Phase II study of unrelated cord blood transplantation for adults with high-risk hematologic malignancies

Lazaros Lekakis, S. Giralt, D. Couriel, E. J. Shpall, C. Hosing, I. F. Khouri, P. Anderlini, M. Korbling, T. Martin, R. E. Champlin, M. de Lima

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Cell dose is a critical determinant of outcomes in unrelated cord blood (CB) transplantation. We investigated a strategy in which CB units should contain at least 2 × 107 total nucleated cells/ kg of recipient weight, otherwise a second unit had to be added. We report the results of a study that was prematurely closed owing to toxicity. Patients with advanced hematologic malignancies without a human leukocyte antigen-matched sibling or unrelated donor were eligible. Conditioning regimen consisted of fludarabine and 12Gy of total body irradiation (n=11), or melphalan (n=4), with antithymocyte globulin. Graft-versus-host disease prophylaxis was tacrolimus and methotrexate. Fifteen patients with acute leukemia (n=9), chronic myelogenous leukemia (n=2), multiple myeloma (n=2) and lymphoma (n=2) were treated; 60% had relapsed disease at transplantation. Three patients received double CB transplants. The 100-day and 1-year treatment-related mortality rates were 40 and 53%, respectively. Median time to neutrophil and platelet engraftment was 22 days (n=10) and 37 days (n=10), respectively. One patient had secondary graft failure and five patients failed to engraft. Two patients are alive and disease free; 4-year actuarial survival is 33 versus 0% for patients transplanted in remission versus in relapse. We concluded that disease status was the main determinant of treatment failure in this study.

Original languageEnglish
Pages (from-to)421-426
Number of pages6
JournalBone Marrow Transplantation
Volume38
Issue number6
DOIs
StatePublished - Sep 1 2006
Externally publishedYes

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Hematologic Neoplasms
Fetal Blood
Transplantation
Transplants
Unrelated Donors
Melphalan
Antilymphocyte Serum
Whole-Body Irradiation
Tacrolimus
Graft vs Host Disease
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
HLA Antigens
Treatment Failure
Multiple Myeloma
Methotrexate
Siblings
Lymphoma
Leukemia
Neutrophils
Blood Platelets

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Phase II study of unrelated cord blood transplantation for adults with high-risk hematologic malignancies. / Lekakis, Lazaros; Giralt, S.; Couriel, D.; Shpall, E. J.; Hosing, C.; Khouri, I. F.; Anderlini, P.; Korbling, M.; Martin, T.; Champlin, R. E.; de Lima, M.

In: Bone Marrow Transplantation, Vol. 38, No. 6, 01.09.2006, p. 421-426.

Research output: Contribution to journalArticle

Lekakis, L, Giralt, S, Couriel, D, Shpall, EJ, Hosing, C, Khouri, IF, Anderlini, P, Korbling, M, Martin, T, Champlin, RE & de Lima, M 2006, 'Phase II study of unrelated cord blood transplantation for adults with high-risk hematologic malignancies', Bone Marrow Transplantation, vol. 38, no. 6, pp. 421-426. https://doi.org/10.1038/sj.bmt.1705467
Lekakis, Lazaros ; Giralt, S. ; Couriel, D. ; Shpall, E. J. ; Hosing, C. ; Khouri, I. F. ; Anderlini, P. ; Korbling, M. ; Martin, T. ; Champlin, R. E. ; de Lima, M. / Phase II study of unrelated cord blood transplantation for adults with high-risk hematologic malignancies. In: Bone Marrow Transplantation. 2006 ; Vol. 38, No. 6. pp. 421-426.
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