Concurrent search for unrelated cord and volunteer donor in high-risk acute lymphoblastic leukemia
| Autor: | Giovanna Meloni, Salvatore Perrone, Nicoletta Sacchi, Luca Laurenti, Anna Maria Testi, Veronica Valle, Roberto Ricci, Fiammetta Natalino, Filippo Milano, Barbarella Lucarelli, Giovanni Fernando Torelli, Maria Screnci, Anna Paola Iori, Maria Paola Perrone, William Arcese, Alfonso Piciocchi, Antonella Vitale, Roberto Foa, Walter Barberi |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Volunteers medicine.medical_specialty Multivariate analysis Cord Adolescent Lymphoblastic Leukemia Blood Donors Young Adult Precursor Cell Lymphoblastic Leukemia-Lymphoma Humans Child Recurrence Child Preschool Infant Histocompatibility Testing Unrelated Donors Risk Factors Fetal Blood Voluntary Workers Middle Aged Female Survival Analysis Remission Induction Internal medicine medicine acute lymphoblastic leukemia allogeneic stem cell transplantation cord blood donor search unrelated volunteer donor Volunteer donor Preschool Univariate analysis Hematology business.industry General Medicine Surgery Increased risk Cord blood business Settore MED/15 - Malattie del Sangue |
| Zdroj: | Annals of hematology. 91(6) |
| ISSN: | 1432-0584 |
| Popis: | To assess the effectiveness of the search for an unrelated donor on the outcome of patients with high-risk acute lymphoblastic leukemia, we analyzed prospectively 136 patients who underwent a search for cord blood (CB) and an unrelated volunteer donor (UD) at the same time. The probability of finding a donor was 58.2%, 70.3%, and 75.7% at 3, 6, and 12 months, respectively. The median time to find a donor was 1.8 months for CB and 3.5 months for UD. Of the 99 patients with a donor, 38.4% failed to undergo the transplant because of a relapse observed at a median of 4 months from the start of the search. In univariate analysis, absence of relapse during the search (p < 0.0001) and transplant (p = 0.004) showed a positive impact on long-term survival. In multivariate analysis, relapse during the search remained the key factor affecting survival (p < 0.0001). Since an extension of the search beyond 3 months enables only a slight increase in the probability of finding a donor compared to the increased risk of relapse, the time of the search should not exceed the 3-month time point. The simultaneous search for CB and UD increases the likelihood of performing a timely transplant. |
| Databáze: | OpenAIRE |
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