Total body irradiation and granulocyte colony-stimulating factor-combined high-dose cytarabine as a conditioning regimen in allogeneic hematopoietic stem cell transplantation for advanced myelodysplastic syndrome: A single-institute experience

Takehiko Mori, Y. Aisa, A. Yokoyama, T. Nakazato, Rie Yamazaki, Takayuki Shimizu, A. Mihara, Jun Kato, R. Watanabe, N. Takayama, Y. Ikeda, Shinichiro Okamoto

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Abstract

In this study, we retrospectively evaluated the efficacy and safety of total body irradiation (TBI) and granulocyte colony-stimulating factor (G-CSF)-combined high-dose cytarabine as a conditioning regimen for allogeneic hematopoietic stem cell transplantation (HSCT) in patients with advanced myelodysplastic syndrome (MDS). We evaluated 22 patients with advanced MDS, including refractory anemia with excess blasts (RAEB; n = 10), RAEB in transformation (n = 2), acute myelogenous leukemia transformed from MDS (n = 6) and chronic myelomonocytic leukemia (n = 4). The conditioning regimen consisted of 12Gy of TBI and high-dose cytarabine (3 g/m2) every 12 h for 4 days, and the cytarabine was combined with continuous administration of G-CSF. The stem cell sources were bone marrow or peripheral blood stem cells from human leukocyte antigen (HLA)-identical siblings (n = 12) and bone marrow from HLA serologically matched unrelated donors (n = 10). Three patients experienced disease relapse, two of whom died of disease progression. Of 22 patients, 16 are currently alive and disease-free. The 5-year estimated overall survival, disease-free survival, relapse and non-relapse mortality rates are 76.7, 72.2, 16.6 and 14.1%, respectively. These results suggest that G-CSF-combined high-dose cytarabine could be a promising component of the conditioning regimen of allogeneic HSCT for advanced MDS, providing a low incidence of both relapse and treatment-related mortality.

Original languageEnglish
Pages (from-to)217-221
Number of pages5
JournalBone Marrow Transplantation
Volume39
Issue number4
DOIs
Publication statusPublished - 2007 Feb

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Whole-Body Irradiation
Hematopoietic Stem Cell Transplantation
Myelodysplastic Syndromes
Cytarabine
Granulocyte Colony-Stimulating Factor
Refractory Anemia with Excess of Blasts
HLA Antigens
Recurrence
Bone Marrow
Leukemia, Myelomonocytic, Chronic
Unrelated Donors
Mortality
Acute Myeloid Leukemia
Disease-Free Survival
Disease Progression
Siblings
Stem Cells
Safety
Survival
Conditioning (Psychology)

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

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title = "Total body irradiation and granulocyte colony-stimulating factor-combined high-dose cytarabine as a conditioning regimen in allogeneic hematopoietic stem cell transplantation for advanced myelodysplastic syndrome: A single-institute experience",
abstract = "In this study, we retrospectively evaluated the efficacy and safety of total body irradiation (TBI) and granulocyte colony-stimulating factor (G-CSF)-combined high-dose cytarabine as a conditioning regimen for allogeneic hematopoietic stem cell transplantation (HSCT) in patients with advanced myelodysplastic syndrome (MDS). We evaluated 22 patients with advanced MDS, including refractory anemia with excess blasts (RAEB; n = 10), RAEB in transformation (n = 2), acute myelogenous leukemia transformed from MDS (n = 6) and chronic myelomonocytic leukemia (n = 4). The conditioning regimen consisted of 12Gy of TBI and high-dose cytarabine (3 g/m2) every 12 h for 4 days, and the cytarabine was combined with continuous administration of G-CSF. The stem cell sources were bone marrow or peripheral blood stem cells from human leukocyte antigen (HLA)-identical siblings (n = 12) and bone marrow from HLA serologically matched unrelated donors (n = 10). Three patients experienced disease relapse, two of whom died of disease progression. Of 22 patients, 16 are currently alive and disease-free. The 5-year estimated overall survival, disease-free survival, relapse and non-relapse mortality rates are 76.7, 72.2, 16.6 and 14.1{\%}, respectively. These results suggest that G-CSF-combined high-dose cytarabine could be a promising component of the conditioning regimen of allogeneic HSCT for advanced MDS, providing a low incidence of both relapse and treatment-related mortality.",
author = "Takehiko Mori and Y. Aisa and A. Yokoyama and T. Nakazato and Rie Yamazaki and Takayuki Shimizu and A. Mihara and Jun Kato and R. Watanabe and N. Takayama and Y. Ikeda and Shinichiro Okamoto",
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T1 - Total body irradiation and granulocyte colony-stimulating factor-combined high-dose cytarabine as a conditioning regimen in allogeneic hematopoietic stem cell transplantation for advanced myelodysplastic syndrome

T2 - A single-institute experience

AU - Mori, Takehiko

AU - Aisa, Y.

AU - Yokoyama, A.

AU - Nakazato, T.

AU - Yamazaki, Rie

AU - Shimizu, Takayuki

AU - Mihara, A.

AU - Kato, Jun

AU - Watanabe, R.

AU - Takayama, N.

AU - Ikeda, Y.

AU - Okamoto, Shinichiro

PY - 2007/2

Y1 - 2007/2

N2 - In this study, we retrospectively evaluated the efficacy and safety of total body irradiation (TBI) and granulocyte colony-stimulating factor (G-CSF)-combined high-dose cytarabine as a conditioning regimen for allogeneic hematopoietic stem cell transplantation (HSCT) in patients with advanced myelodysplastic syndrome (MDS). We evaluated 22 patients with advanced MDS, including refractory anemia with excess blasts (RAEB; n = 10), RAEB in transformation (n = 2), acute myelogenous leukemia transformed from MDS (n = 6) and chronic myelomonocytic leukemia (n = 4). The conditioning regimen consisted of 12Gy of TBI and high-dose cytarabine (3 g/m2) every 12 h for 4 days, and the cytarabine was combined with continuous administration of G-CSF. The stem cell sources were bone marrow or peripheral blood stem cells from human leukocyte antigen (HLA)-identical siblings (n = 12) and bone marrow from HLA serologically matched unrelated donors (n = 10). Three patients experienced disease relapse, two of whom died of disease progression. Of 22 patients, 16 are currently alive and disease-free. The 5-year estimated overall survival, disease-free survival, relapse and non-relapse mortality rates are 76.7, 72.2, 16.6 and 14.1%, respectively. These results suggest that G-CSF-combined high-dose cytarabine could be a promising component of the conditioning regimen of allogeneic HSCT for advanced MDS, providing a low incidence of both relapse and treatment-related mortality.

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