Impact of minimal residual disease on outcomes after umbilical cord blood transplantation for adults with Philadelphia‐positive acute lymphoblastic leukaemia: an analysis on behalf of Eurocord, Cord Blood Committee and the Acute Leukaemia working party of the European group for Blood and Marrow Transplantation. (25th June 2014)

• Record Type: Journal Article
• Authors: Tucunduva, Luciana; Ruggeri, Annalisa; Sanz, Guillermo; Furst, Sabine; Cornelissen, Jan; Linkesch, Werner; Mannone, Lionel; Ribera, Josep‐Maria; Veelken, Hendrik; Yakoub‐Agha, Ibrahim; González Valentín, Maria Elvira; Schots, Rik; Arcese, William; Montesinos, Pau; Labopin, Myriam; Gluckman, Eliane; Mohty, Mohamad; Rocha, Vanderson
• Is Part Of: British journal of haematology. Volume 166:Number 5(2014:Sep.)
• Page Start: 749
• Page End: 757
• Publication Date: 2014-06-25
• Subjects: Hematology -- Periodicals; Blood -- Diseases -- Periodicals; 616.15
• DOI: 10.1111/bjh.12970
• Languages: English
• ISSNs: 0007-1048

Abstract

<abstract abstract-type="main" id="bjh12970-abs-0001"> <title>Summary</title> <p>The status of umbilical cord blood transplantation (UCBT) in adults with Philadelphia‐positive acute lymphoblastic leukaemia (Ph+ALL) and the impact of minimal residual disease (MRD) before transplant are not well established. We analysed 98 patients receiving UCBT for Ph+ALL in first (CR1) or second (CR2) complete remission (CR1, <italic>n</italic> = 79; CR2, <italic>n</italic> = 19) with MRD available before UCBT (92% analysed by reverse transcription polymerase chain reaction). Median age was 38 years and median follow‐up was 36 months; 63% of patients received myeloablative conditioning and 42% received double‐unit UCBT. Eighty‐three patients were treated with at least one tyrosine kinase inhibitor before UCBT. MRD was negative (−) in 39 and positive (+) in 59 patients. Three‐year cumulative incidence of relapse was 34%; 45% in MRD+ and 16% in MRD− patients (<italic>P</italic> =0·013). Three‐year cumulative incidence of non‐relapse mortality was 31%; it was increased in patients older than 35 years (<italic>P</italic> = 0·02). Leukaemia‐free survival (LFS) at 3 years was 36%; 27% in MRD+ and 49% in MRD− patients (<italic>P</italic> = 0·05), and 41% for CR1 and 14% for CR2 (<italic>P</italic> = 0·008). Multivariate analysis identified only CR1 as being associated with improved LFS. In conclusion, MRD+ before UCBT is associated with increased relapse. Strategies to decrease relapse in UCBT recipients with Ph+ALL and MRD+ are needed.</p> </abstract>