Ontology type: schema:ScholarlyArticle
2021-02-23
AUTHORSMasamichi 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
ABSTRACTThe 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... »
PAGES1849-1861
http://scigraph.springernature.com/pub.10.1007/s00277-021-04464-5
DOIhttp://dx.doi.org/10.1007/s00277-021-04464-5
DIMENSIONShttps://app.dimensions.ai/details/publication/pub.1135660329
PUBMEDhttps://www.ncbi.nlm.nih.gov/pubmed/33624134
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"description": "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 \u226560 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)\u2013based 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\u2013IV and grade III\u2013IV 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 \u22651, hematopoietic cell transplantation-specific comorbidity index \u22653, adverse cytogenetics, extramedullary disease at diagnosis, and non-CR status at CBT. By contrast, female sex, HLA disparities \u22652, mycophenolate mofetil\u2013based GVHD prophylaxis, and recent CBT were significantly associated with lower overall mortality. In conclusion, single CBT offers a curative option for AML patients aged \u226560 years with careful patient selection.",
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"name": "Single cord blood transplantation for acute myeloid leukemia patients aged 60 years or older: a retrospective study in Japan",
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