Promising Progression-Free Survival for Patients Low and Intermediate Grade Lymphoid Malignancies after Nonmyeloablative Umbilical Cord Blood Transplantation

Claudio G. Brunstein, Susana Cantero Peral, Qing Cao, Navneet Majhail, Brian McClune, Linda J. Burns, Marcie Tomblyn, Jeffrey S. Miller, Bruce R. Blazar, Philip B. McGlave, Daniel J. Weisdorf, John E. Wagner

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Nonmyeloablative hematopoietic cell transplantation (HCT) has been used to treat patients with advanced or high-risk lymphoid malignancies. We studied 65 patients (median age 46 years) receiving an umbilical cord blood (UCB) graft after a single conditioning regimen consisting of cyclophosphamide (50 mg/kg) on day -6, fludarabine (40 mg/m2) daily on days -6 to -2, as well as a single fraction of total-body irradiation (TBI) (200 cGy) along with cyclosporine mycophenolate mofetil immunosuppression. Median time to neutrophil and platelet recovery was 7.5 days (range: 0-32) and 46 days (range: 8-111), respectively. Cumulative incidences of grade II-IV, grade III-IV acute, and chronic graft-versus-host disease (aGVHD, cGVHD) were 57% (95% confidence interval [CI]: 43%-70%), 25% (95% CI: 14%-35%), and 19% (95% CI: 9%-29%), respectively. Transplant-related mortality at 3 years was 15% (95% CI: 5%-26%). Median follow-up was 23 months. The progression free-survival (PFS), current PFS and overall survival (OS) were 34% (95% CI: 21%-47%), 49% (95% CI: 36%-62%), and 55% (95% CI: 42%-70%) at 3 years. Based on our data, we conclude that a nonmyeloablative conditioning regimen followed by UCB transplantation is an effective treatment for patients with advanced lymphoid malignancies who lack a suitable sibling donor.

Original languageEnglish (US)
Pages (from-to)214-222
Number of pages9
JournalBiology of Blood and Marrow Transplantation
Volume15
Issue number2
DOIs
StatePublished - Feb 1 2009
Externally publishedYes

Fingerprint

Fetal Blood
Disease-Free Survival
Transplantation
Confidence Intervals
Neoplasms
Mycophenolic Acid
Transplants
Whole-Body Irradiation
Cell Transplantation
Graft vs Host Disease
Cyclophosphamide
Immunosuppression
Cyclosporine
Siblings
Neutrophils
Blood Platelets
Tissue Donors
Survival
Mortality
Incidence

Keywords

  • Lymphoid malignancies
  • Nonmyeloablative
  • Umbilical cord blood

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Promising Progression-Free Survival for Patients Low and Intermediate Grade Lymphoid Malignancies after Nonmyeloablative Umbilical Cord Blood Transplantation. / Brunstein, Claudio G.; Cantero Peral, Susana; Cao, Qing; Majhail, Navneet; McClune, Brian; Burns, Linda J.; Tomblyn, Marcie; Miller, Jeffrey S.; Blazar, Bruce R.; McGlave, Philip B.; Weisdorf, Daniel J.; Wagner, John E.

In: Biology of Blood and Marrow Transplantation, Vol. 15, No. 2, 01.02.2009, p. 214-222.

Research output: Contribution to journalArticle

Brunstein, CG, Cantero Peral, S, Cao, Q, Majhail, N, McClune, B, Burns, LJ, Tomblyn, M, Miller, JS, Blazar, BR, McGlave, PB, Weisdorf, DJ & Wagner, JE 2009, 'Promising Progression-Free Survival for Patients Low and Intermediate Grade Lymphoid Malignancies after Nonmyeloablative Umbilical Cord Blood Transplantation', Biology of Blood and Marrow Transplantation, vol. 15, no. 2, pp. 214-222. https://doi.org/10.1016/j.bbmt.2008.11.013
Brunstein, Claudio G. ; Cantero Peral, Susana ; Cao, Qing ; Majhail, Navneet ; McClune, Brian ; Burns, Linda J. ; Tomblyn, Marcie ; Miller, Jeffrey S. ; Blazar, Bruce R. ; McGlave, Philip B. ; Weisdorf, Daniel J. ; Wagner, John E. / Promising Progression-Free Survival for Patients Low and Intermediate Grade Lymphoid Malignancies after Nonmyeloablative Umbilical Cord Blood Transplantation. In: Biology of Blood and Marrow Transplantation. 2009 ; Vol. 15, No. 2. pp. 214-222.
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