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Factors affecting mortality following myeloablative cord blood transplantation in adults: a pooled analysis of three international registries

COHEN, Y. C ; SCARADAVOU, A ; LAUGHLIN, M. J ; DANIELY, Y ; PACHECO, D ; BARISHEV, R ; OLMER, L ; FREEDMAN, L. S ; STEVENS, C. E ; RUBINSTEIN, P ; GLUCKMAN, E ; ROCHA, V ; HOROWITZ, M. M ; EAPEN, M ; NAGLER, A ; SHPALL, E. J

Bone marrow transplantation (Basingstoke), 2011-01, Vol.46 (1), p.70-76 [Periódico revisado por pares]

Basingstoke: Nature Publishing Group

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Factors affecting mortality following myeloablative cord blood transplantation in adults: a pooled analysis of three international registries
Autor: COHEN, Y. C ; SCARADAVOU, A ; LAUGHLIN, M. J ; DANIELY, Y ; PACHECO, D ; BARISHEV, R ; OLMER, L ; FREEDMAN, L. S ; STEVENS, C. E ; RUBINSTEIN, P ; GLUCKMAN, E ; ROCHA, V ; HOROWITZ, M. M ; EAPEN, M ; NAGLER, A ; SHPALL, E. J
Assuntos: Adolescent ; Adult ; Aging ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Bone marrow ; Bone marrow, stem cells transplantation. Graft versus host reaction ; Child ; Cord Blood Stem Cell Transplantation - adverse effects ; Cord Blood Stem Cell Transplantation - methods ; Cord Blood Stem Cell Transplantation - mortality ; Cytomegalovirus Infections - complications ; Europe ; Female ; Hematologic and hematopoietic diseases ; Hematologic Neoplasms - complications ; Hematologic Neoplasms - diagnosis ; Hematologic Neoplasms - therapy ; Hematopoietic stem cells ; Humans ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Male ; Medical sciences ; Middle Aged ; Myeloablative Agonists - adverse effects ; Myeloablative Agonists - therapeutic use ; Neoplasm Staging ; North America ; Patient outcomes ; Prognosis ; Registries ; Reproducibility of Results ; Retrospective Studies ; Stem cell transplantation ; Survival Analysis ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Transplantation ; Transplantation Conditioning - adverse effects ; Young Adult
É parte de: Bone marrow transplantation (Basingstoke), 2011-01, Vol.46 (1), p.70-76
Descrição: A retrospective analysis was conducted to examine factors affecting early mortality after myeloablative, single-unit cord blood transplantation (CBT) for hematological malignancies in adolescents and adults. Data were collected from the three main CBT registries pooling 514 records of unrelated, single, unmanipulated, first myeloablative allogeneic CBTs conducted in North America or Europe from 1995 to 2005, with an HLA match ≥ 4/6 loci, in patients aged 12-55. Overall 100-day, 180-day and 1-year survival (Kaplan-Meier method) were 56, 46 and 37%, respectively, with no significant heterogeneity across registries. Multivariate analysis showed cell dose < 2.5 × 10⁷/kg (odds ratio (OR) 2.76, P < 0.0001), older age (P = 0.002), advanced disease (P = 0.02), positive CMV sero-status (OR 1.37 P = 0.11), female gender (OR 1.43, P = 0.07) and limited CBT center experience (< 10 records contributed, OR 2.08, P = 0.0003) to be associated with higher 100-day mortality. A multivariate model predictive of 1-year mortality included similar prognostic factors except female gender. Transplant year did not appear as a significant independent predictor. This is the first analysis to pool records from three major CBT registries in the United States and Europe. In spite of some differences in practice patterns, survival was remarkably homogeneous. The resulting model may contribute to better understanding factors affecting CBT outcomes.
Editor: Basingstoke: Nature Publishing Group
Idioma: Inglês

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Factors affecting mortality following myeloablative cord blood transplantation in adults: a pooled analysis of three international registries

COHEN, Y. C ; SCARADAVOU, A ; LAUGHLIN, M. J ; DANIELY, Y ; PACHECO, D ; BARISHEV, R ; OLMER, L ; FREEDMAN, L. S ; STEVENS, C. E ; RUBINSTEIN, P ; GLUCKMAN, E ; ROCHA, V ; HOROWITZ, M. M ; EAPEN, M ; NAGLER, A ; SHPALL, E. J

Basingstoke: Nature Publishing Group

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