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
タイトル
Feasibility of Reduced-intensity Cord Blood Transplantation as Salvage Therapy for Graft Failure : Results of a Nationwide Survey of Adult Patients
ファイル
内容記述

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.

著者
著者 脇 房子
著者(ヨミ) ワキ フサコ
著者(別表記) Waki Fusako
掲載誌
Biology of Blood and Marrow Transplantation
17
6
開始ページ
841
終了ページ
851
出版者
Elsevier
出版年月日
2011-06
ISSN
1083-8791
PMID
20849969
DOI
10.1016/j.bbmt.2010.09.005
資料タイプ
学位論文
言語
英語
関連情報URL
出版社版DOIリンク(URL) : https://doi.org/10.1016/j.bbmt.2010.09.005
権利関係
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.
博士論文(全文を含む)
学位授与番号
博甲第644号
学位授与年月日
2016-06-28
学位名
博士(医学)
学位授与機関
香川大学
区分
香川大学
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