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Engraftment kinetics and graft failure after single umbilical cord blood transplantation using a myeloablative conditioning regimen.

Identifieur interne : 003357 ( PubMed/Curation ); précédent : 003356; suivant : 003358

Engraftment kinetics and graft failure after single umbilical cord blood transplantation using a myeloablative conditioning regimen.

Auteurs : Annalisa Ruggeri [France] ; Myriam Labopin [France] ; Maria Pia Sormani [Italie] ; Guillermo Sanz [Espagne] ; Jaime Sanz [Espagne] ; Fernanda Volt [France] ; Gerard Michel [France] ; Franco Locatelli [Italie] ; Cristina Diaz De Heredia [Espagne] ; Tracey O'Brien [Australie] ; William Arcese [Italie] ; Anna Paola Iori [Italie] ; Sergi Querol [Espagne] ; Gesine Kogler [Allemagne] ; Lucilla Lecchi [Italie] ; Fabienne Pouthier [France] ; Federico Garnier [France] ; Cristina Navarrete [Royaume-Uni] ; Etienne Baudoux [Belgique] ; Juliana Fernandes [France] ; Chantal Kenzey [France] ; Mary Eapen [États-Unis] ; Eliane Gluckman [Monaco] ; Vanderson Rocha [Royaume-Uni] ; Riccardo Saccardi [Italie]

Source :

Haematologica [ 1592-8721 ] ; 2014.

