%0 Journal Article
%A Piñana, José Luis
%A Sanz, Jaime
%A Picardi, Alessandra
%A Ferrá, Christelle
%A Martino, Rodrigo
%A Barba, Pere
%A Gonzalez-Vicent, Marta
%A Pascual, María Jesús
%A Martín, Carmen
%A Verdeguer, Amparo
%A Diaz de Heredia, Cristina
%A Montesinos, Pau
%A Ribera, José-María
%A Sanz, Miguel
%A Arcese, William
%A Sanz, Guillermo
%T Umbilical cord blood transplantation from unrelated donors in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia.
%D 2014
%@ 0390-6078
%U http://hdl.handle.net/10668/1838
%X There are very few disease-specific studies focusing on outcomes of umbilical cord blood transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia. We report the outcome of 45 patients with Philadelphia chromosome-positive acute lymphoblastic leukemia who underwent myeloablative single unit cord blood transplantation from unrelated donors within the GETH/GITMO cooperative group. Conditioning regimens were based on combinations of thiotepa, busulfan, cyclophospamide or fludarabine, and antithymocyte globulin. At the time of transplantation, 35 patients (78%) were in first complete remission, four (8%) in second complete remission and six (14%) in third or subsequent response. The cumulative incidence of myeloid engraftment was 96% at a median time of 20 days and significantly better for patients receiving higher doses of CD34(+) cells. The incidence of acute grade II-IV graft-versus-host disease was 31%, while that of overall chronic graft-versus-host disease was 53%. Treatment-related mortality was 17% at day +100 and 31% at 5 years. The 5-year relapse, event-free survival and overall survival rates were 31%, 36% and 44%, respectively. Although the event-free and overall survival rates in patients without BCR/ABL transcripts detectable at time of transplant were better than those in whom BCR/ABL transcripts were detected (46% versus 24% and 60% versus 30%, respectively) these differences were not statistically significant in the univariate analysis (P=0.07). These results demonstrate that umbilical cord blood transplantation from unrelated donors can be a curative treatment for a substantial number of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia.
%K Aloinjertos
%K Enfermedad crónica
%K Trasplante de células madre de la sangre del cordón
%K Supervivencia sin Enfermedad
%K Estudios de Seguimiento
%K Enfermedad injerto contra huésped
%K Agonistas mieloablativos
%K Cromosoma Filadelfia
%K Leucemia-linfoma linfoblástico de células precursoras
%K Estudios retrospectivos
%K Tasa de Supervivencia
%K Acondicionamiento para el trasplante
%~