Outcomes of transplantation of unrelated donor umbilical cord blood and bone marrow in children with acute leukaemia: a comparison study

Eapen, Mary; Rubinstein, Pablo; Zhang, Mei Jie; Stevens, Cladd E.; Kurtzberg, Joanne; Scaradavou, Andromachi; Loberiza, Fausto R.; Champlin, Richard E.; Klein, John P.; Horowitz, Mary M.; Wagner, John E.

doi:10.1016/s0140-6736(07)60915-5

Cited by 743 publications

(702 citation statements)

References 23 publications

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“…Eapen and colleagues in 2007 [4] reviewed the treatment of malignancies and cord blood transplantation in children with acute leukemia as an acceptable alternative to bone marrow. They reported on the outcomes of 503 children (<16 years of age) with acute leukemia and transplanted with umbilical cord blood then compared with outcomes of 282 bone marrow recipients from the USA.…”

Section: Hematology Disorders/oncologymentioning

confidence: 99%

“…Cord blood is considered a treatment option in pediatric and adult patients with hematologic malignancies and disorders (leukemia, thalassemia, sickle cell disease, etc. ), bone marrow failures, inherited metabolic disorders, immunological defects and other genetic diseases [1][2][3][4][5][6][7][8][9][10][11][12]. Double umbilical cord blood grafts, that use cord blood units from two donors, mitigate cell dose limitations for larger children and adults with malignant disorders [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

“…There are now two international registries: NETCORD, which lists cord blood units only and Bone Marrow Donors Worldwide which lists both bone marrow and cord blood donors [22]. EuroCord and the Center for International Blood and Marrow Transplant Research (CIBMTR) provide extensive analytical expertise in evaluating efficacy and outcomes [4,10,12].…”

Section: Introductionmentioning

confidence: 99%

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Umbilical cord blood banking: an update

Butler

Menitove²

2011

J Assist Reprod Genet

101

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Background Umbilical cord blood is a potential vast source of primitive hematopoietic stem and progenitor cells available for clinical application to reconstitute the hematopoietic system and/or restore immunological function in affected individuals requiring treatment. Cord blood can be used as an alternative source for bone marrow transplantation and its use is developing into a new field of treatment for pediatric and adult patients presenting with hematological disorders, immunological defects and specific genetic diseases. Discussion More than 25,000 allogeneic cord blood transplantations have been performed worldwide since the first cord blood transplantation in 1988. There are two banking options for storing umbilical cord blood [private (family) and public]. Cord blood stored in private banks are used for either autologous or allogeneic transplants for the infant donor or related family members but private cord blood banks are not searchable or available to the public. More than 780,000 cord blood units are stored in over 130 private cord blood banks, worldwide, and over 400,000 units in more than 100 quality controlled public cord blood banks.Conclusions Researchers continue to evaluate the usefulness of cord blood cells in treating human diseases or disorders for purposes other than hematological disorders including heart disease, strokes, brain or spinal cord injuries and cancer. This review summarizes the status of umbilical cord blood banking, its history and current and potential use in the treatment of human disease.

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Section: Hematology Disorders/oncologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Umbilical cord blood banking: an update

Butler

Menitove²

2011

J Assist Reprod Genet

101

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“…In patients that lack an available matched-related or -unrelated donor (MUD), mismatched-unrelated donors (MMUD), unrelated cord blood (UCB), and haploidentical related donors have emerged as effective alternative stem cell sources. In comparison with transplants from adult donors, UCB transplants offer the advantage of prompt availability for many recipients and a decreased risk of graft-versus-host disease (GVHD) [2,3], but such transplants are associated with a slower hematological and immune recovery, leading to a higher risk of infection [4,5]. Mismatched-unrelated donor transplants are associated in some studies with a lower risk of relapse, but a higher risk of GVHD [6,7], while haploidentical HSCT may be complicated by a high risk of relapse and delayed immune recovery [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Impact of the source of hematopoietic stem cell in unrelated transplants: Comparison between 10/10, 9/10‐HLAmatched donors and cord blood

