
<aff id="af11-0991509"><label>11</label>
Università La Sapienza, Dip. Biotecnologie Cellulari ed Ematologia, Rome, Italy</aff>
<aff id="af12-0991509"><label>12</label>
Barcelona Cord Blood Bank, Barcelona, Spain</aff>
<aff id="af13-0991509"><label>13</label>
Dusseldorf Cord Blood Bank, University of Dusseldorf, Germany</aff>
<aff id="af14-0991509"><label>14</label>
Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy</aff>
<aff id="af15-0991509"><label>15</label>
Besançon Cord Blood Bank of the Etablissement Français du Sang, Besançon, France</aff>
<aff id="af16-0991509"><label>16</label>
Agence de la Biomedecine, Paris, France</aff>
<aff id="af17-0991509"><label>17</label>
NHS-Cord Blood Bank, NHSBT, Colindale Ave, and University College London, UK</aff>
<aff id="af18-0991509"><label>18</label>
Liege Cord Blood Bank, University of Liege, Belgium</aff>
<aff id="af19-0991509"><label>19</label>
Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA</aff>
<aff id="af20-0991509"><label>20</label>
Monacord, Centre Scientifique de Monaco, Monaco</aff>
<aff id="af21-0991509"><label>21</label>
Churchill Hospital, Oxford University Hospitals, UK</aff>
<aff id="af22-0991509"><label>22</label>
Careggi University Hospital, Florence, Italy</aff>
<author-notes><corresp id="c1-0991509">Correspondence:
<email>annalisa.ruggeri@sls.aphp.fr</email>
</corresp>
<fn id="fn1-0991509"><label>*</label>
<p>EG, VR and RS are co-senior authors</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><month>9</month>
<year>2014</year>
</pub-date>
<volume>99</volume>
<issue>9</issue>
<fpage>1509</fpage>
<lpage>1515</lpage>
<history><date date-type="received"><day>15</day>
<month>4</month>
<year>2014</year>
</date>
<date date-type="accepted"><day>23</day>
<month>6</month>
<year>2014</year>
</date>
</history>
<permissions><copyright-statement>Copyright© Ferrata Storti Foundation</copyright-statement>
<copyright-year>2014</copyright-year>
</permissions>
<self-uri content-type="pdf" xlink:type="simple" xlink:href="991509.pdf"></self-uri>
<abstract><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>
</abstract>
</article-meta>
</front>
</pmc>
</record>

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