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Biol Blood Marrow Transplant. 2014 Nov;20(11):1841-6. doi: 10.1016/j.bbmt.2014.06.011. Epub 2014 Jun 16.

Unrelated cord blood transplantation for patients with primary or secondary myelofibrosis.

Author information

1
Hematology-Bone Marrow Transplantation, Saint-Louis Hospital, Paris, France. Electronic address: marie.robin@paris7.jussieu.fr.
2
Eurocord International Registry, Hôpital Saint-Louis, Paris, France.
3
Service d'Hématologie, CHU de Besançon, INSERM U-645, Université de Franche-Comté, Besançon, France.
4
Hematologie, CHU Saint-Antoine, Paris, France.
5
Hematology Department 1G, Centre Hospitalier Lyon Sud, Pierre Benite, France.
6
Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
7
Hematology, Nantes University Hospital, Nantes, France.
8
Department of Hematology, University Hospital, Grenoble, France.
9
Hematology, Nice University Hospital, Nice, France.
10
Hematology, Hospital Clínic, IDIBAPS, Barcelona, Spain.
11
Hematology Department, Basel University Hospital, Basel, Switzerland.
12
Clinical Hematology, Hospital De Sant Pau, Barcelona, Spain.
13
Hematology, Hôpital Pitié-Salpêtrière, Paris, France.
14
CHU Hematology, Poitiers, France.
15
Hematology, CHRU de Lille, Lille, France.
16
Medical University Graz, Graz, Austria.
17
Hematology, Royal Perth Hospital, Perth, Australia.
18
Hematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milan, Italy.
19
Service de Thérapie Cellulaire et d'Hématologie Clinique Adulte, Hotel-Dieu, Clermont-Ferrand, France.
20
Hôpitaux universitaires de Genève, Suisse.
21
University Medical Center Hamburg-Eppendorf Center of Oncology, Department of Stem Cell Transplantation, Chairman of the CMWP EBMT, Hamburg, Germany.
22
Eurocord International Registry, Hôpital Saint-Louis, Paris, France; Monacord, Centre scientifique de Monaco, Monaco.
23
Eurocord International Registry, Hôpital Saint-Louis, Paris, France; Department of Clinical Haematology, Bone Marrow Transplant Unit, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.
24
Hospital de Navarra, Chairman of MPN Subcommittee of the CMWP-EBMT, Pamplona, Spain.
25
Eurocord International Registry, Hôpital Saint-Louis, Paris, France; Hematologie, CHU Saint-Antoine, Paris, France.

Abstract

To determine whether umbilical cord blood transplantation (UCBT) is an alternative cure for myelofibrosis (MF), we evaluated 35 UCBTs reported to Eurocord. Seven patients had secondary acute myeloid leukemia (AML) at UCBT, and median age at UCBT was 54 years. Twenty-four patients received a reduced-intensity conditioning (RIC) regimen, and 17 of 35 patients received total body irradiation (2 to 12 Gy)-fludarabine-cyclophosphamide (TCF) conditioning. The median follow-up was 24 months. The cumulative incidence of neutrophil recovery at 60 days was 80%. Fifteen patients relapsed after UCBT. The 2-year overall survival and event-free-survival (EFS) rates were 44% and 30%, respectively. All patients given TCF achieved neutrophil and platelet recovery, and the use of TCF was associated with superior EFS in the RIC population (44% versus 0%, P = .001). Patients with transformation to AML had similar outcomes to patients with less advanced stages. In conclusion, despite graft failure remaining a major concern, the role of UCBT in the management of MF, especially using RIC TCF-based regimens, deserves further investigation to improve results.

KEYWORDS:

Myelofibrosis; Umbilical cord blood transplantation

PMID:
24946719
DOI:
10.1016/j.bbmt.2014.06.011
[Indexed for MEDLINE]
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