Prospective Multicenter Study of Single-Unit Cord Blood Transplantation with Myeloablative Conditioning for Adult Patients with High-Risk Hematologic Malignancies

Takehiko Mori, Masatsugu Tanaka, Takeshi Kobayashi, Kazuteru Ohashi, Shin Fujisawa, Akira Yokota, Hiroyuki Fujita, Chiaki Nakaseko, Toru Sakura, Yasuhito Nannya, Satoshi Takahashi, Heiwa Kanamori, Yoshinobu Kanda, Hisashi Sakamaki, Shinichiro Okamoto

研究成果: Article査読

13 被引用数 (Scopus)

抄録

Although the use of cord blood transplantation (CBT) is increasing, the optimal methods for conditioning and graft-versus-host disease (GVHD) prophylaxis remain to be established. Among previous reports, the Institute of Medical Science, University of Tokyo (IMSUT) has reported remarkably favorable results of CBT for hematologic malignancies as a single-institute experience. The aim of the present multicenter prospective study was to assess the safety and efficacy of CBT performed precisely according to IMSUT transplantation procedures. Thirty-three adult patients with hematologic malignancies, such as acute leukemia, chronic myelogenous leukemia, or myelodysplastic syndrome, either lacking an HLA-identical sibling/HLA-matched unrelated donor or requiring urgent transplantation were enrolled. Conditioning consisted of total body irradiation (12 Gy), cytarabine, and cyclophosphamide. Cyclosporine A and methotrexate were used for GVHD prophylaxis. Diagnoses were acute leukemia in 26 patients, chronic myelogenous leukemia in 4, and myelodysplastic syndrome in 3; 12 patients were in first complete remission, and the others were in advanced stages at the time of CBT. Thirty-one patients achieved engraftment, and the cumulative incidence of grade II-IV acute GVHD was 45% (95% confidence interval, 28%-62%). With a median follow-up of 46.2 months in 16 surviving patients, the 1-year cumulative incidence of nonrelapse mortality was 15% (95% confidence interval, 5%-30%). Causes of nonrelapse mortality were infection (n = 4) and graft failure (n = 1). The overall and disease-free survival rates were 51% (95% CI, 34%-68%) and 42% (95% CI, 26%-59%), respectively. These results suggest that the IMSUT CBT procedures can safely provide a high disease-free survival rate in patients with high-risk hematologic malignancies.

本文言語English
ページ(範囲)486-491
ページ数6
ジャーナルBiology of Blood and Marrow Transplantation
19
3
DOI
出版ステータスPublished - 2013 3

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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