RBID : pubmed:24972767

Descripteurs français

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

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<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>
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<author><name sortKey="O Brien, Tracey" sort="O Brien, Tracey" uniqKey="O Brien T" first="Tracey" last="O'Brien">Tracey O'Brien</name>
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<author><name sortKey="Arcese, William" sort="Arcese, William" uniqKey="Arcese W" first="William" last="Arcese">William Arcese</name>
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<author><name sortKey="Kogler, Gesine" sort="Kogler, Gesine" uniqKey="Kogler G" first="Gesine" last="Kogler">Gesine Kogler</name>
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<author><name sortKey="Lecchi, Lucilla" sort="Lecchi, Lucilla" uniqKey="Lecchi L" first="Lucilla" last="Lecchi">Lucilla Lecchi</name>
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<author><name sortKey="Pouthier, Fabienne" sort="Pouthier, Fabienne" uniqKey="Pouthier F" first="Fabienne" last="Pouthier">Fabienne Pouthier</name>
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<author><name sortKey="Garnier, Federico" sort="Garnier, Federico" uniqKey="Garnier F" first="Federico" last="Garnier">Federico Garnier</name>
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<author><name sortKey="Navarrete, Cristina" sort="Navarrete, Cristina" uniqKey="Navarrete C" first="Cristina" last="Navarrete">Cristina Navarrete</name>
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<author><name sortKey="Baudoux, Etienne" sort="Baudoux, Etienne" uniqKey="Baudoux E" first="Etienne" last="Baudoux">Etienne Baudoux</name>
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<author><name sortKey="Fernandes, Juliana" sort="Fernandes, Juliana" uniqKey="Fernandes J" first="Juliana" last="Fernandes">Juliana Fernandes</name>
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<author><name sortKey="Kenzey, Chantal" sort="Kenzey, Chantal" uniqKey="Kenzey C" first="Chantal" last="Kenzey">Chantal Kenzey</name>
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<author><name sortKey="Eapen, Mary" sort="Eapen, Mary" uniqKey="Eapen M" first="Mary" last="Eapen">Mary Eapen</name>
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<author><name sortKey="Gluckman, Eliane" sort="Gluckman, Eliane" uniqKey="Gluckman E" first="Eliane" last="Gluckman">Eliane Gluckman</name>
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<author><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name>
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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 wicri:level="1"><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>
<country wicri:rule="url">France</country>
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</affiliation>
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<author><name sortKey="Labopin, Myriam" sort="Labopin, Myriam" uniqKey="Labopin M" first="Myriam" last="Labopin">Myriam Labopin</name>
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<country xml:lang="fr">France</country>
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<author><name sortKey="Sormani, Maria Pia" sort="Sormani, Maria Pia" uniqKey="Sormani M" first="Maria Pia" last="Sormani">Maria Pia Sormani</name>
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<country xml:lang="fr">Italie</country>
<wicri:regionArea>Biostatistics Unit, Department of Health Sciences (DISSAL), University of Genova</wicri:regionArea>
</affiliation>
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<author><name sortKey="Sanz, Guillermo" sort="Sanz, Guillermo" uniqKey="Sanz G" first="Guillermo" last="Sanz">Guillermo Sanz</name>
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<country xml:lang="fr">Espagne</country>
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</affiliation>
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<author><name sortKey="Sanz, Jaime" sort="Sanz, Jaime" uniqKey="Sanz J" first="Jaime" last="Sanz">Jaime Sanz</name>
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</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>
</author>
<author><name sortKey="Michel, Gerard" sort="Michel, Gerard" uniqKey="Michel G" first="Gerard" last="Michel">Gerard Michel</name>
<affiliation wicri:level="1"><nlm:affiliation>Hôpital d'Enfants de la Timone, Marseille, France.</nlm:affiliation>
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</affiliation>
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<author><name sortKey="Locatelli, Franco" sort="Locatelli, Franco" uniqKey="Locatelli F" first="Franco" last="Locatelli">Franco Locatelli</name>
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<country xml:lang="fr">Italie</country>
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<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>
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<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Servicio de Hematologia y Oncologia Pediátricas, Hospital Universitario Vall d'Hebron, Barcelona</wicri:regionArea>
</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 wicri:level="1"><nlm:affiliation>Sydney Children's Hospital, Sydney, Australia.</nlm:affiliation>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Sydney Children's Hospital, Sydney</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Arcese, William" sort="Arcese, William" uniqKey="Arcese W" first="William" last="Arcese">William Arcese</name>
