Comparison of the outcomes after haploidentical and cord blood salvage transplantations for graft failure following allogeneic hematopoietic stem cell transplantation View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2020-02-12

AUTHORS

Kaito Harada, Shigeo Fuji, Sachiko Seo, Junya Kanda, Toshimitsu Ueki, Fumihiko Kimura, Koji Kato, Naoyuki Uchida, Kazuhiro Ikegame, Makoto Onizuka, Ken-ichi Matsuoka, Noriko Doki, Toshiro Kawakita, Yasushi Onishi, Shingo Yano, Takahiro Fukuda, Minoko Takanashi, Yoshinobu Kanda, Yoshiko Atsuta, Masao Ogata

ABSTRACT

Graft failure (GF) is a life-threatening complication after allogeneic stem cell transplantation (SCT). Although salvage SCTs can be performed with haploidentical donor (HID) or cord blood (CB), no study has compared the performances of these two sources. Using nationwide registration data, we compared the transplant outcomes of patients who developed GF and underwent salvage transplantation from HID (n = 129) and CB (n = 570) from 2007 to 2016. The HID group demonstrated better neutrophil recovery (79.7 vs. 52.5% at 30 days, P < 0.001). With a median follow-up of 3 years, both groups demonstrated similar overall survival (OS) and nonrelapse mortality (NRM; 1-year OS, 33.1 vs. 34.6% and 1-year NRM, 45.1 vs. 49.8% for the HID and CB groups). After adjustments for other covariates, OS did not differ in both groups. However, HID was associated with a lower NRM (hazard ratio, 0.71; P = 0.038) than CB. The incidence of acute graft-versus-host disease (GVHD)-related deaths was significantly higher in the HID group, although infection-related deaths were observed more frequently in the CB group. HID may be a promising salvage SCT option after GF due to its faster engraftment and low NRM. More... »

PAGES

1784-1795

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  • Journal

    TITLE

    Bone Marrow Transplantation

    ISSUE

    9

    VOLUME

    55

    Author Affiliations

  • Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Japan
  • Department of Hematology, Osaka International Cancer Institute, Osaka, Japan
  • Department of Hematology and Oncology, Dokkyo Medical University School of Medicine, Mibu, Japan
  • Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
  • Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan
  • Division of Hematology, National Defense Medical College, Tokorozawa, Japan
  • Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
  • Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan
  • Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
  • Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
  • Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
  • Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
  • Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan
  • Clinical oncology and Hematology, The Jikei University School of Medicine, Tokyo, Japan
  • Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan
  • Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
  • Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
  • Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Department of Hematology, Oita University Hospital, Yufu, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1038/s41409-020-0821-9

    DOI

    http://dx.doi.org/10.1038/s41409-020-0821-9

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1124831381

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/32051535


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