et al. 2015

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In absence of available matched-related or unrelated donor (MUD), mismatched unrelated donors (MMUD) and unrelated cord blood (UCB) are both considered to be suitable donors, with similar post-transplant overall survival. In most of these retrospective comparisons, HLA typing of adult donors was performed at eight loci. The aim of this study was to compare the outcome of patients transplanted from UCB (N 5 64) with those transplanted from 9/10-HLA MMUD (N 5 84) or 10/10-HLA MUD (N 5 196). In multivariate analysis, UCB was associated with less Grade II-IV acute GVHD in comparison with MUD (aHR 1.97, 95% CI 1.19-3.27, P 5 0.009) and MMUD transplants (aHR 1.79, 95% CI 1.02-3.15, P 5 0.042), while the cumulative incidence of chronic GVHD was not significantly different between the three groups. Overall survival (OS), non-relapse mortality, and relapse were not different between MMUD and UCB transplantation, whereas OS was impaired after UCB in comparison with MUD (aHR 0.65, 95% CI 0.43-0.99, P 5 0.043). Factors also impacting OS were the donor/recipient CMV serostatus (Donor2/Recipient1 aHR 1.76, 95% CI 1.23-2.52, P 5 0.002 compared with D2/R2), the donor/recipient gender combination (Female/Male versus other combinations aHR 1.57, 95% CI 1.11-2.22, P 5 0.012) and disease risk (aHR 1.58, 95% CI 1.05-2.38, P 5 0.027 for high vs. low risk disease). Our data confirm that UCB and 9/10-HLA MMUD are both relevant alternative options when no 10/10-HLA donor is available. Donor/recipient gender combination and CMV serostatus had a significant impact on survival and may be taken into account, along with donor type, in the setting of MMUD and UCB transplants.

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“…6 Comparable probability of leukemia-free survival (LFS) has been reported in children with acute leukemia receiving either unrelated allele-matched bone marrow transplantation (BMT) or 1 or 2 loci mismatched UCBT. 7 Degree of minimal residual disease (MRD) after induction chemotherapy has been identified as an independent prognostic factor of outcome in childhood ALL and some reports showed that the prognostic value of MRD might overcome that of other biological and clinical variables with widely recognized predictive significance. 8,9 Owing to its strong predictive value, MRD is being used as a tool for risk stratification in most ALL treatment protocols for both children and adults.…”

Section: Introductionmentioning

confidence: 99%

Impact of pretransplant minimal residual disease after cord blood transplantation for childhood acute lymphoblastic leukemia in remission: an Eurocord, PDWP–EBMT analysis

et al. 2012

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To address the prognostic value of minimal residual disease (MRD) before unrelated cord blood transplantation (UCBT) in children with acute lymphoblastic leukemia (ALL), we analyzed 170 ALL children transplanted in complete remission (CR) after myeloablative conditioning regimen. In all, 72 (43%) were in first CR (CR1), 77 (45%) in second CR (CR2) and 21 (12%) in third CR (CR3). The median interval from MRD quantification to UCBT was 18 days. All patients received single-unit UCBT. Median follow-up was 4 years. Cumulative incidence (CI) of day-60 neutrophil engraftment was 85%. CI of 4 years relapse was 30%, incidence being lower in patients with negative MRD before UCBT (hazard ratio (HR) ¼ 0.4, P ¼ 0.01) and for those transplanted in CR1 and CR2 (HR ¼ 0.3, P ¼ 0.002). Probability of 4 years leukemia-free survival (LFS) was 44%, (56, 44 and 14% for patients transplanted in CR1, CR2 and CR3, respectively (P ¼ 0.0001)). Patients with negative MRD before UCBT had better LFS after UCBT compared with those with positive MRD (54% vs 29%; HR ¼ 2, P ¼ 0.003). MRD assessment before UCBT for children with ALL in remission allows identifying patients at higher risk of relapse after transplantation. Approaches that may decrease relapse incidence in children given UCBT with positive MRD should be investigated to improve final outcomes.

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Outcomes of transplantation of unrelated donor umbilical cord blood and bone marrow in children with acute leukaemia: a comparison study

Cited by 743 publications

References 23 publications

Umbilical cord blood banking: an update

Umbilical cord blood banking: an update

Impact of the source of hematopoietic stem cell in unrelated transplants: Comparison between 10/10, 9/10‐HLAmatched donors and cord blood

Impact of pretransplant minimal residual disease after cord blood transplantation for childhood acute lymphoblastic leukemia in remission: an Eurocord, PDWP–EBMT analysis

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