MISC

2004年12月

Single-institute comparative analysis of unrelated bone marrow transplantation and cord blood transplantation for adult patients with hematologic malignancies

BLOOD
  • S Takahashi
  • ,
  • T Iseki
  • ,
  • J Ooi
  • ,
  • A Tomonari
  • ,
  • K Takasugi
  • ,
  • Y Shimohakamada
  • ,
  • T Yamada
  • ,
  • K Uchimaru
  • ,
  • A Tojo
  • ,
  • N Shirafuji
  • ,
  • H Kodo
  • ,
  • K Tani
  • ,
  • T Takahashi
  • ,
  • T Yamaguchi
  • ,
  • S Asano

104
12
開始ページ
3813
終了ページ
3820
記述言語
英語
掲載種別
DOI
10.1182/blood-2004-03-1001
出版者・発行元
AMER SOC HEMATOLOGY

Unrelated cord blood transplantation (CBT) has now become more common, but as yet there have been only a few reports on its outcome compared with bone marrow transplantation (BMT), especially for adults. We studied the clinical outcomes of 113 adult patients with hematologic malignancies who received unrelated BM transplants (n = 45) or unrelated CB transplants (n = 68). We analyzed the hematopoietic recovery, rates of graft-versus-host disease (GVHD), risks of trans plantation-related mortality (TRM) and relapse, and disease-free survival (DFS) using Cox proportional hazards models. The time from donor search to transplantation was significantly shorter among CB transplant recipients (median, 2 months) than BM transplant recipients (median, 11 months; P < .01). Multivariate analysis demonstrated slow neutrophil (P < .01) and platelet (P < .01) recoveries in CBT patients compared with BMT patients. Despite rapid tapering of immunosuppressants after transplantation and infrequent use of steroids to treat severe acute GVHD, there were no GVHD-related deaths among CB transplant recipients compared with 10 deaths of 24 among BM transplant recipients. Unrelated CBT showed better TRM and DFS results compared with BMT (P = .02 and P < .01, respectively), despite the higher human leukocyte antigen mismatching rate and lower number of infused cells. These data strongly suggest that CBT could be safely and effectively used for adult patients with hematologic malignancies.

Web of Science ® 被引用回数 : 240

リンク情報
DOI
https://doi.org/10.1182/blood-2004-03-1001
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000225351600064&DestApp=WOS_CPL