Tacrolimus instead of cyclosporine used for prophylaxis against graft-versus-host disease improves outcome after hematopoietic stem cell transplantation from unrelated donors, but not from HLA-identical sibling donors: a nationwide survey conducted in Japan
| Autor: | Satoshi Takahashi, Nobuyuki Hamajima, Yoshiko Atsuta, Hisashi Sakamaki, Mitsune Tanimoto, Akira Hiraoka, Masamitsu Yanada, Noriyuki Hirabayashi, Yoshinobu Kanda, Nobuhiko Emi, Ryuji Tanosaki, Shingo Kato, K Iwato, Shinichiro Okamoto, Tomoki Naoe |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent medicine.medical_treatment Graft vs Host Disease chemical and pharmacologic phenomena Hematopoietic stem cell transplantation Tacrolimus Japan immune system diseases Internal medicine Humans Medicine Aged Transplantation business.industry Histocompatibility Testing Siblings Hazard ratio Retrospective cohort study Hematology Middle Aged Ciclosporin medicine.disease Tissue Donors Histocompatibility Surgery Regimen Treatment Outcome surgical procedures operative Graft-versus-host disease Acute Disease Chronic Disease Cyclosporine Female business Immunosuppressive Agents Follow-Up Studies Stem Cell Transplantation medicine.drug |
| Zdroj: | Bone Marrow Transplantation. 34:331-337 |
| ISSN: | 1476-5365 0268-3369 |
| DOI: | 10.1038/sj.bmt.1704596 |
| Popis: | Despite recent advances, graft-versus-host disease (GVHD) remains the main cause of treatment failure for patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). Tacrolimus (FK506) has been increasingly used in place of cyclosporine (CSP), and several studies have shown that FK506 reduces the incidence of acute GVHD more effectively than does CSP. However, no survival benefits have been demonstrated, and no established consensus exists on the choice of these immunosuppressive agents. To compare a CSP-based and an FK506-based regimen, we performed a large-scale retrospective study by using the data of 1935 patients who underwent HSCT from HLA-identical sibling donors (SIB-HSCT) and 777 patients who underwent HSCT from unrelated donors (UD-HSCT). For patients undergoing UD-HSCT, FK506 significantly reduced the risk of acute GVHD and treatment-related mortality (TRM) without an increase in relapse, thus improving overall survival (OS) (hazard ratio (HR): 2.20, 95% confidence interval (CI): 1.60-3.04, P |
| Databáze: | OpenAIRE |
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