Promising Progression-Free Survival for Patients Low and Intermediate Grade Lymphoid Malignancies after Nonmyeloablative Umbilical Cord Blood Transplantation

Claudio G. Brunstein; Susana Cantero; Qing Cao; Navneet Majhail; Brian McClune; Linda J. Burns; Marcie Tomblyn; Jeffrey S. Miller; Bruce R. Blazar; Philip B. McGlave; Daniel J. Weisdorf; John E. Wagner

doi:10.1016/j.bbmt.2008.11.013

Promising Progression-Free Survival for Patients Low and Intermediate Grade Lymphoid Malignancies after Nonmyeloablative Umbilical Cord Blood Transplantation

Claudio G. Brunstein, Susana Cantero, Qing Cao, Navneet Majhail, Brian McClune, Linda J. Burns, Marcie Tomblyn, Jeffrey S. Miller, Bruce R. Blazar, Philip B. McGlave, Daniel J. Weisdorf, John E. Wagner

Research output: Contribution to journal › Article › peer-review

40 Scopus citations

Abstract

Nonmyeloablative hematopoietic cell transplantation (HCT) has been used to treat patients with advanced or high-risk lymphoid malignancies. We studied 65 patients (median age 46 years) receiving an umbilical cord blood (UCB) graft after a single conditioning regimen consisting of cyclophosphamide (50 mg/kg) on day -6, fludarabine (40 mg/m²) daily on days -6 to -2, as well as a single fraction of total-body irradiation (TBI) (200 cGy) along with cyclosporine mycophenolate mofetil immunosuppression. Median time to neutrophil and platelet recovery was 7.5 days (range: 0-32) and 46 days (range: 8-111), respectively. Cumulative incidences of grade II-IV, grade III-IV acute, and chronic graft-versus-host disease (aGVHD, cGVHD) were 57% (95% confidence interval [CI]: 43%-70%), 25% (95% CI: 14%-35%), and 19% (95% CI: 9%-29%), respectively. Transplant-related mortality at 3 years was 15% (95% CI: 5%-26%). Median follow-up was 23 months. The progression free-survival (PFS), current PFS and overall survival (OS) were 34% (95% CI: 21%-47%), 49% (95% CI: 36%-62%), and 55% (95% CI: 42%-70%) at 3 years. Based on our data, we conclude that a nonmyeloablative conditioning regimen followed by UCB transplantation is an effective treatment for patients with advanced lymphoid malignancies who lack a suitable sibling donor.

Original language	English (US)
Pages (from-to)	214-222
Number of pages	9
Journal	Biology of Blood and Marrow Transplantation
Volume	15
Issue number	2
DOIs	https://doi.org/10.1016/j.bbmt.2008.11.013
State	Published - Feb 2009

Bibliographical note

Funding Information:
Financial disclosure: This work was supported in part by grants from the National Cancer Institute PO1-CA65493 (J.E.W., T.E.D., P.B.M., J.S.M.) and the Children's Cancer Research Fund (J.E.W., T.E.D.). The authors acknowledge Dr. John Klein for his assistance on the multistate model, and Michael Franklin for assistance in editing and preparing this manuscript.

Keywords

Lymphoid malignancies
Nonmyeloablative
Umbilical cord blood

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.bbmt.2008.11.013

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Brunstein, C. G., Cantero, S., Cao, Q., Majhail, N., McClune, B., Burns, L. J., Tomblyn, M., Miller, J. S., Blazar, B. R., McGlave, P. B., Weisdorf, D. J., & Wagner, J. E. (2009). Promising Progression-Free Survival for Patients Low and Intermediate Grade Lymphoid Malignancies after Nonmyeloablative Umbilical Cord Blood Transplantation. Biology of Blood and Marrow Transplantation, 15(2), 214-222. https://doi.org/10.1016/j.bbmt.2008.11.013

Promising Progression-Free Survival for Patients Low and Intermediate Grade Lymphoid Malignancies after Nonmyeloablative Umbilical Cord Blood Transplantation. / Brunstein, Claudio G.; Cantero, Susana; Cao, Qing et al.
In: Biology of Blood and Marrow Transplantation, Vol. 15, No. 2, 02.2009, p. 214-222.

