Engraftment kinetics and graft failure after single umbilical cord blood transplantation using a myeloablative conditioning regimen.
Identifieur interne : 003470 ( PubMed/Corpus ); précédent : 003469; suivant : 003471Engraftment kinetics and graft failure after single umbilical cord blood transplantation using a myeloablative conditioning regimen.
Auteurs : Annalisa Ruggeri ; Myriam Labopin ; Maria Pia Sormani ; Guillermo Sanz ; Jaime Sanz ; Fernanda Volt ; Gerard Michel ; Franco Locatelli ; Cristina Diaz De Heredia ; Tracey O'Brien ; William Arcese ; Anna Paola Iori ; Sergi Querol ; Gesine Kogler ; Lucilla Lecchi ; Fabienne Pouthier ; Federico Garnier ; Cristina Navarrete ; Etienne Baudoux ; Juliana Fernandes ; Chantal Kenzey ; Mary Eapen ; Eliane Gluckman ; Vanderson Rocha ; Riccardo SaccardiSource :
- Haematologica [ 1592-8721 ] ; 2014.
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.
DOI: 10.3324/haematol.2014.109280
PubMed: 24972767
Links to Exploration step
pubmed:24972767Le document en format XML
<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:affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Hospital Saint Antoine, Service d'Hématologie et Thérapie Cellulaire, AP-HP, UPMC University of Paris 06, UMR-S 938, CEREST-TC EBMT, France Cord Blood Committee EBMT, University of Genova, Italy annalisa.ruggeri@sls.aphp.fr.</nlm:affiliation>
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<author><name sortKey="Labopin, Myriam" sort="Labopin, Myriam" uniqKey="Labopin M" first="Myriam" last="Labopin">Myriam Labopin</name>
<affiliation><nlm:affiliation>Hospital Saint Antoine, Service d'Hématologie et Thérapie Cellulaire, AP-HP, UPMC University of Paris 06, UMR-S 938, CEREST-TC EBMT, France.</nlm:affiliation>
</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:affiliation>Biostatistics Unit, Department of Health Sciences (DISSAL), University of Genova, Italy.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Sanz, Guillermo" sort="Sanz, Guillermo" uniqKey="Sanz G" first="Guillermo" last="Sanz">Guillermo Sanz</name>
<affiliation><nlm:affiliation>Hospital Universitario y Politécnico La Fe, Valencia, Spain.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sanz, Jaime" sort="Sanz, Jaime" uniqKey="Sanz J" first="Jaime" last="Sanz">Jaime Sanz</name>
<affiliation><nlm:affiliation>Hospital Universitario y Politécnico La Fe, Valencia, Spain.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Volt, Fernanda" sort="Volt, Fernanda" uniqKey="Volt F" first="Fernanda" last="Volt">Fernanda Volt</name>
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</affiliation>
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<author><name sortKey="Michel, Gerard" sort="Michel, Gerard" uniqKey="Michel G" first="Gerard" last="Michel">Gerard Michel</name>
<affiliation><nlm:affiliation>Hôpital d'Enfants de la Timone, Marseille, France.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Locatelli, Franco" sort="Locatelli, Franco" uniqKey="Locatelli F" first="Franco" last="Locatelli">Franco Locatelli</name>
<affiliation><nlm:affiliation>Dipartimento di Oncoematologia Pediatrica, Ospedale Bambino Gesù, IRCSS, Rome/University of Pavia, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Diaz De Heredia, Cristina" sort="Diaz De Heredia, Cristina" uniqKey="Diaz De Heredia C" first="Cristina" last="Diaz De Heredia">Cristina Diaz De Heredia</name>
<affiliation><nlm:affiliation>Servicio de Hematologia y Oncologia Pediátricas, Hospital Universitario Vall d'Hebron, Barcelona, Spain.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="O Brien, Tracey" sort="O Brien, Tracey" uniqKey="O Brien T" first="Tracey" last="O'Brien">Tracey O'Brien</name>
<affiliation><nlm:affiliation>Sydney Children's Hospital, Sydney, Australia.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Arcese, William" sort="Arcese, William" uniqKey="Arcese W" first="William" last="Arcese">William Arcese</name>
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</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:affiliation>Università La Sapienza, Dip. Biotecnologie Cellulari ed Ematologia, Rome, Italy.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Querol, Sergi" sort="Querol, Sergi" uniqKey="Querol S" first="Sergi" last="Querol">Sergi Querol</name>
<affiliation><nlm:affiliation>Barcelona Cord Blood Bank, Barcelona, Spain.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Kogler, Gesine" sort="Kogler, Gesine" uniqKey="Kogler G" first="Gesine" last="Kogler">Gesine Kogler</name>
