Cord Blood Transplantation for Multiple Myeloma: A Study from the Multiple Myeloma Working Group of the Japan Society for Hematopoietic Cell Transplantation
| Autor: | Nobuhiro Tsukada, Hiroyuki Takamatsu, Yasuji Kouzai, Yuju Ohno, Kazutaka Sunami, Ken Ishiyama, Go Yamamoto, Naoyuki Anzai, Koji Kawamura, Itsuto Amano, Kentaro Watanabe, Kosei Matsue, Koji Kato, Takashi Ikeda, Ritsuro Suzuki, Yoshinobu Kanda, Tsunehiko Komatsu, Nobuyuki Aotsuka |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Oncology medicine.medical_specialty Transplantation Conditioning Cord blood transplantation Neutrophils medicine.medical_treatment Graft vs Host Disease Hematopoietic stem cell transplantation Japan Risk Factors Internal medicine medicine Humans Multiple myeloma Aged Retrospective Studies Tandem transplantation Transplantation Neutrophil Engraftment business.industry Incidence (epidemiology) Retrospective cohort study Hematology Chronic graft-versus-host disease Middle Aged Myeloablative Agonists medicine.disease Survival Analysis Surgery Treatment Outcome surgical procedures operative Cord blood Acute Disease Chronic Disease Female Cord Blood Stem Cell Transplantation Stem cell Multiple Myeloma business Immunosuppressive Agents |
| Zdroj: | Biology of Blood and Marrow Transplantation. 21:1291-1298 |
| ISSN: | 1083-8791 |
| DOI: | 10.1016/j.bbmt.2015.02.015 |
| Popis: | Cord blood has been investigated as an alternative source for hematopoietic stem cell transplantation, but information about its use for multiple myeloma is limited. The purpose of this study was to evaluate the feasibility of cord blood transplantation (CBT) for patients with multiple myeloma. Eighty-six patients with multiple myeloma who underwent a first CBT between 2001 and 2011 were included in this retrospective study. Sixty-two of them had received other types of stem cell transplantation before CBT. The cumulative incidences of neutrophil engraftment at day 50, grade II to IV acute graft-versus-host disease (GVHD), and chronic GVHD were 81.4%, 39.0%, and 19.5%, respectively. The incidence of nonrelapse mortality at 2 years was 39.0%, but it was only 6.2% in patients who underwent planned tandem autologous/reduced-intensity conditioning CBT (auto/RIC-CBT). Progression-free survival (PFS) and overall survival (OS) at 6 years were 13.0% and 15.2%, respectively. Less than a partial response before CBT and lack of prior transplantation were independent significant adverse factors for PFS, whereas the presence of prior transplantation and planned tandem transplantation were associated with better OS. OS at 6 years in patients who underwent auto/RIC-CBT was 45.9%. In addition, the development of chronic GVHD was associated with superior PFS. In conclusion, we demonstrated that cord blood is feasible as an alternative graft source for myeloma patients. Although CBT provided long-term survival for a fraction of patients, optimal use of this graft requires further clinical studies. |
| Databáze: | OpenAIRE |
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