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Better outcomes of modified myeloablative conditioning without antithymocyte globulin versus myeloablative conditioning in cord blood transplantation for hematological malignancies: A retrospective (development) and a prospective (validation) study
Cord blood transplantation (CBT) is an effective option for treating hematological malignancies, but graft failure (GF) remains the primary cause of therapy failure. Thus, based on myeloablative conditioning (MAC) of busulfan with cyclophosphamide (Bu/Cy) or total body irradiation with Cy (TBI/Cy),...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6033117/ https://www.ncbi.nlm.nih.gov/pubmed/29473150 http://dx.doi.org/10.1002/ijc.31339 |
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author | Sun, Zimin Liu, Huilan Luo, Chenhui Geng, Liangquan Zheng, Changcheng Tang, Baolin Zhu, Xiaoyu Tong, Juan Wang, Xingbing Ding, Kaiyang Wan, Xiang Zhang, Lei Yao, Wen Song, Kaiding Zhang, Xuhan Wu, Yue Yang, Huizhi Han, Yongsheng Liu, Xin Zhu, Weibo Wu, Jingsheng Wang, Zuyi |
author_facet | Sun, Zimin Liu, Huilan Luo, Chenhui Geng, Liangquan Zheng, Changcheng Tang, Baolin Zhu, Xiaoyu Tong, Juan Wang, Xingbing Ding, Kaiyang Wan, Xiang Zhang, Lei Yao, Wen Song, Kaiding Zhang, Xuhan Wu, Yue Yang, Huizhi Han, Yongsheng Liu, Xin Zhu, Weibo Wu, Jingsheng Wang, Zuyi |
author_sort | Sun, Zimin |
collection | PubMed |
description | Cord blood transplantation (CBT) is an effective option for treating hematological malignancies, but graft failure (GF) remains the primary cause of therapy failure. Thus, based on myeloablative conditioning (MAC) of busulfan with cyclophosphamide (Bu/Cy) or total body irradiation with Cy (TBI/Cy), fludarabine (Flu) was added to Bu/Cy and cytarabine (CA) to TBI/Cy for a modified myeloablative conditioning (MMAC). To compare the prognosis of MMAC with MAC, we conducted a retrospective study including 58 patients who underwent CBT with MAC or MMAC from 2000 to 2011. Neutrophil and platelet engraftment rate, overall survival (OS) and disease free survival (DFS) were significantly higher in the MMAC group (adjusted hazard ratio [HR], 2.58, 2.43, 0.36 and 0.37; p < 0.01, p = 0.01, p = 0.02 and p = 0.02, separately). Nonrelapse mortality (NRM) was comparable (p = 0.183). To validate the outcomes noted in the MMAC group, we conducted a prospective single‐arm clinical trial including 188 patients who underwent CBT with MMAC from 2011 to 2015. Engraftment rate, survival and NRM of the MMAC group in the prospective trail (MMAC‐P) were similar to the MMAC group in the retrospective study (MMAC‐R). This study is the first to demonstrate the superiority of MMAC to MAC in CBT for hematological malignancies. |
format | Online Article Text |
id | pubmed-6033117 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-60331172018-07-12 Better outcomes of modified myeloablative conditioning without antithymocyte globulin versus myeloablative conditioning in cord blood transplantation for hematological malignancies: A retrospective (development) and a prospective (validation) study Sun, Zimin Liu, Huilan Luo, Chenhui Geng, Liangquan Zheng, Changcheng Tang, Baolin Zhu, Xiaoyu Tong, Juan Wang, Xingbing Ding, Kaiyang Wan, Xiang Zhang, Lei Yao, Wen Song, Kaiding Zhang, Xuhan Wu, Yue Yang, Huizhi Han, Yongsheng Liu, Xin Zhu, Weibo Wu, Jingsheng Wang, Zuyi Int J Cancer Cancer Therapy and Prevention Cord blood transplantation (CBT) is an effective option for treating hematological malignancies, but graft failure (GF) remains the primary cause of therapy failure. Thus, based on myeloablative conditioning (MAC) of busulfan with cyclophosphamide (Bu/Cy) or total body irradiation with Cy (TBI/Cy), fludarabine (Flu) was added to Bu/Cy and cytarabine (CA) to TBI/Cy for a modified myeloablative conditioning (MMAC). To compare the prognosis of MMAC with MAC, we conducted a retrospective study including 58 patients who underwent CBT with MAC or MMAC from 2000 to 2011. Neutrophil and platelet engraftment rate, overall survival (OS) and disease free survival (DFS) were significantly higher in the MMAC group (adjusted hazard ratio [HR], 2.58, 2.43, 0.36 and 0.37; p < 0.01, p = 0.01, p = 0.02 and p = 0.02, separately). Nonrelapse mortality (NRM) was comparable (p = 0.183). To validate the outcomes noted in the MMAC group, we conducted a prospective single‐arm clinical trial including 188 patients who underwent CBT with MMAC from 2011 to 2015. Engraftment rate, survival and NRM of the MMAC group in the prospective trail (MMAC‐P) were similar to the MMAC group in the retrospective study (MMAC‐R). This study is the first to demonstrate the superiority of MMAC to MAC in CBT for hematological malignancies. John Wiley and Sons Inc. 2018-03-12 2018-08-01 /pmc/articles/PMC6033117/ /pubmed/29473150 http://dx.doi.org/10.1002/ijc.31339 Text en © 2018 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Cancer Therapy and Prevention Sun, Zimin Liu, Huilan Luo, Chenhui Geng, Liangquan Zheng, Changcheng Tang, Baolin Zhu, Xiaoyu Tong, Juan Wang, Xingbing Ding, Kaiyang Wan, Xiang Zhang, Lei Yao, Wen Song, Kaiding Zhang, Xuhan Wu, Yue Yang, Huizhi Han, Yongsheng Liu, Xin Zhu, Weibo Wu, Jingsheng Wang, Zuyi Better outcomes of modified myeloablative conditioning without antithymocyte globulin versus myeloablative conditioning in cord blood transplantation for hematological malignancies: A retrospective (development) and a prospective (validation) study |
title | Better outcomes of modified myeloablative conditioning without antithymocyte globulin versus myeloablative conditioning in cord blood transplantation for hematological malignancies: A retrospective (development) and a prospective (validation) study |
title_full | Better outcomes of modified myeloablative conditioning without antithymocyte globulin versus myeloablative conditioning in cord blood transplantation for hematological malignancies: A retrospective (development) and a prospective (validation) study |
title_fullStr | Better outcomes of modified myeloablative conditioning without antithymocyte globulin versus myeloablative conditioning in cord blood transplantation for hematological malignancies: A retrospective (development) and a prospective (validation) study |
title_full_unstemmed | Better outcomes of modified myeloablative conditioning without antithymocyte globulin versus myeloablative conditioning in cord blood transplantation for hematological malignancies: A retrospective (development) and a prospective (validation) study |
title_short | Better outcomes of modified myeloablative conditioning without antithymocyte globulin versus myeloablative conditioning in cord blood transplantation for hematological malignancies: A retrospective (development) and a prospective (validation) study |
title_sort | better outcomes of modified myeloablative conditioning without antithymocyte globulin versus myeloablative conditioning in cord blood transplantation for hematological malignancies: a retrospective (development) and a prospective (validation) study |
topic | Cancer Therapy and Prevention |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6033117/ https://www.ncbi.nlm.nih.gov/pubmed/29473150 http://dx.doi.org/10.1002/ijc.31339 |
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