Cord-Blood Engraftment Using an Enhanced Dual-Conditioning Regimen for Malignant Hematologic Diseases

To explore a more effective conditioning regimen for umbilical cord blood transplantation (UCBT) to treat hematologic malignancies, we conducted a cohort study of a fludarabine/busulfan/cytarabine plus cyclophosphamide 200 mg/kg regimen. Forty-two consecutive patients with leukemia, myelodysplastic...

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Bibliographic Details
Published in:Cell transplantation 2022-01, Vol.31, p.9636897211070238-9636897211070238
Main Authors: Ding, Jiahua, Fang, Yongjun, Zhou, Rongfu, Gu, Yan, Du, Shengnan, Lu, Qin, Yue, Qingqing
Format: Article
Language:English
Subjects:
Blood diseases
Busulfan
CD34 antigen
Cohort Studies
Cord blood
Cord Blood Stem Cell Transplantation - adverse effects
Cyclophosphamide
Cytarabine
Fludarabine
Graft rejection
Graft vs Host Disease - etiology
Grafts
Hematologic Diseases - complications
Hematologic Neoplasms - therapy
Hematological diseases
Humans
Leukocytes (neutrophilic)
Lymphoma
Malignancy
Myelodysplastic syndrome
Myelodysplastic syndromes
Neutrophils
Original
Retrospective Studies
Transplantation
Transplantation Conditioning
Transplants & implants
Umbilical cord
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Summary:To explore a more effective conditioning regimen for umbilical cord blood transplantation (UCBT) to treat hematologic malignancies, we conducted a cohort study of a fludarabine/busulfan/cytarabine plus cyclophosphamide 200 mg/kg regimen. Forty-two consecutive patients with leukemia, myelodysplastic syndrome, or lymphoma received the regimen. The median number of infused total nucleated cells per kilogram was 5.5 × 107 (1.81–20.6), the median number of infused CD34+ cells per kilogram was 1.58 × 105 (0.58–6.6), and the median follow-up for surviving patients was 37 months (4.0–79.5 months). The cumulative incidence of neutrophil engraftment at 31 days was 100% [95% confidence interval (CI): 0.9159–1.0], and the median time to neutrophil engraftment was 19 days. The cumulative incidence of nonrelapse mortality was 12.76% (95% CI: 0.0455–0.2356) at 180 days and 3 years. The 3-year overall survival (OS) and disease-free survival (DFS) rates were 71.6% and 59.6%, respectively. Especially in patients who received transplants in the early and intermediate stages, the 3-year OS and DFS rates were 90.3% (95% CI: 0.805–1.0) and 76.2% (95% CI: 0.608–0.956), respectively. The regimen significantly improved engraftment and survival, indicating that the high graft failure of UCBT was caused by rejection.
ISSN:0963-6897
1555-3892
DOI:10.1177/09636897211070238