COMPARISON OF INTENSIFIED MYELOABLATIVE CONDITIONING REGIMEN WITHOUT ATG TO MYELOABLATIVE CONDITIONING REGIMEN FOR SINGLE-UNIT UMBILICAL CORD BLOOD TRANSPLANTATION IN HEMATOLOGICAL MALIGNANCIES
(Abstract release date: 05/19/16)
EHA Library. Sun Z. 06/09/16; 133069; E1520
Ms. Zimin Sun
Contributions
Contributions
Abstract
Abstract: E1520
Type: Eposter Presentation
Background
The superiority and safety of strengthening conditioning regimen for single-unit umbilical cord blood transplantation (sUCBT) in hematological malignancies remain controversial.
Aims
To define whether intensified myeloablative regimen is superior to conventional myeloablative regimen for single-unit umbilical cord blood transplantation (sUCBT) in hematological malignancies.
Methods
We retrospectively analyzed the clinical data of 251 hematological malignancies undergoing sUCBT from Apr 2000 to Dec 2014 at Anhui provincial hospital hematology department. In these patients, 216 received the intensified myeloablative conditioning regimen (IMCR), and 35 received the myeloablative conditioning regimen (MCR). We evaluated the effect of IMCR without ATG on patient outcomes. Among the IMCR group, 106 patient received TBI/Ara-C/CY regimen, 41 received Ara-C/Bu/CY regimen, 69 received Flu/Bu/CY regimen, and all received a combination of CsA and MMF for the prophylaxis of GVHD. For the MCR group, 35 patients received Bu/CY regimen using CsA/MMF ± ATG or MTX for the prophylaxis of GVHD.
Results
The cumulative incidence of myeloid and platelet engraftment of the IMCR group was significantly higher than that in the MCR group (96.98% vs. 82.81%, 85.89% vs. 51.79%, P=0.000, 0.003, respectively). Corresponding incidences of transplantation-related mortality (TRM) by 180 days in the IMCR group and the MCR group were 19.50% vs. 41.67% (P=0.0028), respectively. The incidence of CMV infection and pre-engraftment syndrome were significantly higher in the IMCR group compared with that in the MCR group (68.8% vs. 40%, 82.9% vs.48.6%, P=0.001, 0.000, respectively). There were no differences in the incidence of grade II to IV aGVHD, grade III to IV aGVHD and 2-year cumulative incidence of relapse. Up to Oct. 2015,with a median follow-up of 30 months, the estimated 3-year overall survival and disease-free survival in the IMCR group were both significantly higher than that of the MCR group (62.4% vs. 35.5%, 60.1% vs. 35.5%, P=0.000,0.004, respectively). For 49 patients not in remission at transplantation in the IMCR group, the cumulative incidence of 2-year relapse was 21.92% (95%CI, 21.15-22.69%), which was comparable with patients in remission (P=0.115). The estimated 3-year overall survival and disease-free survival of advanced patients undergoing IMCR were 54.8% and 52.1%, respectively. For six patients older than 40 years, the incidences of myeloid, platelet engraftment and 180d TRM were not significantly different from patients between 20 and 40 year old and those younger than 20 year（100% vs.96.36% vs.96.73%, 66.67% vs.91.32% vs.84.75%, 16.67% vs.19.87% vs.18.48%, P=0.418, 0.405, 0.975, respectively).
Conclusion
This study is the first to show the superiority of intensified myeloablative regimen to conventional myeloablative regimen. A large-scale prospective study was needed to investigate its application.
Session topic: E-poster
Keyword(s): Cord blood transplant, Hematological malignancy
Type: Eposter Presentation
Background
The superiority and safety of strengthening conditioning regimen for single-unit umbilical cord blood transplantation (sUCBT) in hematological malignancies remain controversial.
Aims
To define whether intensified myeloablative regimen is superior to conventional myeloablative regimen for single-unit umbilical cord blood transplantation (sUCBT) in hematological malignancies.
