Phase II study of intrabone single unit cord blood transplantation for hematological malignancies

Autor: Hironori Kobayashi, Tomoyuki Endo, Tatsunori Goto, Tomoki Naoe, Yoshinobu Maeda, Nobuharu Fujii, Yasushi Onishi, Tetsuya Nishida, Masayoshi Masuko, Yoshihiro Inamoto, Yoko Ushijima, Yoshihisa Kodera, Makoto Murata, Yasuhiko Shibasaki, Seitaro Terakura, Noriko Fukuhara, Yuichi Ishikawa, Ritsuro Suzuki, Hitoshi Kiyoi, Chisako Iriyama, Mitsune Tanimoto, Tadashi Matsushita
Rok vydání: 2017
Předmět:
Male
Cancer Research
Transplantation Conditioning
Cord blood transplantation
Neutrophils
Graft vs Host Disease
Phases of clinical research
Gastroenterology
0302 clinical medicine
General Medicine
Middle Aged
Fludarabine
Treatment Outcome
Oncology
Hematologic Neoplasms
030220 oncology & carcinogenesis
Cord blood
Female
Original Article
Cord Blood Stem Cell Transplantation
Vidarabine
engraftment
medicine.drug
Adult
medicine.medical_specialty
Adolescent
Injections
Young Adult
03 medical and health sciences
Reticulocyte Count
Clinical Research
Internal medicine
medicine
Humans
hematological malignancy
intrabone
non-myeloablative conditioning
Adverse effect
Cryopreservation
Neutrophil Engraftment
Platelet Count
business.industry
Original Articles
Survival Analysis
Tacrolimus
Surgery
Transplantation
non‐myeloablative conditioning
Methotrexate
business
030215 immunology
Zdroj: Cancer Science
ISSN: 1349-7006
1347-9032
DOI: 10.1111/cas.13291
Popis: The outcomes of cord blood transplantation with non-irradiated reduced-intensity conditioning for hematological malignancies need to be improved because of graft failure and delayed engraftment. Intrabone infusion of cord blood cells has the potential to resolve the problems. In this phase 2 study, twenty-one adult patients with hematological malignancy received intrabone transplantation of serological HLA-A, B, and DR ≥4/6 matched single cord blood with a median number of cryopreserved total nucleated cells of 2.7 × 107/kg (range, 2.0-4.9 × 107/kg) following non-irradiated fludarabine-based reduced-intensity conditioning. Short-term methotrexate and tacrolimus were given as graft-versus-host disease prophylaxis, and granulocyte colony-stimulating factor was administered after transplantation. No severe adverse events related to intrabone injection were observed. The cumulative incidences of neutrophils ≥0.5 × 109/L, reticulocytes ≥1%, and platelets ≥20 × 109/L recoveries were 76.2%, 71.4%, and 76.2%, respectively, with median time to recoveries of 17, 28, and 32 days after transplantation, respectively. The probability of survival with neutrophil engraftment on day 60 was 71.4%, and overall survival at 1 year after transplantation was 52.4%. The incidences of grade II-IV and III-IV acute graft-versus-host disease were 44% and 19%, respectively, with no cases of chronic graft-versus-host disease. The present study demonstrated the safety of direct intrabone infusion of cord blood. Further analysis is required to confirm the efficacy of intrabone single cord blood transplantation with non-irradiated reduced-intensity conditioning for adult patients with hematological malignancy. This article is protected by copyright. All rights reserved.
Databáze: OpenAIRE
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