Summary of results of nonmyeloablative unrelated umbilical cord blood transplantation in adult patients.
| Investigator . | Barker et al18 . | McSweeney et al19 . | Chao et al20 . |
|---|---|---|---|
| Abbreviations: Gd, grade; aGVHD, acute graft-versus-host disease; cGVHD, chronic graft-versus-host disease; N.C., nucleated cell; ANC, absolute neutrophil count; NHL, non-Hodgkin’s disease; MDS, myelodysplastic syndrome; AML, acute myeloid leukemia; MEL, melanoma; ALL, acute lymphoblastic leukemia; HD, Hodgkin’s disease; CLL, chronic lymphocytic leukemia; THAL, thalassemia; WAS, Wiskott–Aldrich syndrome; NBL, neuroblastoma; HM, hematological malignancies; F, fludarabine; ATG, antithymocyte globulin; C, cyclophosphamide; TBI, total body irradiation; Bu, busulphan; CYA, cyclosporin A; MMF, mycophenolate mofetil; PDN, prednisolone; FK506, tracrolimus; NA, not available; C.I., cumulative incidence; PR, partial remission; OS, overall survival; DFS, disease-free survival | |||
| † The results refer to patients given F + Bu + TBI 200cGy as conditioning regimen. | |||
| ‡ The results refer to patients given F + C + TBI 200cGy as conditioning regimen. | |||
| Number of patients | 43 | 5 | 13 |
| Age, years: median (range) | 49.5 (22–65) | 64.5 (25–78) | 49 (19–62) |
| Diagnosis | HM | HD; AML; CLL; NHL | NHL; MDS; AML; MEL; ALL |
| Preparative regimen | F + Bu + TB I (200cGy (n = 21) F + C + TBI (200cGy) (n = 22) | F + TBI (200cGy) | F + C + ATG (n = 10) F + C + ATG + TBI (200cGy) (n = 3) |
| GVHD prophylaxis | CYA + MMF | CYA + MMF | CYA + Pred (n = 8) CYA + MMF (n = 5) |
| Cell Dose | |||
| N.C. (×107/kg): median (range) | 2.6 (1.6–3.8)† 3.2 (1.1–5.1)‡ | 1.1 (1.75–1.3) | 2.07 (1.07–5.53) |
| CD34 (×106/kg): median (range) | 3.7 (1.1–8.1)† 4.3 (1.1–10.3)‡ | NA (0.01–0.04) | 1.3 (0.5–9.6) |
| CD3 (×106/kg): median (range) | 0.06 (0.02–0.15)† 0.05 (0.02–0.12)‡ | NA (1.4–3.3) | 4.6 (2.02–22.82) |
| Engraftment (n) | C.I. = 76%† C.I. = 94%‡ | 2 | 8/12 |
| Median days to ANC > 500/μL (range) | 26 (12–30)† 9.5 (5–28)‡ | NA | 12 (6–24) |
| Median days to platelet > 20,000/μL (range) | NA | 14 (6–61) | |
| Grade II–IV aGVHD / cGVHD (n) | C.I. for aGVHD = 44% C.I. for cGVHD = 21% | 1/NA | 1/1 |
| Outcome | O.S. : 39% at 1 year DFS.: 31% at 1 year | Alive: n = 3 PR: n = 1 | O.S.: 43% at 1 year DFS: 43% at 1 year |
| Investigator . | Barker et al18 . | McSweeney et al19 . | Chao et al20 . |
|---|---|---|---|
| Abbreviations: Gd, grade; aGVHD, acute graft-versus-host disease; cGVHD, chronic graft-versus-host disease; N.C., nucleated cell; ANC, absolute neutrophil count; NHL, non-Hodgkin’s disease; MDS, myelodysplastic syndrome; AML, acute myeloid leukemia; MEL, melanoma; ALL, acute lymphoblastic leukemia; HD, Hodgkin’s disease; CLL, chronic lymphocytic leukemia; THAL, thalassemia; WAS, Wiskott–Aldrich syndrome; NBL, neuroblastoma; HM, hematological malignancies; F, fludarabine; ATG, antithymocyte globulin; C, cyclophosphamide; TBI, total body irradiation; Bu, busulphan; CYA, cyclosporin A; MMF, mycophenolate mofetil; PDN, prednisolone; FK506, tracrolimus; NA, not available; C.I., cumulative incidence; PR, partial remission; OS, overall survival; DFS, disease-free survival | |||
| † The results refer to patients given F + Bu + TBI 200cGy as conditioning regimen. | |||
| ‡ The results refer to patients given F + C + TBI 200cGy as conditioning regimen. | |||
| Number of patients | 43 | 5 | 13 |
| Age, years: median (range) | 49.5 (22–65) | 64.5 (25–78) | 49 (19–62) |
| Diagnosis | HM | HD; AML; CLL; NHL | NHL; MDS; AML; MEL; ALL |
| Preparative regimen | F + Bu + TB I (200cGy (n = 21) F + C + TBI (200cGy) (n = 22) | F + TBI (200cGy) | F + C + ATG (n = 10) F + C + ATG + TBI (200cGy) (n = 3) |
| GVHD prophylaxis | CYA + MMF | CYA + MMF | CYA + Pred (n = 8) CYA + MMF (n = 5) |
| Cell Dose | |||
| N.C. (×107/kg): median (range) | 2.6 (1.6–3.8)† 3.2 (1.1–5.1)‡ | 1.1 (1.75–1.3) | 2.07 (1.07–5.53) |
| CD34 (×106/kg): median (range) | 3.7 (1.1–8.1)† 4.3 (1.1–10.3)‡ | NA (0.01–0.04) | 1.3 (0.5–9.6) |
| CD3 (×106/kg): median (range) | 0.06 (0.02–0.15)† 0.05 (0.02–0.12)‡ | NA (1.4–3.3) | 4.6 (2.02–22.82) |
| Engraftment (n) | C.I. = 76%† C.I. = 94%‡ | 2 | 8/12 |
| Median days to ANC > 500/μL (range) | 26 (12–30)† 9.5 (5–28)‡ | NA | 12 (6–24) |
| Median days to platelet > 20,000/μL (range) | NA | 14 (6–61) | |
| Grade II–IV aGVHD / cGVHD (n) | C.I. for aGVHD = 44% C.I. for cGVHD = 21% | 1/NA | 1/1 |
| Outcome | O.S. : 39% at 1 year DFS.: 31% at 1 year | Alive: n = 3 PR: n = 1 | O.S.: 43% at 1 year DFS: 43% at 1 year |