Methods
We retrospectively analyzed the clinical data of 251 hematological malignancies undergoing sUCBT from Apr 2000 to Dec 2014 at Anhui provincial hospital hematology department. In these patients, 216 received the intensified myeloablative conditioning regimen (IMCR), and 35 received the myeloablative conditioning regimen (MCR). We evaluated the effect of IMCR without ATG on patient outcomes. Among the IMCR group, 106 patient received TBI/Ara-C/CY regimen, 41 received Ara-C/Bu/CY regimen, 69 received Flu/Bu/CY regimen, and all received a combination of CsA and MMF for the prophylaxis of GVHD. For the MCR group, 35 patients received Bu/CY regimen using CsA/MMF ± ATG or MTX for the prophylaxis of GVHD.
Results
The cumulative incidence of myeloid and platelet engraftment of the IMCR group was significantly higher than that in the MCR group (96.98% vs. 82.81%, 85.89% vs. 51.79%, P=0.000, 0.003, respectively). Corresponding incidences of transplantation-related mortality (TRM) by 180 days in the IMCR group and the MCR group were 19.50% vs. 41.67% (P=0.0028), respectively. The incidence of CMV infection and pre-engraftment syndrome were significantly higher in the IMCR group compared with that in the MCR group (68.8% vs. 40%, 82.9% vs.48.6%, P=0.001, 0.000, respectively). There were no differences in the incidence of grade II to IV aGVHD, grade III to IV aGVHD and 2-year cumulative incidence of relapse. Up to Oct. 2015,with a median follow-up of 30 months, the estimated 3-year overall survival and disease-free survival in the IMCR group were both significantly higher than that of the MCR group (62.4% vs. 35.5%, 60.1% vs. 35.5%, P=0.000,0.004, respectively). For 49 patients not in remission at transplantation in the IMCR group, the cumulative incidence of 2-year relapse was 21.92% (95%CI, 21.15-22.69%), which was comparable with patients in remission (P=0.115). The estimated 3-year overall survival and disease-free survival of advanced patients undergoing IMCR were 54.8% and 52.1%, respectively. For six patients older than 40 years, the incidences of myeloid, platelet engraftment and 180d TRM were not significantly different from patients between 20 and 40 year old and those younger than 20 year（100% vs.96.36% vs.96.73%, 66.67% vs.91.32% vs.84.75%, 16.67% vs.19.87% vs.18.48%, P=0.418, 0.405, 0.975, respectively).
Conclusion
This study is the first to show the superiority of intensified myeloablative regimen to conventional myeloablative regimen. A large-scale prospective study was needed to investigate its application.
Session topic: E-poster
Keyword(s): Cord blood transplant, Hematological malignancy
Abstract: E1520
Type: Eposter Presentation
Background
The superiority and safety of strengthening conditioning regimen for single-unit umbilical cord blood transplantation (sUCBT) in hematological malignancies remain controversial.
Aims
To define whether intensified myeloablative regimen is superior to conventional myeloablative regimen for single-unit umbilical cord blood transplantation (sUCBT) in hematological malignancies.
Methods
We retrospectively analyzed the clinical data of 251 hematological malignancies undergoing sUCBT from Apr 2000 to Dec 2014 at Anhui provincial hospital hematology department. In these patients, 216 received the intensified myeloablative conditioning regimen (IMCR), and 35 received the myeloablative conditioning regimen (MCR). We evaluated the effect of IMCR without ATG on patient outcomes. Among the IMCR group, 106 patient received TBI/Ara-C/CY regimen, 41 received Ara-C/Bu/CY regimen, 69 received Flu/Bu/CY regimen, and all received a combination of CsA and MMF for the prophylaxis of GVHD. For the MCR group, 35 patients received Bu/CY regimen using CsA/MMF ± ATG or MTX for the prophylaxis of GVHD.
