Results of the Cord Blood Transplantation Study (COBLT): Clinical outcomes of unrelated donor umbilical cord blood transplantation in pediatric patients with hematologic malignancies Journal Article
| Authors: | Kurtzberg, J.; Prasad, V. K.; Carter, S. L.; Wagner, J. E.; Lee, A. B. L.; Wall, D.; Kapoor, N.; Guinan, E. C.; Feig, S. A.; Wagner, E. L.; Kernan, N. A.; on behalf of the COBLT Steering Committee |
| Article Title: | Results of the Cord Blood Transplantation Study (COBLT): Clinical outcomes of unrelated donor umbilical cord blood transplantation in pediatric patients with hematologic malignancies |
| Abstract: | Outcomes of unrelated donor cord blood transplantation in 191 hematologic malignancy children (median age, 7.7 years; median weight, 25.9 kg) enrolled between 1999 and 2003 were studied (median follow- up, 27.4 months) in a prospective phase 2 multicenter trial. Human leukocyte antigen (HLA) matching at enrollment was 6/6 (n = 17), 5/6 (n = 58), 4/6 (n = 111), or 3/6 (n = 5) by low-resolution HLA-A, -B, and high-resolution (HR) DRB1. Retrospectively, 179 pairs were HLAtyped by HR. The median precryopreservation total nucleated cell (TNC) dose was 5.1 × 107 TNC/kg (range, 1.5-23.7) with 3.9 × 107 TNC/kg (range, 0.8-22.8) infused. The median time to engraftment (absolute neutrophil count > 500/mm3 and platelets 50 000/μL) was 27 and 174 days. The cumulative incidence of neutrophil engraftment by day 42 was 79.9% (95% confidence interval [CI], 75.1%-85.2%); acute grades III/IV GVHD by day 100 was 19.5% (95% CI, 13.9%-25.5%); and chronic GVHD at 2 years was 20.8% (95% CI, 14.8%-27.7%). HR matching decreased the probability of severe acute GVHD. The cumulative incidence of relapse at 2 years was 19.9% (95% CI, 14.8%-25.7%). The probabilities of 6-month and 2-year survivals were 67.4% and 49.5%. Unrelated donor cord blood transplantation from partially HLA-mismatched units can cure many children with leukemias. The study was registered at www.clinicaltrials.gov as #NCT00000603. © 2008 by The American Society of Hematology. |
| Keywords: | adolescent; cancer survival; child; preschool child; school child; treatment outcome; child, preschool; disease-free survival; survival rate; retrospective studies; transplantation, homologous; acute granulocytic leukemia; major clinical study; clinical trial; mortality; drug dose reduction; disease free survival; follow up; methodology; prospective study; prospective studies; phase 2 clinical trial; thrombocyte; incidence; cyclophosphamide; continuous infusion; chronic myeloid leukemia; retrospective study; acute lymphoblastic leukemia; childhood cancer; time; time factors; cause of death; blood; cryopreservation; acute graft versus host disease; chronic graft versus host disease; cord blood stem cell transplantation; disease severity; engraftment; hematologic malignancy; hla matching; myelodysplastic syndrome; whole body radiation; blood disease; donor; hematologic neoplasms; neutrophil; infant; probability; multicenter study; hla dr antigen; graft versus host reaction; thrombocyte count; methylprednisolone; virus infection; cell nucleus; drug blood level; leukocyte count; graft survival; hla a antigen; hla b antigen; leukemia relapse; graft vs host disease; bacterial infection; granulocyte colony stimulating factor; mycosis; cyclosporin; hla antigen; hla antigens; allotransplantation; acute disease; thymocyte antibody; platelet count; histocompatibility testing; histocompatibility test; lymphoblastoma; acute biphenotypic leukemia; juvenile myelomonocytic leukemia |
| Journal Title: | Blood |
| Volume: | 112 |
| Issue: | 10 |
| ISSN: | 0006-4971 |
| Publisher: | American Society of Hematology |
| Date Published: | 2008-11-15 |
| Start Page: | 4318 |
| End Page: | 4327 |
| Language: | English |
| DOI: | 10.1182/blood-2007-06-098020 |
| PUBMED: | 18723429 |
| PROVIDER: | scopus |
| PMCID: | PMC2581998 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 76" - "Export Date: 17 November 2011" - "CODEN: BLOOA" - "Source: Scopus" |