<affiliation><nlm:affiliation>Dusseldorf Cord Blood Bank, University of Dusseldorf, Germany.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Lecchi, Lucilla" sort="Lecchi, Lucilla" uniqKey="Lecchi L" first="Lucilla" last="Lecchi">Lucilla Lecchi</name>
<affiliation><nlm:affiliation>Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Pouthier, Fabienne" sort="Pouthier, Fabienne" uniqKey="Pouthier F" first="Fabienne" last="Pouthier">Fabienne Pouthier</name>
<affiliation><nlm:affiliation>Besançon Cord Blood Bank of the Etablissement Français du Sang, Besançon, France.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Garnier, Federico" sort="Garnier, Federico" uniqKey="Garnier F" first="Federico" last="Garnier">Federico Garnier</name>
<affiliation><nlm:affiliation>Agence de la Biomedecine, Paris, France.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Navarrete, Cristina" sort="Navarrete, Cristina" uniqKey="Navarrete C" first="Cristina" last="Navarrete">Cristina Navarrete</name>
<affiliation><nlm:affiliation>NHS-Cord Blood Bank, NHSBT, Colindale Ave, and University College London, UK.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Baudoux, Etienne" sort="Baudoux, Etienne" uniqKey="Baudoux E" first="Etienne" last="Baudoux">Etienne Baudoux</name>
<affiliation><nlm:affiliation>Liege Cord Blood Bank, University of Liege, Belgium.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Fernandes, Juliana" sort="Fernandes, Juliana" uniqKey="Fernandes J" first="Juliana" last="Fernandes">Juliana Fernandes</name>
<affiliation><nlm:affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Kenzey, Chantal" sort="Kenzey, Chantal" uniqKey="Kenzey C" first="Chantal" last="Kenzey">Chantal Kenzey</name>
<affiliation><nlm:affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Eapen, Mary" sort="Eapen, Mary" uniqKey="Eapen M" first="Mary" last="Eapen">Mary Eapen</name>
<affiliation><nlm:affiliation>Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Gluckman, Eliane" sort="Gluckman, Eliane" uniqKey="Gluckman E" first="Eliane" last="Gluckman">Eliane Gluckman</name>
<affiliation><nlm:affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Monacord, Centre Scientifique de Monaco, Monaco.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name>
<affiliation><nlm:affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Churchill Hospital, Oxford University Hospitals, UK.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Saccardi, Riccardo" sort="Saccardi, Riccardo" uniqKey="Saccardi R" first="Riccardo" last="Saccardi">Riccardo Saccardi</name>
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<sourceDesc><biblStruct><analytic><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:affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Hospital Saint Antoine, Service d'Hématologie et Thérapie Cellulaire, AP-HP, UPMC University of Paris 06, UMR-S 938, CEREST-TC EBMT, France Cord Blood Committee EBMT, University of Genova, Italy annalisa.ruggeri@sls.aphp.fr.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Labopin, Myriam" sort="Labopin, Myriam" uniqKey="Labopin M" first="Myriam" last="Labopin">Myriam Labopin</name>
<affiliation><nlm:affiliation>Hospital Saint Antoine, Service d'Hématologie et Thérapie Cellulaire, AP-HP, UPMC University of Paris 06, UMR-S 938, CEREST-TC EBMT, France.</nlm:affiliation>
</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:affiliation>Biostatistics Unit, Department of Health Sciences (DISSAL), University of Genova, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sanz, Guillermo" sort="Sanz, Guillermo" uniqKey="Sanz G" first="Guillermo" last="Sanz">Guillermo Sanz</name>
<affiliation><nlm:affiliation>Hospital Universitario y Politécnico La Fe, Valencia, Spain.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sanz, Jaime" sort="Sanz, Jaime" uniqKey="Sanz J" first="Jaime" last="Sanz">Jaime Sanz</name>
<affiliation><nlm:affiliation>Hospital Universitario y Politécnico La Fe, Valencia, Spain.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Volt, Fernanda" sort="Volt, Fernanda" uniqKey="Volt F" first="Fernanda" last="Volt">Fernanda Volt</name>
<affiliation><nlm:affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Michel, Gerard" sort="Michel, Gerard" uniqKey="Michel G" first="Gerard" last="Michel">Gerard Michel</name>
<affiliation><nlm:affiliation>Hôpital d'Enfants de la Timone, Marseille, France.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Locatelli, Franco" sort="Locatelli, Franco" uniqKey="Locatelli F" first="Franco" last="Locatelli">Franco Locatelli</name>
