Reduction of Cord Blood Transplantation Toxicity in Patients With Acute Myeloid Leukemia

Assessment of Reduction of Cord Blood Transplantation Toxicity by Using Reduced Intensity Conditioning in Patients With Acute Myeloid Leukemia.

Multicentric evaluation of the reduction of unrelated cord blood transplantation (UCBT) toxicity by using reduced intensity conditioning (RIC) in patients with acute myeloid leukaemia.UCBT related mortality and morbidity were limiting factors for the development of this procedure in adults. Non myeloablative conditioning regimen showed promising results and prospective evaluation has to be developed to confirm these retrospective data.

Individual meta-analysis is planned to compare geno-identical transplantation with myeloid-ablative or non myeloid-ablative conditioning with UCBT after RIC.

Inclusion Criteria:

• Ages : 4 to 65
• De novo or secondary AML requiring allogeneic transplant
• No donor (related or unrelated) compatible 10/10
• Complete remission excepted CR1 with t(8;21) or inv (16) or t (15;17)
• Smouldering AML without progression
• Signed assent of recipient

Exclusion Criteria:

• If CR1: AML with with t(8;21) or inv (16) or t (15;17)
• Karnofsky < 50% - Clearance of creatinin < 40 ml/min
• Transaminases > 8 N
• Previous autologous or allogeneic transplantation within 6 month prior to the study (except if tandem)
• total body irradiation contra-indicating 2 Gy TBI
• local irradiation contra-indicating 2 Gy TBI