Umbilical cord blood transplantation in adults with haematological malignancies - UK Single Centre Pilot Study

M.M. Ceesay, Z.Y. Lim, S. Querol, M. Kenyon, A. Ho, A. Mijovic, S. Devereux, R. Ireland, J. Marsh, G.J. Mufti, A. Pagliuca

Author address: 

King’s College Hospital (London, UK)

Abstract: 

Recent results of adults who received umbilical cord blood (UBC) allografts have been extremely promising, with overall and disease free survival data being comparable to transplantation using adult VUD. However, the UK has been slow in embracing this type of program. We report on preliminary results from a single centre pilot study evaluating the feasibility of UBC allografts for adults in UK. Between July 2006 and October 2009 a total of 23 adults were transplanted using 11 single UBC and 13 double UCB (one patient had 2 transplants). Use of single or double UCB was based on the recipient weight. Diagnoses at transplantation were AML (n = 11), MDS (n = 5), ALL (n = 3), CML (n = 2), aplastic anaemia (n = 2) and non-Hodgkin’s lymphoma (n = 1). Patients received partial HLA-matched UCB grafts using 3 different protocols: Fludarabine, Cylophosphamide, TBI and ATG for the double UCB (n = 10), Thiotepa, Fludarabine, Busulphan and ATG for the single UCB (n = 10) and FCC (Fludarabine, Cyclosphosphamide and Alemtuxumab (n = 4) for marrow failures. Cyclosporine and Mycophenolate were used as the standard GVHD prophylaxis except in FCC where cyclosporine alone was used. The median age was 40 (range 17-72) years. The median total nucleated cell dose (TNC) and cryopreserved CD34 + cell dose were 2.7 x 10 7 /kg and 1.0 x 10 5 /kg respectively. The median time to sustained neutrophil engraftment was 21.0 (range 6-39) days. Four patients had primary graft failure and 2 others died before engraftment. There were no cases of grade III-IV acute GVHD and only one case of chronic extensive gut GVHD. The day 100 and 1 year transplant related mortality (TRM) was 9% and 41% respectively. Causes of TRM included: infection (n = 5) (CMV/adenovirus reactivation = 2, pseudomonas = 1, aspergillosis = 1 and CNS toxoplasmosis = 1), pulmonary haemorrhage (n = 1), intracerebral bleed/EBV PTLD (n = 1) and hepatic VOD (n = 1). Relapse occurred in only 2 patients and both died at day 63 and 117 post transplant. The overall survival (OS) at one year was 59%. However, the 1-year OS for patients > 55 yrs was 17% vs. 72% for
2010

abstract No: 

P602

Full conference title: 

Annual Meeting of the EBMT, 36th
    • EBMT 36th (2010)