GvHD prophylaxis after single-unit reduced intensity conditioning cord blood transplantation in adults with acute leukemia

S. Terakura, Y. Kuwatsuka, S. Yamasaki, A. Wake, J. Kanda, Y. Inamoto, S. Mizuta, T. Yamaguchi, N. Uchida, Y. Kouzai, N. Aotsuka, H. Ogawa, H. Kanamori, K. Nishiwaki, S. Miyakoshi, M. Onizuka, I. Amano, T. Fukuda, T. Ichinohe, Y. AtsutaM. Murata, T. Teshima

研究成果: Contribution to journalArticle査読

24 被引用数 (Scopus)

抄録

To investigate better GVHD prophylaxis in reduced intensity conditioning umbilical cord blood transplantation (RIC-UCBT), we compared transplant outcomes after UCBT among GvHD prophylaxes using the registry data. We selected patients transplanted for AML or ALL with a calcineurin inhibitor and methotrexate (MTX)/mycophenolate mofetil (MMF) combination. A total of 748 first RIC-UCBT between 2000 and 2012 (MTX+ group, 446, MMF+ group, 302) were included. The cumulative incidence of neutrophil and platelet counts higher than 50 000/μL was significantly better in the MMF+ group (relative risk (RR), 1.55; P<0.001: RR, 1.34; P=0.003, respectively). In multivariate analyses, the risk of grade II-IV and III-IV acute GvHD was significantly higher in the MMF+ group than in the MTX+ group (RR, 1.75; P<0.001: RR, 1.97; P=0.004, respectively). In disease-specific analyses of AML, the risk of relapse of high-risk disease was significantly lower in the MMF+ group (RR, 0.69; P=0.009), whereas no significant difference was observed in the risk of relapse-free and overall survival in high-risk disease. In patients with standard-risk disease, no significant differences were noted in the risk of relapse or survival between the MTX+ and MMF+ groups. Collectively, these results suggest that MMF-containing prophylaxis may be preferable in RIC-UCBT, particularly for high-risk disease.

本文言語英語
ページ(範囲)1261-1267
ページ数7
ジャーナルBone Marrow Transplantation
52
9
DOI
出版ステータス出版済み - 9 1 2017
外部発表はい

All Science Journal Classification (ASJC) codes

  • 血液学
  • 移植

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