Feasibility of Reduced-intensity Cord Blood Transplantation as Salvage Therapy for Graft Failure : Results of a Nationwide Survey of Adult Patients

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URI http://shark.lib.kagawa-u.ac.jp/kuir/metadata/28495
Title
Feasibility of Reduced-intensity Cord Blood Transplantation as Salvage Therapy for Graft Failure : Results of a Nationwide Survey of Adult Patients
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Description

Abstract

To evaluate whether rescue with cord blood transplantation (CBT) could improve the poor survival after graft failure (GF), we surveyed the data of 80 adult patients (median age, 51 years) who received CBT within 3 months of GF (primary 64, secondary 16), with fludarabine-based reduced-intensity regimens with or without melphalan, busulfan, cyclophosphamide, and/or 2-4 Gy total-body irradiation (TBI). A median number of 2.4 × 10(7)/kg total nucleated cells (TNC) were infused, and among the 61 evaluable patients who survived for more than 28 days, 45 (74%) engrafted. The median follow-up of surviving patients was 325 days, and the 1-year overall survival rate was 33% despite poor performance status (2-4, 60%), carryover organ toxicities (grade 3/4, 14%), and infections (82%) prior to CBT. Day 100 transplantation-related mortality was 45%, with 60% related to infectious complications. Multivariate analysis showed that the infusion of TNC ≥2.5 × 10(7)/kg and an alkylating agent-containing regimen were associated with a higher probability of engraftment, and that high risk-status at the preceding transplantation and grade 3/4 organ toxicities before CBT were associated with an increased risk of mortality. In conclusion, in an older population of patients, our data support the feasibility of CBT with a reduced-intensity conditioning regimen for GF.

Author
著者 脇 房子
著者(ヨミ) ワキ フサコ
著者(別表記) Waki Fusako
Publication Title
Biology of Blood and Marrow Transplantation
Volume
17
Issue
6
Start Page
841
End Page
851
Publisher
Elsevier
Published Date
2011-06
ISSN
1083-8791
PMID
20849969
DOI
10.1016/j.bbmt.2010.09.005
Resource Type
Thesis or Dissertation
Language
eng
Resource URL
出版社版DOIリンク(URL) : https://doi.org/10.1016/j.bbmt.2010.09.005
Rights
エルゼビア・ジャパンに著作権ポリシーを確認した結果、リポジトリでの公開可能を確認した。 / As a result of confirming the copyright policy to Elsevier Japan, we confirmed the possibility of publishing in the repository.
Text Version
ETD
Grant ID
博甲第644号
Grant Date
2016-06-28
Degree Name
博士(医学)
Grantor
香川大学
Set
香川大学
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