Results
The cumulative incidence of myeloid and platelet engraftment of the IMCR group was significantly higher than that in the MCR group (96.98% vs. 82.81%, 85.89% vs. 51.79%, P=0.000, 0.003, respectively). Corresponding incidences of transplantation-related mortality (TRM) by 180 days in the IMCR group and the MCR group were 19.50% vs. 41.67% (P=0.0028), respectively. The incidence of CMV infection and pre-engraftment syndrome were significantly higher in the IMCR group compared with that in the MCR group (68.8% vs. 40%, 82.9% vs.48.6%, P=0.001, 0.000, respectively). There were no differences in the incidence of grade II to IV aGVHD, grade III to IV aGVHD and 2-year cumulative incidence of relapse. Up to Oct. 2015,with a median follow-up of 30 months, the estimated 3-year overall survival and disease-free survival in the IMCR group were both significantly higher than that of the MCR group (62.4% vs. 35.5%, 60.1% vs. 35.5%, P=0.000,0.004, respectively). For 49 patients not in remission at transplantation in the IMCR group, the cumulative incidence of 2-year relapse was 21.92% (95%CI, 21.15-22.69%), which was comparable with patients in remission (P=0.115). The estimated 3-year overall survival and disease-free survival of advanced patients undergoing IMCR were 54.8% and 52.1%, respectively. For six patients older than 40 years, the incidences of myeloid, platelet engraftment and 180d TRM were not significantly different from patients between 20 and 40 year old and those younger than 20 year（100% vs.96.36% vs.96.73%, 66.67% vs.91.32% vs.84.75%, 16.67% vs.19.87% vs.18.48%, P=0.418, 0.405, 0.975, respectively).
Conclusion
This study is the first to show the superiority of intensified myeloablative regimen to conventional myeloablative regimen. A large-scale prospective study was needed to investigate its application.
Session topic: E-poster
Keyword(s): Cord blood transplant, Hematological malignancy
Type: Eposter Presentation
Background
The superiority and safety of strengthening conditioning regimen for single-unit umbilical cord blood transplantation (sUCBT) in hematological malignancies remain controversial.
Aims
To define whether intensified myeloablative regimen is superior to conventional myeloablative regimen for single-unit umbilical cord blood transplantation (sUCBT) in hematological malignancies.
Methods
We retrospectively analyzed the clinical data of 251 hematological malignancies undergoing sUCBT from Apr 2000 to Dec 2014 at Anhui provincial hospital hematology department. In these patients, 216 received the intensified myeloablative conditioning regimen (IMCR), and 35 received the myeloablative conditioning regimen (MCR). We evaluated the effect of IMCR without ATG on patient outcomes. Among the IMCR group, 106 patient received TBI/Ara-C/CY regimen, 41 received Ara-C/Bu/CY regimen, 69 received Flu/Bu/CY regimen, and all received a combination of CsA and MMF for the prophylaxis of GVHD. For the MCR group, 35 patients received Bu/CY regimen using CsA/MMF ± ATG or MTX for the prophylaxis of GVHD.
Results
The cumulative incidence of myeloid and platelet engraftment of the IMCR group was significantly higher than that in the MCR group (96.98% vs. 82.81%, 85.89% vs. 51.79%, P=0.000, 0.003, respectively). Corresponding incidences of transplantation-related mortality (TRM) by 180 days in the IMCR group and the MCR group were 19.50% vs. 41.67% (P=0.0028), respectively. The incidence of CMV infection and pre-engraftment syndrome were significantly higher in the IMCR group compared with that in the MCR group (68.8% vs. 40%, 82.9% vs.48.6%, P=0.001, 0.000, respectively). There were no differences in the incidence of grade II to IV aGVHD, grade III to IV aGVHD and 2-year cumulative incidence of relapse. Up to Oct. 2015,with a median follow-up of 30 months, the estimated 3-year overall survival and disease-free survival in the IMCR group were both significantly higher than that of the MCR group (62.4% vs. 35.5%, 60.1% vs. 35.5%, P=0.000,0.004, respectively). For 49 patients not in remission at transplantation in the IMCR group, the cumulative incidence of 2-year relapse was 21.92% (95%CI, 21.15-22.69%), which was comparable with patients in remission (P=0.115). The estimated 3-year overall survival and disease-free survival of advanced patients undergoing IMCR were 54.8% and 52.1%, respectively. For six patients older than 40 years, the incidences of myeloid, platelet engraftment and 180d TRM were not significantly different from patients between 20 and 40 year old and those younger than 20 year（100% vs.96.36% vs.96.73%, 66.67% vs.91.32% vs.84.75%, 16.67% vs.19.87% vs.18.48%, P=0.418, 0.405, 0.975, respectively).
Conclusion
This study is the first to show the superiority of intensified myeloablative regimen to conventional myeloablative regimen. A large-scale prospective study was needed to investigate its application.
Session topic: E-poster
Keyword(s): Cord blood transplant, Hematological malignancy
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