A phase I/II trial of intrabone marrow cord blood transplantation and comparison of the hematological recovery with the Japanese nationwide ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-01-09

AUTHORS

N Kurita, M Gosho, Y Yokoyama, T Kato, N Obara, M Sakata-Yanagimoto, Y Hasegawa, N Uchida, S Takahashi, Y Kouzai, Y Atsuta, M Kurata, T Ichinohe, S Chiba

ABSTRACT

Intrabone marrow cord blood transplantation (IB-CBT) was proposed as a promising treatment modality to improve hematological recovery. However, clinical advantages of IB-CBT over conventional IV CBT have been unclear. We conducted a prospective single-center trial of IB-CBT to evaluate its safety and superiority in terms of hematological recovery. Fifteen adults with hematological malignancies were enrolled. A thawed and unwashed single cord blood unit was injected into the bilateral superior-posterior iliac crests under local anesthesia. Engraftments of neutrophils and platelets were achieved in 13 cases, with medians of 17 and 45 days, respectively. For the control, we extracted data from the Japanese nationwide database and compared the hematological recovery of contemporaneously transplanted 1135 CBT cases. Multivariate analysis revealed that IB-CBT enhanced platelet recovery (hazard ratio, 2.13; P=0.007), but neutrophil recovery did not differ significantly (hazard ratio, 1.70; P=0.19). Better donor chimerism was seen in the bone marrow of the ilium than of the sternum on day 14, suggesting that the local hematopoiesis at the injected site was established earlier than that at the remote bone marrow site. Collectively, IB-CBT was well tolerated and may enhance local engraftment, which promotes prompter platelet recovery than does IV-CBT. More... »

PAGES

574-579

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/bmt.2016.319

DOI

http://dx.doi.org/10.1038/bmt.2016.319

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1043880938

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28067880


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32 schema:description Intrabone marrow cord blood transplantation (IB-CBT) was proposed as a promising treatment modality to improve hematological recovery. However, clinical advantages of IB-CBT over conventional IV CBT have been unclear. We conducted a prospective single-center trial of IB-CBT to evaluate its safety and superiority in terms of hematological recovery. Fifteen adults with hematological malignancies were enrolled. A thawed and unwashed single cord blood unit was injected into the bilateral superior-posterior iliac crests under local anesthesia. Engraftments of neutrophils and platelets were achieved in 13 cases, with medians of 17 and 45 days, respectively. For the control, we extracted data from the Japanese nationwide database and compared the hematological recovery of contemporaneously transplanted 1135 CBT cases. Multivariate analysis revealed that IB-CBT enhanced platelet recovery (hazard ratio, 2.13; P=0.007), but neutrophil recovery did not differ significantly (hazard ratio, 1.70; P=0.19). Better donor chimerism was seen in the bone marrow of the ilium than of the sternum on day 14, suggesting that the local hematopoiesis at the injected site was established earlier than that at the remote bone marrow site. Collectively, IB-CBT was well tolerated and may enhance local engraftment, which promotes prompter platelet recovery than does IV-CBT.
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46 blood transplantation
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53 comparison
54 control
55 cord blood transplantation
56 cord blood units
57 crest
58 data
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60 day 14
61 days
62 donor chimerism
63 engraftment
64 engraftment of neutrophils
65 hematological malignancies
66 hematological recovery
67 hematopoiesis
68 iliac crest
69 ilium
70 injected site
71 local anesthesia
72 local engraftment
73 malignancy
74 marrow
75 marrow sites
76 median
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78 multivariate analysis
79 nationwide database
80 neutrophil recovery
81 neutrophils
82 phase I/II trial
83 platelet recovery
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85 promising treatment modality
86 prospective single-center trial
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