<affiliation><nlm:affiliation>Dipartimento di Oncoematologia Pediatrica, Ospedale Bambino Gesù, IRCSS, Rome/University of Pavia, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Diaz De Heredia, Cristina" sort="Diaz De Heredia, Cristina" uniqKey="Diaz De Heredia C" first="Cristina" last="Diaz De Heredia">Cristina Diaz De Heredia</name>
<affiliation><nlm:affiliation>Servicio de Hematologia y Oncologia Pediátricas, Hospital Universitario Vall d'Hebron, Barcelona, Spain.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="O Brien, Tracey" sort="O Brien, Tracey" uniqKey="O Brien T" first="Tracey" last="O'Brien">Tracey O'Brien</name>
<affiliation><nlm:affiliation>Sydney Children's Hospital, Sydney, Australia.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Arcese, William" sort="Arcese, William" uniqKey="Arcese W" first="William" last="Arcese">William Arcese</name>
<affiliation><nlm:affiliation>Rome Transplant Network, University Tor Vergata, Rome, Italy.</nlm:affiliation>
</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:affiliation>Università La Sapienza, Dip. Biotecnologie Cellulari ed Ematologia, Rome, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Querol, Sergi" sort="Querol, Sergi" uniqKey="Querol S" first="Sergi" last="Querol">Sergi Querol</name>
<affiliation><nlm:affiliation>Barcelona Cord Blood Bank, Barcelona, Spain.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Kogler, Gesine" sort="Kogler, Gesine" uniqKey="Kogler G" first="Gesine" last="Kogler">Gesine Kogler</name>
<affiliation><nlm:affiliation>Dusseldorf Cord Blood Bank, University of Dusseldorf, Germany.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Lecchi, Lucilla" sort="Lecchi, Lucilla" uniqKey="Lecchi L" first="Lucilla" last="Lecchi">Lucilla Lecchi</name>
<affiliation><nlm:affiliation>Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Pouthier, Fabienne" sort="Pouthier, Fabienne" uniqKey="Pouthier F" first="Fabienne" last="Pouthier">Fabienne Pouthier</name>
<affiliation><nlm:affiliation>Besançon Cord Blood Bank of the Etablissement Français du Sang, Besançon, France.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Garnier, Federico" sort="Garnier, Federico" uniqKey="Garnier F" first="Federico" last="Garnier">Federico Garnier</name>
<affiliation><nlm:affiliation>Agence de la Biomedecine, Paris, France.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Navarrete, Cristina" sort="Navarrete, Cristina" uniqKey="Navarrete C" first="Cristina" last="Navarrete">Cristina Navarrete</name>
<affiliation><nlm:affiliation>NHS-Cord Blood Bank, NHSBT, Colindale Ave, and University College London, UK.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Baudoux, Etienne" sort="Baudoux, Etienne" uniqKey="Baudoux E" first="Etienne" last="Baudoux">Etienne Baudoux</name>
<affiliation><nlm:affiliation>Liege Cord Blood Bank, University of Liege, Belgium.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Fernandes, Juliana" sort="Fernandes, Juliana" uniqKey="Fernandes J" first="Juliana" last="Fernandes">Juliana Fernandes</name>
<affiliation><nlm:affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Kenzey, Chantal" sort="Kenzey, Chantal" uniqKey="Kenzey C" first="Chantal" last="Kenzey">Chantal Kenzey</name>
<affiliation><nlm:affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Eapen, Mary" sort="Eapen, Mary" uniqKey="Eapen M" first="Mary" last="Eapen">Mary Eapen</name>
<affiliation><nlm:affiliation>Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Gluckman, Eliane" sort="Gluckman, Eliane" uniqKey="Gluckman E" first="Eliane" last="Gluckman">Eliane Gluckman</name>
<affiliation><nlm:affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Monacord, Centre Scientifique de Monaco, Monaco.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name>
<affiliation><nlm:affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Churchill Hospital, Oxford University Hospitals, UK.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Saccardi, Riccardo" sort="Saccardi, Riccardo" uniqKey="Saccardi R" first="Riccardo" last="Saccardi">Riccardo Saccardi</name>
<affiliation><nlm:affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Careggi University Hospital, Florence, Italy.</nlm:affiliation>
</affiliation>
</author>
</analytic>
<series><title level="j">Haematologica</title>
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<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="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Myeloablative Agonists</term>
</keywords>
<keywords scheme="MESH" qualifier="cytology" xml:lang="en"><term>Neutrophils</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="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" 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>
