Higher Early Monocyte and Total Lymphocyte Counts Are Associated with Better Overall Survival after Standard Total Body Irradiation, Cyclophosphamide, and Fludarabine Reduced-Intensity Conditioning Double Umbilical Cord Blood Allogeneic Stem Cell Transplantation in Adults.

Autor: Le Bourgeois A; Centre Hospitalier et Universitaire de Nantes, Département d'Hématologie Clinique, Centre d'Investigation Clinique en Cancérologie (CI2C), Nantes, France. Electronic address: amandine.lebourgeois@chu-nantes.fr., Peterlin P; Centre Hospitalier et Universitaire de Nantes, Département d'Hématologie Clinique, Centre d'Investigation Clinique en Cancérologie (CI2C), Nantes, France., Guillaume T; Centre Hospitalier et Universitaire de Nantes, Département d'Hématologie Clinique, Centre d'Investigation Clinique en Cancérologie (CI2C), Nantes, France., Delaunay J; Centre Hospitalier et Universitaire de Nantes, Département d'Hématologie Clinique, Centre d'Investigation Clinique en Cancérologie (CI2C), Nantes, France., Duquesne A; Unité d'ingénierie cellulaire, EFS Pays de la Loire, Nantes, France., Le Gouill S; Centre Hospitalier et Universitaire de Nantes, Département d'Hématologie Clinique, Centre d'Investigation Clinique en Cancérologie (CI2C), Nantes, France., Moreau P; Centre Hospitalier et Universitaire de Nantes, Département d'Hématologie Clinique, Centre d'Investigation Clinique en Cancérologie (CI2C), Nantes, France., Mohty M; Hôpital saint Antoine, Département d'Hématologie Clinique, Paris, France., Campion L; Institut de Cancérologie de l'Ouest - Centre René Gauducheau - Saint-Herblain, France; Université de Nantes and INSERM CRNCA UMR 892, Nantes, France., Chevallier P; Centre Hospitalier et Universitaire de Nantes, Département d'Hématologie Clinique, Centre d'Investigation Clinique en Cancérologie (CI2C), Nantes, France; Université de Nantes and INSERM CRNCA UMR 892, Nantes, France.
Jazyk: angličtina
Zdroj: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation [Biol Blood Marrow Transplant] 2016 Aug; Vol. 22 (8), pp. 1473-1479. Date of Electronic Publication: 2016 Apr 24.
DOI: 10.1016/j.bbmt.2016.04.015
Abstrakt: This single-center retrospective study aimed to report the impact of early hematopoietic and immune recoveries after a standard total body irradiation, cyclophosphamide, and fludarabine (TCF) reduced-intensity conditioning (RIC) regimen for double umbilical cord blood (dUCB) allogeneic stem cell transplantation (allo-SCT) in adults. We analyzed 47 consecutive patients older than 17 years who engrafted after a dUCB TCF allo-SCT performed between January 2006 and April 2013 in our department. Median times for neutrophil and platelet recoveries were 17 (range, 6 to 59) and 37 days (range, 0 to 164), respectively. The 3-year overall (OS) and disease-free survivals, relapse incidence, and nonrelapse mortality were 65.7%, 57.2%, 27.1%, and 19%, respectively. In multivariate analysis, higher day +30 monocyte (≥615/mm(3); hazard ratio [HR], .04; 95% confidence interval [CI], .004 to .36; P < .01) and day +42 lymphocyte (≥395/mm(3); HR, .16; 95% CI, .03 to .78; P = .02) counts were independently associated with better OS. These results suggest that early higher hematopoietic and immune recovery is predictive of survival after dUCB TCF RIC allo-SCT in adults. Factors other than granulocyte colony-stimulating factor, which was used in all cases, favoring expansion of monocytes or lymphocytes, should be tested in the future as part of the UCB transplantation procedure.
(Copyright © 2016 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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