Cord Blood Unit Dominance Analysis and Effect of the Winning Unit on Outcomes after Double-Unit Umbilical Cord Blood Transplantation in Adults with Acute Leukemia: A Retrospective Study on Behalf of Eurocord, the Cord Blood Committee of Cellular Therapy, Immunobiology Working Party, and the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation - Université de Lorraine Access content directly
Journal Articles Biology of Blood and Marrow Transplantation Year : 2018

Cord Blood Unit Dominance Analysis and Effect of the Winning Unit on Outcomes after Double-Unit Umbilical Cord Blood Transplantation in Adults with Acute Leukemia: A Retrospective Study on Behalf of Eurocord, the Cord Blood Committee of Cellular Therapy, Immunobiology Working Party, and the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation

Karina Tozatto-Maio
  • Function : Author
Federica Giannotti
  • Function : Author
Myriam Labopin
  • Function : Author
  • PersonId : 973513
Annalisa Ruggeri
  • Function : Author
  • PersonId : 973514
Fernanda Volt
  • Function : Author
Annalisa Paviglianiti
Chantal Kenzey
  • Function : Author
Hiromi Hayashi
  • Function : Author
Dimitrios Karakasis
  • Function : Author
Didier Blaise
Nigel Russell
  • Function : Author
Arnon Nagler
  • Function : Author
  • PersonId : 973523
Eliane Gluckman
  • Function : Author
  • PersonId : 973522
Vanderson Rocha
  • Function : Correspondent author
  • PersonId : 1131525

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Abstract

Usually, after double umbilical cord blood transplantation (DUCBT), only 1 of the transplanted units persists in the long term. The characteristics of the winning cord blood unit (W-CBU) that determine unit dominance and how they influence the outcomes of DUCBT remain unclear. We retrospectively analyzed 347 patients with acute leukemia transplanted with a DUCBT (694 CBU) from 2005 to 2013 who had documented neutrophil engraftment and a W-CBU identified by chimerism analysis, to identify unit characteristics impacting on dominance. Median age at DUCBT was 40 years and median follow-up was 35 months. Among W-CBUs, 41% were ≥5/6 HLA matched to the recipient and 59% were ≤4/6. Multivariate analysis indicated that ≤4/6 HLA-matched W-CBUs led to lower leukemia-free survival (44% versus 56%; hazard ratio [HR], 1.5; P = .032) and overall survival (49% versus 62%; HR, 1.5; P = .028), increased nonrelapse mortality (26% versus 18%; HR, 1.9; P = .027), and acute graft-versus-host disease (46% versus 35%; HR, 1.7; P = .013). We were unable to predict unit dominance, but we demonstrated that outcomes were strongly influenced by the degree of HLA mismatch between W-CBU and recipient. Therefore, selection of both units with the lower number of HLA mismatches with the recipient is indicated.

Dates and versions

hal-01777730 , version 1 (25-04-2018)

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Karina Tozatto-Maio, Federica Giannotti, Myriam Labopin, Annalisa Ruggeri, Fernanda Volt, et al.. Cord Blood Unit Dominance Analysis and Effect of the Winning Unit on Outcomes after Double-Unit Umbilical Cord Blood Transplantation in Adults with Acute Leukemia: A Retrospective Study on Behalf of Eurocord, the Cord Blood Committee of Cellular Therapy, Immunobiology Working Party, and the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation. Biology of Blood and Marrow Transplantation, 2018, 24 (8), pp.1657-1663. ⟨10.1016/j.bbmt.2018.02.014⟩. ⟨hal-01777730⟩
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