Umbilical cord blood transplantation after nonmyeloablative conditioning: impact on transplantation outcomes in 110 adults with hematologic disease
Umbilical cord blood transplantation after nonmyeloablative conditioning: impact on transplantation outcomes in 110 adults with hematologic disease
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DOI：
10.1182/blood-2007-04-067215
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发表时间：
2007-10-15
期刊：
影响因子：
20.3
通讯作者：
Wagner, John E.
中科院分区：
文献类型：
--
作者：
Brunstein, Claudio G.;Barker, Juliet N.;Wagner, John E.
我们评估了在非清髓方案中脐带血（UCB）的疗效，该方案包括氟达拉滨（200 mg/m2）、环磷酰胺（50 mg/kg）和单次全身照射（200 cGy），并使用环孢素和霉酚酸酯进行移植后免疫预防。UCB移植物的靶细胞剂量为3.0 x 10（7）个有核细胞/kg，导致85%的第二个部分人白细胞抗原匹配的UCB单位的选择。入组了110例血液病患者。在中位数12天时，92%的患者实现了神经元恢复。III级和IV级急性和慢性移植物抗宿主病（GVHD）的发生率分别为22%和23%。3年时移植相关死亡率为26%。3年生存率和无事件生存率（EFS）分别为45%和38%。生存的有利危险因素是没有高危临床特征（Karnofsky 50 - 60，严重器官功能障碍，近期真菌感染，P
We evaluated the efficacy of umbilical cord blood (UCB) in the setting of a nonmyeloablative regimen consisting of fludarabine (200 mg/m(2)), cyclophosphamide (50 mg/kg), and a single fraction of total body irradiation (200 cGy) with cyclosporine and mycophenolate mofetil for posttransplantation immunoprophylaxis. The target cell dose for the UCB graft was 3.0 x 10(7) nucleated cells/kg, resulting in the selection of a second partially human leukocyte antigen-matched UCB unit in 85%. One hundred ten patients with hematologic disease were enrolled. Neutrophil recovery was achieved in 92% at a median of 12 days. Incidences of grades III and IV acute and chronic graft-versus-host disease (GVHD) were 22% and 23%, respectively. Transplantation-related mortality was 26% at 3 years. Survival and event-free survival (EFS) at 3 years were 45% and 38%, respectively. Favorable risk factors for survival were absence of high-risk clinical features (Karnofsky 50-60, serious organ dysfunction, recent fungal infection, P