<affiliation wicri:level="1"><nlm:affiliation>Rome Transplant Network, University Tor Vergata, Rome, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Rome Transplant Network, University Tor Vergata, Rome</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Iori, Anna Paola" sort="Iori, Anna Paola" uniqKey="Iori A" first="Anna Paola" last="Iori">Anna Paola Iori</name>
<affiliation wicri:level="1"><nlm:affiliation>Università La Sapienza, Dip. Biotecnologie Cellulari ed Ematologia, Rome, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Università La Sapienza, Dip. Biotecnologie Cellulari ed Ematologia, Rome</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Querol, Sergi" sort="Querol, Sergi" uniqKey="Querol S" first="Sergi" last="Querol">Sergi Querol</name>
<affiliation wicri:level="1"><nlm:affiliation>Barcelona Cord Blood Bank, Barcelona, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Barcelona Cord Blood Bank, Barcelona</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Kogler, Gesine" sort="Kogler, Gesine" uniqKey="Kogler G" first="Gesine" last="Kogler">Gesine Kogler</name>
<affiliation wicri:level="1"><nlm:affiliation>Dusseldorf Cord Blood Bank, University of Dusseldorf, Germany.</nlm:affiliation>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Dusseldorf Cord Blood Bank, University of Dusseldorf</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Lecchi, Lucilla" sort="Lecchi, Lucilla" uniqKey="Lecchi L" first="Lucilla" last="Lecchi">Lucilla Lecchi</name>
<affiliation wicri:level="1"><nlm:affiliation>Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Pouthier, Fabienne" sort="Pouthier, Fabienne" uniqKey="Pouthier F" first="Fabienne" last="Pouthier">Fabienne Pouthier</name>
<affiliation wicri:level="1"><nlm:affiliation>Besançon Cord Blood Bank of the Etablissement Français du Sang, Besançon, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Besançon Cord Blood Bank of the Etablissement Français du Sang, Besançon</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Garnier, Federico" sort="Garnier, Federico" uniqKey="Garnier F" first="Federico" last="Garnier">Federico Garnier</name>
<affiliation wicri:level="1"><nlm:affiliation>Agence de la Biomedecine, Paris, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Agence de la Biomedecine, Paris</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Navarrete, Cristina" sort="Navarrete, Cristina" uniqKey="Navarrete C" first="Cristina" last="Navarrete">Cristina Navarrete</name>
<affiliation wicri:level="1"><nlm:affiliation>NHS-Cord Blood Bank, NHSBT, Colindale Ave, and University College London, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>NHS-Cord Blood Bank, NHSBT, Colindale Ave, and University College London</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Baudoux, Etienne" sort="Baudoux, Etienne" uniqKey="Baudoux E" first="Etienne" last="Baudoux">Etienne Baudoux</name>
<affiliation wicri:level="1"><nlm:affiliation>Liege Cord Blood Bank, University of Liege, Belgium.</nlm:affiliation>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea>Liege Cord Blood Bank, University of Liege</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Fernandes, Juliana" sort="Fernandes, Juliana" uniqKey="Fernandes J" first="Juliana" last="Fernandes">Juliana Fernandes</name>
<affiliation wicri:level="1"><nlm:affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Kenzey, Chantal" sort="Kenzey, Chantal" uniqKey="Kenzey C" first="Chantal" last="Kenzey">Chantal Kenzey</name>
<affiliation wicri:level="1"><nlm:affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Eapen, Mary" sort="Eapen, Mary" uniqKey="Eapen M" first="Mary" last="Eapen">Mary Eapen</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Medicine, Medical College of Wisconsin, Milwaukee, WI</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Gluckman, Eliane" sort="Gluckman, Eliane" uniqKey="Gluckman E" first="Eliane" last="Gluckman">Eliane Gluckman</name>
<affiliation wicri:level="1"><nlm:affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Monacord, Centre Scientifique de Monaco, Monaco.</nlm:affiliation>
<country xml:lang="fr">Monaco</country>
<wicri:regionArea>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Monacord, Centre Scientifique de Monaco</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Rocha, Vanderson" sort="Rocha, Vanderson" uniqKey="Rocha V" first="Vanderson" last="Rocha">Vanderson Rocha</name>
<affiliation wicri:level="1"><nlm:affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Churchill Hospital, Oxford University Hospitals, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Churchill Hospital, Oxford University Hospitals</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Saccardi, Riccardo" sort="Saccardi, Riccardo" uniqKey="Saccardi R" first="Riccardo" last="Saccardi">Riccardo Saccardi</name>
<affiliation wicri:level="1"><nlm:affiliation>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Careggi University Hospital, Florence, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Careggi University Hospital, Florence</wicri:regionArea>
</affiliation>
</author>
</analytic>
<series><title level="j">Haematologica</title>
<idno type="eISSN">1592-8721</idno>
<imprint><date when="2014" type="published">2014</date>
