Better outcomes of modified myeloablative conditioning without antithymocyte globulin versus myeloablative conditioning in cord blood transplantation for hematological malignancies: A retrospective (development) and a prospective (validation) study

Cord blood transplantation (CBT) is an effective option for treating hematological malignancies, but graft failure (GF) remains the primary cause of therapy failure. Thus, based on myeloablative conditioning (MAC) of busulfan with cyclophosphamide (Bu/Cy) or total body irradiation with Cy (TBI/Cy),...

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Bibliographic Details
Published in:International journal of cancer 2018-08, Vol.143 (3), p.699-708
Main Authors: Sun, Zimin, Liu, Huilan, Luo, Chenhui, Geng, Liangquan, Zheng, Changcheng, Tang, Baolin, Zhu, Xiaoyu, Tong, Juan, Wang, Xingbing, Ding, Kaiyang, Wan, Xiang, Zhang, Lei, Yao, Wen, Song, Kaiding, Zhang, Xuhan, Wu, Yue, Yang, Huizhi, Han, Yongsheng, Liu, Xin, Zhu, Weibo, Wu, Jingsheng, Wang, Zuyi
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Antilymphocyte serum
Antilymphocyte Serum - therapeutic use
antithymocyte globulin
Blood Platelets
Busulfan
Cancer
Cancer Therapy and Prevention
Child
Child, Preschool
Conditioning
Cord blood
Cord Blood Stem Cell Transplantation - adverse effects
Cord Blood Stem Cell Transplantation - methods
cord blood transplantation
Cyclophosphamide
Cytarabine
engraftment
Female
Fludarabine
Globulins
Graft rejection
Graft vs Host Disease - etiology
Grafts
Hematologic Neoplasms - complications
Hematologic Neoplasms - mortality
Hematologic Neoplasms - therapy
hematological malignancies
Hematology
Humans
Irradiation
Male
Medical prognosis
Medical research
Middle Aged
myeloablative conditioning
Neutrophils
Patients
Radiation
Retrospective Studies
Thymocytes
Transplantation
Transplantation Conditioning - adverse effects
Transplantation Conditioning - methods
Treatment Outcome
Young Adult
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Summary:Cord blood transplantation (CBT) is an effective option for treating hematological malignancies, but graft failure (GF) remains the primary cause of therapy failure. Thus, based on myeloablative conditioning (MAC) of busulfan with cyclophosphamide (Bu/Cy) or total body irradiation with Cy (TBI/Cy), fludarabine (Flu) was added to Bu/Cy and cytarabine (CA) to TBI/Cy for a modified myeloablative conditioning (MMAC). To compare the prognosis of MMAC with MAC, we conducted a retrospective study including 58 patients who underwent CBT with MAC or MMAC from 2000 to 2011. Neutrophil and platelet engraftment rate, overall survival (OS) and disease free survival (DFS) were significantly higher in the MMAC group (adjusted hazard ratio [HR], 2.58, 2.43, 0.36 and 0.37; p 
ISSN:0020-7136
1097-0215
DOI:10.1002/ijc.31339