Single cord blood transplantation for acute myeloid leukemia patients aged 60 years or older: a retrospective study in Japan View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-02-23

AUTHORS

Masamichi Isobe, Takaaki Konuma, Masayoshi Masuko, Naoyuki Uchida, Shigesaburo Miyakoshi, Yasuhiro Sugio, Shuro Yoshida, Masatsugu Tanaka, Yoshiko Matsuhashi, Norimichi Hattori, Makoto Onizuka, Nobuyuki Aotsuka, Yasushi Kouzai, Atsushi Wake, Takafumi Kimura, Tatsuo Ichinohe, Yoshiko Atsuta, Masamitsu Yanada

ABSTRACT

The availability of alternative donor sources could allow elderly patients to receive allogeneic hematopoietic cell transplantation (HCT). We retrospectively evaluated the outcomes of single-unit cord blood transplantation (CBT) in 1577 patients aged ≥60 years with acute myeloid leukemia (AML) in Japan between 2002 and 2017. In total, 990 (63%) patients were not in complete remission (CR) at the time of CBT. A myeloablative conditioning regimen (52%) and calcineurin inhibitor (CI) + mycophenolate mofetil (MMF)–based graft-versus-host disease (GVHD) prophylaxis (45%) were more commonly used. With a median follow-up for survivors of 31 months, the probability of overall survival and the cumulative incidence of leukemia-related mortality at 3 years was 31% and 29%, respectively. The cumulative incidence of non-relapse mortality (NRM) at 100 days and 3 years were 24% and 41%, respectively. The cumulative incidences of grade II–IV and grade III–IV acute GVHD at 100 days and extensive chronic GVHD at 2 years were 44%, 16%, and 14%, respectively. The cumulative incidence of neutrophil engraftment was 80% at 42 days. Results of multivariate analysis indicated that the following factors were significantly associated with higher overall mortality: performance status ≥1, hematopoietic cell transplantation-specific comorbidity index ≥3, adverse cytogenetics, extramedullary disease at diagnosis, and non-CR status at CBT. By contrast, female sex, HLA disparities ≥2, mycophenolate mofetil–based GVHD prophylaxis, and recent CBT were significantly associated with lower overall mortality. In conclusion, single CBT offers a curative option for AML patients aged ≥60 years with careful patient selection. More... »

PAGES

1849-1861

References to SciGraph publications

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  • Journal

    TITLE

    Annals of Hematology

    ISSUE

    7

    VOLUME

    100

    Author Affiliations

  • Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, 108-8639, Tokyo, Japan
  • Department of Hematopoietic Cell Transplantation, Niigata University Medical and Dental Hospital, Niigata, Japan
  • Department of Hematology, Toranomon Hospital, Tokyo, Japan
  • Department of Hematology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
  • Department of Internal Medicine, Kitakyushu City Hospital Organization, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
  • Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
  • Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
  • Department of Hematology, Kawasaki Medical School Hospital, Kurashiki, Japan
  • Division of Hematology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
  • Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Japan
  • Division of Hematology-Oncology, Japanese Red Cross Society Narita Hospital, Narita, Japan
  • Department of Transfusion Medicine, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
  • Department of Hematology, Toranomon Hospital Kajigaya, Kawasaki, Japan
  • Preparation Department, Japanese Red Cross Kinki Block Blood Center, Osaka, Japan
  • Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
  • Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Department of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00277-021-04464-5

    DOI

    http://dx.doi.org/10.1007/s00277-021-04464-5

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1135660329

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/33624134


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