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<front><div type="abstract" xml:lang="en">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.</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">24972767</PMID>
<DateCreated><Year>2014</Year>
<Month>09</Month>
<Day>01</Day>
</DateCreated>
<DateCompleted><Year>2015</Year>
<Month>04</Month>
<Day>06</Day>
</DateCompleted>
<DateRevised><Year>2017</Year>
<Month>09</Month>
<Day>22</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1592-8721</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>99</Volume>
<Issue>9</Issue>
<PubDate><Year>2014</Year>
<Month>Sep</Month>
</PubDate>
</JournalIssue>
<Title>Haematologica</Title>
<ISOAbbreviation>Haematologica</ISOAbbreviation>
</Journal>
<ArticleTitle>Engraftment kinetics and graft failure after single umbilical cord blood transplantation using a myeloablative conditioning regimen.</ArticleTitle>
<Pagination><MedlinePgn>1509-15</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.3324/haematol.2014.109280</ELocationID>
<Abstract><AbstractText>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.</AbstractText>
<CopyrightInformation>Copyright© Ferrata Storti Foundation.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ruggeri</LastName>
<ForeName>Annalisa</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Hospital Saint Antoine, Service d'Hématologie et Thérapie Cellulaire, AP-HP, UPMC University of Paris 06, UMR-S 938, CEREST-TC EBMT, France Cord Blood Committee EBMT, University of Genova, Italy annalisa.ruggeri@sls.aphp.fr.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Labopin</LastName>
<ForeName>Myriam</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Hospital Saint Antoine, Service d'Hématologie et Thérapie Cellulaire, AP-HP, UPMC University of Paris 06, UMR-S 938, CEREST-TC EBMT, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sormani</LastName>
<ForeName>Maria Pia</ForeName>
<Initials>MP</Initials>
<AffiliationInfo><Affiliation>Biostatistics Unit, Department of Health Sciences (DISSAL), University of Genova, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sanz</LastName>
<ForeName>Guillermo</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>Hospital Universitario y Politécnico La Fe, Valencia, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sanz</LastName>
<ForeName>Jaime</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Hospital Universitario y Politécnico La Fe, Valencia, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Volt</LastName>
<ForeName>Fernanda</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Michel</LastName>
<ForeName>Gerard</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>Hôpital d'Enfants de la Timone, Marseille, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Locatelli</LastName>
<ForeName>Franco</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>Dipartimento di Oncoematologia Pediatrica, Ospedale Bambino Gesù, IRCSS, Rome/University of Pavia, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Diaz De Heredia</LastName>
<ForeName>Cristina</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Servicio de Hematologia y Oncologia Pediátricas, Hospital Universitario Vall d'Hebron, Barcelona, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>O'Brien</LastName>
<ForeName>Tracey</ForeName>
<Initials>T</Initials>
<AffiliationInfo><Affiliation>Sydney Children's Hospital, Sydney, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Arcese</LastName>
<ForeName>William</ForeName>
<Initials>W</Initials>
<AffiliationInfo><Affiliation>Rome Transplant Network, University Tor Vergata, Rome, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Iori</LastName>
<ForeName>Anna Paola</ForeName>
<Initials>AP</Initials>
<AffiliationInfo><Affiliation>Università La Sapienza, Dip. Biotecnologie Cellulari ed Ematologia, Rome, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Querol</LastName>
<ForeName>Sergi</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Barcelona Cord Blood Bank, Barcelona, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Kogler</LastName>
<ForeName>Gesine</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>Dusseldorf Cord Blood Bank, University of Dusseldorf, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lecchi</LastName>
<ForeName>Lucilla</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Pouthier</LastName>
<ForeName>Fabienne</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>Besançon Cord Blood Bank of the Etablissement Français du Sang, Besançon, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Garnier</LastName>
