TY - JOUR
T1 - Unrelated cord blood transplantation in CML
T2 - Japan Cord Blood Bank Network analysis
AU - Nagamura-Inoue, T.
AU - Kai, S.
AU - Azuma, H.
AU - Takanashi, M.
AU - Isoyama, K.
AU - Kato, K.
AU - Takahashi, S.
AU - Taniguchi, S.
AU - Miyamura, K.
AU - Aoki, K.
AU - Hidaka, M.
AU - Nagamura, F.
AU - Tojo, A.
AU - Fang, X. M.
AU - Kato, S.
N1 - Funding Information:
We thank Masato Takeuchi of Kitasato University Graduate School for the statistical discussion. We thank all of the physicians and staff at the hospitals and the 11 cord blood banks in Japan who collaborated on this study. We also thank all the data managers and officers of the Japan Cord Blood Bank Network and the Transplantation Data Management Committee. This work was supported in part by a Health and Labor Science Research Grant from the Ministry of Health, Labor and Welfare of Japan.
PY - 2008
Y1 - 2008
N2 - We analysed 86 patients with CML who received unrelated cord blood transplantation (UCBT), identified through a registry of the Japan Cord Blood Bank Network. At transplantation, the median patient age was 39 years (range, 1-67 years); 38 patients were in chronic phase (CP), 13 in the accelerated phase (AP) and 35 in blast crisis (BC). Median duration from diagnosis to UCBT was 1.5 years (range, 0.2-14.6 years). A nucleated cell (NC) dose of more than 3.0 × 107 per kg was sufficient to achieve neutrophil (91%) and platelet recovery (86%), whereas the lower dose of NC achieved only 60 and 61%, respectively. The duration and type of pre-transplant treatment did not affect neutrophil or platelet recovery. Results of multivariate analysis indicated that older patients (>50 years) had a higher incidence of transplant-related mortality. Advanced-disease stage and lower doses of NCs were significantly associated with lower leukaemia-free and event-free survival. At 2-year survival for patients in CP, AP and BC was 71, 59 and 32%, respectively (P=0.0004). A pre-transplant European Group for Blood and Marrow Transplantation scoring system was effective in predicting the outcome of UCBT. We conclude that UCBT is a reasonable alternative therapy for patients with CML.
AB - We analysed 86 patients with CML who received unrelated cord blood transplantation (UCBT), identified through a registry of the Japan Cord Blood Bank Network. At transplantation, the median patient age was 39 years (range, 1-67 years); 38 patients were in chronic phase (CP), 13 in the accelerated phase (AP) and 35 in blast crisis (BC). Median duration from diagnosis to UCBT was 1.5 years (range, 0.2-14.6 years). A nucleated cell (NC) dose of more than 3.0 × 107 per kg was sufficient to achieve neutrophil (91%) and platelet recovery (86%), whereas the lower dose of NC achieved only 60 and 61%, respectively. The duration and type of pre-transplant treatment did not affect neutrophil or platelet recovery. Results of multivariate analysis indicated that older patients (>50 years) had a higher incidence of transplant-related mortality. Advanced-disease stage and lower doses of NCs were significantly associated with lower leukaemia-free and event-free survival. At 2-year survival for patients in CP, AP and BC was 71, 59 and 32%, respectively (P=0.0004). A pre-transplant European Group for Blood and Marrow Transplantation scoring system was effective in predicting the outcome of UCBT. We conclude that UCBT is a reasonable alternative therapy for patients with CML.
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U2 - 10.1038/bmt.2008.164
DO - 10.1038/bmt.2008.164
M3 - Article
C2 - 18574449
AN - SCOPUS:51049114261
SN - 0268-3369
VL - 42
SP - 241
EP - 251
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 4
ER -