TY - JOUR
T1 - Long-term outcome of cord blood transplantation from unrelated donors as an initial transplantation procedure for children with AML in Japan
AU - Isoyama, K.
AU - Oda, M.
AU - Kato, K.
AU - Nagamura-Inoue, T.
AU - Kai, S.
AU - Kigasawa, H.
AU - Kobayashi, R.
AU - Mimaya, J.
AU - Inoue, M.
AU - Kikuchi, A.
AU - Kato, S.
N1 - Funding Information:
This study was supported in part by a research grant on Tissue Engineering (H17-014) and a research grant on Allergic Disease and Immunology (H20-015) from the Japanese Ministry of Health, Labour and Welfare. We thank Vipul N Mankad, MD (the former Senior Vice-President and Chief Medical Officer), Children’s Hospital and Research Center Oakland, CA, USA for editorial assistance and critical comments.
PY - 2010/1
Y1 - 2010/1
N2 - To assess the outcome of unrelated umbilical cord blood transplantation (UCBT), 141 children with AML who underwent UCBT (39 in first CR (CR1), 33 in CR2, 4 in CR3 and 65 at more advanced stages (not in CR)) were analyzed in a retrospective multicenter study in Japan. Short-term MTX was used for prophylaxis of acute GVHD in 80 cases (57%). The cumulative incidences of neutrophil recovery, platelet recovery and acute GVHD (grades 2-4) were 78.7, 62.4 and 40.1%, respectively, and the 100-day transplantation-related mortality (TRM) was 10.8%. Multivariate analysis showed that an infused CD34+ cell dose of 1.35 × 105 cells per kg or more was associated with favorable neutrophil and platelet recovery, and that short-term MTX was associated with a lower 100-day TRM. The 6-year relapse rate was 38.8% and was associated with disease status. Six-year overall survival was 45.8% (70.4 ± 8.3% in CR1, 59.3 ± 11.3% in CR2, 75.5 ± 21% in CR3 and 20.6 ± 6.2% for children with non-CR). We conclude that the results of UCBT are particularly promising for children with a karyotype suggesting a poor prognosis, and for those who receive transplants in CR2 and CR3 after an early relapse.
AB - To assess the outcome of unrelated umbilical cord blood transplantation (UCBT), 141 children with AML who underwent UCBT (39 in first CR (CR1), 33 in CR2, 4 in CR3 and 65 at more advanced stages (not in CR)) were analyzed in a retrospective multicenter study in Japan. Short-term MTX was used for prophylaxis of acute GVHD in 80 cases (57%). The cumulative incidences of neutrophil recovery, platelet recovery and acute GVHD (grades 2-4) were 78.7, 62.4 and 40.1%, respectively, and the 100-day transplantation-related mortality (TRM) was 10.8%. Multivariate analysis showed that an infused CD34+ cell dose of 1.35 × 105 cells per kg or more was associated with favorable neutrophil and platelet recovery, and that short-term MTX was associated with a lower 100-day TRM. The 6-year relapse rate was 38.8% and was associated with disease status. Six-year overall survival was 45.8% (70.4 ± 8.3% in CR1, 59.3 ± 11.3% in CR2, 75.5 ± 21% in CR3 and 20.6 ± 6.2% for children with non-CR). We conclude that the results of UCBT are particularly promising for children with a karyotype suggesting a poor prognosis, and for those who receive transplants in CR2 and CR3 after an early relapse.
UR - http://www.scopus.com/inward/record.url?scp=75149193159&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=75149193159&partnerID=8YFLogxK
U2 - 10.1038/bmt.2009.93
DO - 10.1038/bmt.2009.93
M3 - Article
C2 - 19430503
AN - SCOPUS:75149193159
SN - 0268-3369
VL - 45
SP - 69
EP - 77
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 1
ER -