Double Cord Blood Units Allogeneic Transplantation for Hematological Malignancies: Study of the '3 Partners' Matching Variables on Transplant Outcomes

Autor: Mohamad Sobh, Franck E. Nicolini, Fiorenza Barraco, Isabelle Mollet, Stephane Morisset, Xavier Thomas, Jihane Fattoum, Mauricette Michallet, Youcef Chelghoum, Valérie Dubois, Marie Y. Detrait, Sophie Ducastelle, Nathalie Tedone, Hélène Labussière
Rok vydání: 2011
Předmět:
Zdroj: Blood. 118:3111-3111
ISSN: 1528-0020
0006-4971
Popis: Abstract 3111 Cord blood transplantation (CB-T) is increasingly used as a treatment alternative for hematological malignancies. The use of double CB-T has leaded to interesting results in adult patients. We retrospectively evaluated 31 patients, 19 males and 12 females with a median age of 36 years (range: 20–63) who received double CB-T for hematological malignancies at our institution between 2005 and 2011. There were 15 AML, 9 ALL, 2 CML, 1 Hodgkin disease, 1 NHL, 1 MM and 1 MDS; at transplantation, 18 (58%) were in CR, 5 (16%) in PR and 8 (26%) in relapse, 16 patients received a myeloablative conditioning and 15 a reduced intensity one. Different characteristics of both CB units (CBU) are described in Table 1. When considering matching variables between the 2 CBUs and the recipient, for sex matching: in 10 cases, CBUs were both matched with the recipient, in 1 case both mismatched and in 20 cases, only 1 CBU was mismatched with recipient. For ABO compatibility, in 7 cases, CBUs were both compatible with the recipient, in 13 cases both were incompatible and in 1 case, only one was incompatible. For HLA matching, in 18 cases, both CBUs were 4/6 with the recipient and in 13 cases, only one CBU was 5/6. When considering HLA matching between the 2 CBUs, there were 7 with 3/6 HLA matching, 17 with 4/6, 6 with 5/6 and 1 with 6/6. After transplantation, 25 (81%) patients engrafted among them, 6 had mixed chimerism (presence of the 2 CBUs) and 19 had one dominant CBU. Non-engrafted patients were in relapse or progressive disease and received RIC before allo-HSCT. There were 13 patients who developed acute GVHD ≥2 (8 grade III-IV) and 6 chronic GVHD (3 limited and 3 extensive). After a median follow-up of 6.5 months (range: 1–54), the median OS was not reached with a 1 year probability of 58% (95%CI: 42–80), only 3 patients relapsed. The cumulative incidence of transplant related mortality (TRM) was 37% (95%CI: 28–46). A multivariate model that studied the different matching possibilities (sex, ABO and HLA) between the 2 CBUs together and then between the 2 CBUs with the recipient combined to CNT and CD34 cells number, showed that only the sex matching between the 3 partners can determine the dominant CBU later (p=0.04). In multivariate analysis taking into account pre-transplant and the matching variables, no factor impacted the engraftment while factors that impacted on OS were age [HR=1.1 (1.03–1.25), p=0.01], disease status at HSCT [relapse, HR=8.7 (1.4–52), p=0.01] and TNC number [ HR=0.99 (0.98–1), p=0.02]. Age and TNC number also had a significant impact on TRM [HR=1.12 (1.02–1.23), p=0.01 and HR=0.99 (0.98–1), p=0.003]. In conclusion, we did not find any impact of the different matching variables between the 2 CBUs either together or with the recipient on different transplantation outcomes. Nevertheless, sex matching between the 3 partners seems to play a role in the determination of the dominant CBU later and its installation in the recipient. Disclosures: No relevant conflicts of interest to declare.
Databáze: OpenAIRE