Research output: Contribution to journal › Article › peer-review

Brunstein, CG, Cantero, S, Cao, Q, Majhail, N, McClune, B, Burns, LJ, Tomblyn, M, Miller, JS , Blazar, BR, McGlave, PB, Weisdorf, DJ & Wagner, JE 2009, 'Promising Progression-Free Survival for Patients Low and Intermediate Grade Lymphoid Malignancies after Nonmyeloablative Umbilical Cord Blood Transplantation', Biology of Blood and Marrow Transplantation, vol. 15, no. 2, pp. 214-222. https://doi.org/10.1016/j.bbmt.2008.11.013

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abstract = "Nonmyeloablative hematopoietic cell transplantation (HCT) has been used to treat patients with advanced or high-risk lymphoid malignancies. We studied 65 patients (median age 46 years) receiving an umbilical cord blood (UCB) graft after a single conditioning regimen consisting of cyclophosphamide (50 mg/kg) on day -6, fludarabine (40 mg/m2) daily on days -6 to -2, as well as a single fraction of total-body irradiation (TBI) (200 cGy) along with cyclosporine mycophenolate mofetil immunosuppression. Median time to neutrophil and platelet recovery was 7.5 days (range: 0-32) and 46 days (range: 8-111), respectively. Cumulative incidences of grade II-IV, grade III-IV acute, and chronic graft-versus-host disease (aGVHD, cGVHD) were 57% (95% confidence interval [CI]: 43%-70%), 25% (95% CI: 14%-35%), and 19% (95% CI: 9%-29%), respectively. Transplant-related mortality at 3 years was 15% (95% CI: 5%-26%). Median follow-up was 23 months. The progression free-survival (PFS), current PFS and overall survival (OS) were 34% (95% CI: 21%-47%), 49% (95% CI: 36%-62%), and 55% (95% CI: 42%-70%) at 3 years. Based on our data, we conclude that a nonmyeloablative conditioning regimen followed by UCB transplantation is an effective treatment for patients with advanced lymphoid malignancies who lack a suitable sibling donor.",

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note = "Funding Information: Financial disclosure: This work was supported in part by grants from the National Cancer Institute PO1-CA65493 (J.E.W., T.E.D., P.B.M., J.S.M.) and the Children's Cancer Research Fund (J.E.W., T.E.D.). The authors acknowledge Dr. John Klein for his assistance on the multistate model, and Michael Franklin for assistance in editing and preparing this manuscript.",

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AU - Cao, Qing

AU - Majhail, Navneet

AU - McClune, Brian

AU - Burns, Linda J.

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AU - Miller, Jeffrey S.

AU - Blazar, Bruce R.

AU - McGlave, Philip B.

AU - Weisdorf, Daniel J.

AU - Wagner, John E.

N1 - Funding Information: Financial disclosure: This work was supported in part by grants from the National Cancer Institute PO1-CA65493 (J.E.W., T.E.D., P.B.M., J.S.M.) and the Children's Cancer Research Fund (J.E.W., T.E.D.). The authors acknowledge Dr. John Klein for his assistance on the multistate model, and Michael Franklin for assistance in editing and preparing this manuscript.

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N2 - Nonmyeloablative hematopoietic cell transplantation (HCT) has been used to treat patients with advanced or high-risk lymphoid malignancies. We studied 65 patients (median age 46 years) receiving an umbilical cord blood (UCB) graft after a single conditioning regimen consisting of cyclophosphamide (50 mg/kg) on day -6, fludarabine (40 mg/m2) daily on days -6 to -2, as well as a single fraction of total-body irradiation (TBI) (200 cGy) along with cyclosporine mycophenolate mofetil immunosuppression. Median time to neutrophil and platelet recovery was 7.5 days (range: 0-32) and 46 days (range: 8-111), respectively. Cumulative incidences of grade II-IV, grade III-IV acute, and chronic graft-versus-host disease (aGVHD, cGVHD) were 57% (95% confidence interval [CI]: 43%-70%), 25% (95% CI: 14%-35%), and 19% (95% CI: 9%-29%), respectively. Transplant-related mortality at 3 years was 15% (95% CI: 5%-26%). Median follow-up was 23 months. The progression free-survival (PFS), current PFS and overall survival (OS) were 34% (95% CI: 21%-47%), 49% (95% CI: 36%-62%), and 55% (95% CI: 42%-70%) at 3 years. Based on our data, we conclude that a nonmyeloablative conditioning regimen followed by UCB transplantation is an effective treatment for patients with advanced lymphoid malignancies who lack a suitable sibling donor.

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Promising Progression-Free Survival for Patients Low and Intermediate Grade Lymphoid Malignancies after Nonmyeloablative Umbilical Cord Blood Transplantation

Abstract

Bibliographical note

Keywords

UN SDGs

Publisher link

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