<ForeName>Federico</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>Agence de la Biomedecine, Paris, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Navarrete</LastName>
<ForeName>Cristina</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>NHS-Cord Blood Bank, NHSBT, Colindale Ave, and University College London, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Baudoux</LastName>
<ForeName>Etienne</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Liege Cord Blood Bank, University of Liege, Belgium.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Fernandes</LastName>
<ForeName>Juliana</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Kenzey</LastName>
<ForeName>Chantal</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Eapen</LastName>
<ForeName>Mary</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Gluckman</LastName>
<ForeName>Eliane</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Monacord, Centre Scientifique de Monaco, Monaco.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Rocha</LastName>
<ForeName>Vanderson</ForeName>
<Initials>V</Initials>
<AffiliationInfo><Affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Churchill Hospital, Oxford University Hospitals, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Saccardi</LastName>
<ForeName>Riccardo</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Careggi University Hospital, Florence, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><CollectiveName>Eurocord</CollectiveName>
</Author>
<Author ValidYN="Y"><CollectiveName>Cord Blood Committee EBMT</CollectiveName>
</Author>
<Author ValidYN="Y"><CollectiveName>Netcord</CollectiveName>
</Author>
</AuthorList>
<Language>eng</Language>
<GrantList CompleteYN="Y"><Grant><GrantID>RP-PG-0310-1003</GrantID>
<Agency>Department of Health</Agency>
<Country>United Kingdom</Country>
</Grant>
<Grant><Agency>Department of Health</Agency>
<Country>United Kingdom</Country>
</Grant>
</GrantList>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2014</Year>
<Month>06</Month>
<Day>27</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>Italy</Country>
<MedlineTA>Haematologica</MedlineTA>
<NlmUniqueID>0417435</NlmUniqueID>
<ISSNLinking>0390-6078</ISSNLinking>
</MedlineJournalInfo>
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<NameOfSubstance UI="D019653">Myeloablative Agonists</NameOfSubstance>
</Chemical>
</ChemicalList>
<CitationSubset>IM</CitationSubset>
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<MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D002675" MajorTopicYN="N">Child, Preschool</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D036101" MajorTopicYN="Y">Cord Blood Stem Cell Transplantation</DescriptorName>
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<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
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<MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName>
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<MeshHeading><DescriptorName UI="D015470" MajorTopicYN="N">Leukemia, Myeloid, Acute</DescriptorName>
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<QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName>
<QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName>
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<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
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<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
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<MeshHeading><DescriptorName UI="D019653" MajorTopicYN="N">Myeloablative Agonists</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName>
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<MeshHeading><DescriptorName UI="D009504" MajorTopicYN="N">Neutrophils</DescriptorName>
<QualifierName UI="Q000166" MajorTopicYN="N">cytology</QualifierName>
<QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D054198" MajorTopicYN="N">Precursor Cell Lymphoblastic Leukemia-Lymphoma</DescriptorName>
<QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName>
<QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName>
<QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName>
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<MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName>
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<QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName>
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<MeshHeading><DescriptorName UI="D014184" MajorTopicYN="N">Transplantation, Homologous</DescriptorName>
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