Patients with acute leukemia may benefit from intrabone cord-blood transplant

In adult patients with acute leukemia, intrabone cord-blood transplantation was effective and did not result in graft failure, even with low numbers of HLA-mismatched cord-blood cells transplanted.

Researchers from San Martino Hospital in Genoa, Italy and other sites in Italy and France conducted a phase-1/2 study to determine the safety and efficacy of intrabone administration.

The study included 32 patients with acute myeloid leukemia (n=20) or acute lymphoblastic leukemia (n=12) in first complete remission (n=8), second complete remission (n=10) or advanced-stage, refractory disease (n=14). The median age of patients was 36 years.

Patients underwent cord-blood transplant without any complications during or after the procedure. HLA matching was 5/6 for nine patients, 4/6 for 22 patients and 3/6 for one patient. Within 12 days, four patients with advanced disease died.

In 28 patients, median time to neutrophil recovery was 23 days and in 27 patients, median time to platelet recovery was 36 days. Thirty days following transplant to the last day of follow-up, patients were fully chimeric, which the researchers said suggested early complete donor engraftment.

The researchers reported no grade III-IV graft-versus-host disease in the patients. At a median of 13 months follow-up, 16 patients were still alive and in hematologic remission.

Lancet Oncol. 2008;doi:10.1016/S1470-2045(08)70180-3.