</imprint>
</series>
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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="KwdFr" xml:lang="fr"><term>Adolescent</term>
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Agonistes myélo-ablatifs (usage thérapeutique)</term>
<term>Analyse de survie</term>
<term>Conditionnement pour greffe ()</term>
<term>Enfant</term>
<term>Enfant d'âge préscolaire</term>
<term>Facteurs temps</term>
<term>Femelle</term>
<term>Granulocytes neutrophiles (cytologie)</term>
<term>Granulocytes neutrophiles (immunologie)</term>
<term>Humains</term>
<term>Induction de rémission</term>
<term>Leucémie aigüe myéloïde ()</term>
<term>Leucémie aigüe myéloïde (anatomopathologie)</term>
<term>Leucémie aigüe myéloïde (immunologie)</term>
<term>Leucémie aigüe myéloïde (mortalité)</term>
<term>Leucémie-lymphome lymphoblastique à précurseurs B et T ()</term>
<term>Leucémie-lymphome lymphoblastique à précurseurs B et T (anatomopathologie)</term>
<term>Leucémie-lymphome lymphoblastique à précurseurs B et T (immunologie)</term>
<term>Leucémie-lymphome lymphoblastique à précurseurs B et T (mortalité)</term>
<term>Maladie du greffon contre l'hôte ()</term>
<term>Maladie du greffon contre l'hôte (anatomopathologie)</term>
<term>Maladie du greffon contre l'hôte (immunologie)</term>
<term>Maladie du greffon contre l'hôte (mortalité)</term>
<term>Mâle</term>
<term>Nourrisson</term>
<term>Rejet du greffon (immunologie)</term>
<term>Transplantation de cellules souches de sang du cordon</term>
<term>Transplantation homologue</term>
<term>Études de suivi</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Myeloablative Agonists</term>
</keywords>
<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Leucémie aigüe myéloïde</term>
<term>Leucémie-lymphome lymphoblastique à précurseurs B et T</term>
<term>Maladie du greffon contre l'hôte</term>
</keywords>
<keywords scheme="MESH" qualifier="cytologie" xml:lang="fr"><term>Granulocytes neutrophiles</term>
</keywords>
<keywords scheme="MESH" qualifier="cytology" xml:lang="en"><term>Neutrophils</term>
</keywords>
<keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Granulocytes neutrophiles</term>
<term>Leucémie aigüe myéloïde</term>
<term>Leucémie-lymphome lymphoblastique à précurseurs B et T</term>
<term>Maladie du greffon contre l'hôte</term>
<term>Rejet du greffon</term>
</keywords>
<keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>Graft Rejection</term>
<term>Graft vs Host Disease</term>
<term>Leukemia, Myeloid, Acute</term>
<term>Neutrophils</term>
<term>Precursor Cell Lymphoblastic Leukemia-Lymphoma</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Transplantation Conditioning</term>
</keywords>
<keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Graft vs Host Disease</term>
<term>Leukemia, Myeloid, Acute</term>
<term>Precursor Cell Lymphoblastic Leukemia-Lymphoma</term>
</keywords>
<keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Leucémie aigüe myéloïde</term>
<term>Leucémie-lymphome lymphoblastique à précurseurs B et T</term>
<term>Maladie du greffon contre l'hôte</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Graft vs Host Disease</term>
<term>Leukemia, Myeloid, Acute</term>
<term>Precursor Cell Lymphoblastic Leukemia-Lymphoma</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Graft vs Host Disease</term>
<term>Leukemia, Myeloid, Acute</term>
<term>Precursor Cell Lymphoblastic Leukemia-Lymphoma</term>
</keywords>
<keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Agonistes myélo-ablatifs</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Child</term>
<term>Child, Preschool</term>
<term>Cord Blood Stem Cell Transplantation</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Infant</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Remission Induction</term>
<term>Survival Analysis</term>
<term>Time Factors</term>
<term>Transplantation, Homologous</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term>
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Analyse de survie</term>
<term>Conditionnement pour greffe</term>
<term>Enfant</term>
<term>Enfant d'âge préscolaire</term>
<term>Facteurs temps</term>
<term>Femelle</term>
<term>Humains</term>
<term>Induction de rémission</term>
<term>Leucémie aigüe myéloïde</term>
<term>Leucémie-lymphome lymphoblastique à précurseurs B et T</term>
<term>Maladie du greffon contre l'hôte</term>
<term>Mâle</term>
<term>Nourrisson</term>
<term>Transplantation de cellules souches de sang du cordon</term>
<term>Transplantation homologue</term>
<term>Études de suivi</term>
</keywords>
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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>
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   |texte=   Engraftment kinetics and graft failure after single umbilical cord blood transplantation using a myeloablative conditioning regimen.
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	Serveur d'exploration sur les relations entre la France et l'Australie
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Engraftment kinetics and graft failure after single umbilical cord blood transplantation using a myeloablative conditioning regimen.

Engraftment kinetics and graft failure after single umbilical cord blood transplantation using a myeloablative conditioning regimen.

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