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Higher Early Monocyte and Total Lymphocyte Counts Are Associated with Better Overall Survival after Standard Total Body Irradiation, Cyclophosphamide, and Fludarabine Reduced-Intensity Conditioning Double Umbilical Cord Blood Allogeneic Stem Cell Transplantation in Adults

Abstract : This single-center retrospective study aimed to report the impact of early hematopoietic and immune recoveries after a standard total body irradiation, cyclophosphamide, and fludarabine (TCF) reduced-intensity conditioning (RIC) regimen for double umbilical cord blood (dUCB) allogeneic stem cell transplantation (allo-SCT) in adults. We analyzed 47 consecutive patients older than 17 years who engrafted after a dUCB TCF allo-SCT performed between January 2006 and April 2013 in our department. Median times for neutrophil and platelet recoveries were 17 (range, 6 to 59) and 37 days (range, 0 to 164), respectively. The 3-year overall (OS) and disease-free survivals, relapse incidence, and nonrelapse mortality were 65.7%, 57.2%, 27.1%, and 19%, respectively. In multivariate analysis, higher day þ30 monocyte (!615/mm 3 ; hazard ratio [HR], .04; 95% confidence interval [CI], .004 to .36; P < .01) and day þ42 lymphocyte (!395/mm 3 ; HR, .16; 95% CI, .03 to .78; P ¼ .02) counts were independently associated with better OS. These results suggest that early higher he-matopoietic and immune recovery is predictive of survival after dUCB TCF RIC allo-SCT in adults. Factors other than granulocyte colonyestimulating factor, which was used in all cases, favoring expansion of monocytes or lymphocytes, should be tested in the future as part of the UCB transplantation procedure.
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Submitted on : Monday, December 19, 2016 - 2:29:15 PM
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Amandine Le Bourgeois, Pierre Peterlin, Thierry Guillaume, Jacques Delaunay, Alix Duquesne, et al.. Higher Early Monocyte and Total Lymphocyte Counts Are Associated with Better Overall Survival after Standard Total Body Irradiation, Cyclophosphamide, and Fludarabine Reduced-Intensity Conditioning Double Umbilical Cord Blood Allogeneic Stem Cell Transplantation in Adults. Biology of Blood and Marrow Transplantation, Elsevier, 2016, ⟨10.1016/j.bbmt.2016.04.015⟩. ⟨inserm-01419441⟩

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