Single-institute comparative analysis of unrelated bone marrow transplantation and cord blood transplantation for adult patients with hematologic malignancies

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  • Satoshi Takahashi
    From the Division of Molecular Therapy, The Advanced Clinical Research Center and Division of Cell Processing, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; and Department of Biostatistics/Epidemiology and Preventive Health Sciences, School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan.
  • Tohru Iseki
    From the Division of Molecular Therapy, The Advanced Clinical Research Center and Division of Cell Processing, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; and Department of Biostatistics/Epidemiology and Preventive Health Sciences, School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan.
  • Jun Ooi
    From the Division of Molecular Therapy, The Advanced Clinical Research Center and Division of Cell Processing, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; and Department of Biostatistics/Epidemiology and Preventive Health Sciences, School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan.
  • Akira Tomonari
    From the Division of Molecular Therapy, The Advanced Clinical Research Center and Division of Cell Processing, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; and Department of Biostatistics/Epidemiology and Preventive Health Sciences, School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan.
  • Kashiya Takasugi
    From the Division of Molecular Therapy, The Advanced Clinical Research Center and Division of Cell Processing, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; and Department of Biostatistics/Epidemiology and Preventive Health Sciences, School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan.
  • Yoko Shimohakamada
    From the Division of Molecular Therapy, The Advanced Clinical Research Center and Division of Cell Processing, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; and Department of Biostatistics/Epidemiology and Preventive Health Sciences, School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan.
  • Toshiki Yamada
    From the Division of Molecular Therapy, The Advanced Clinical Research Center and Division of Cell Processing, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; and Department of Biostatistics/Epidemiology and Preventive Health Sciences, School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan.
  • Kaoru Uchimaru
    From the Division of Molecular Therapy, The Advanced Clinical Research Center and Division of Cell Processing, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; and Department of Biostatistics/Epidemiology and Preventive Health Sciences, School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan.
  • Arinobu Tojo
    From the Division of Molecular Therapy, The Advanced Clinical Research Center and Division of Cell Processing, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; and Department of Biostatistics/Epidemiology and Preventive Health Sciences, School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan.
  • Naoki Shirafuji
    From the Division of Molecular Therapy, The Advanced Clinical Research Center and Division of Cell Processing, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; and Department of Biostatistics/Epidemiology and Preventive Health Sciences, School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan.
  • Hideki Kodo
    From the Division of Molecular Therapy, The Advanced Clinical Research Center and Division of Cell Processing, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; and Department of Biostatistics/Epidemiology and Preventive Health Sciences, School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan.
  • Kenzaburo Tani
    From the Division of Molecular Therapy, The Advanced Clinical Research Center and Division of Cell Processing, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; and Department of Biostatistics/Epidemiology and Preventive Health Sciences, School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan.
  • Tsuneo Takahashi
    From the Division of Molecular Therapy, The Advanced Clinical Research Center and Division of Cell Processing, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; and Department of Biostatistics/Epidemiology and Preventive Health Sciences, School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan.
  • Takuhiro Yamaguchi
    From the Division of Molecular Therapy, The Advanced Clinical Research Center and Division of Cell Processing, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; and Department of Biostatistics/Epidemiology and Preventive Health Sciences, School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan.
  • Shigetaka Asano
    From the Division of Molecular Therapy, The Advanced Clinical Research Center and Division of Cell Processing, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; and Department of Biostatistics/Epidemiology and Preventive Health Sciences, School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan.

抄録

<jats:p>Unrelated cord blood transplantation (CBT) has now become more common, but as yet there have been only a few reports on its outcome compared with bone marrow transplantation (BMT), especially for adults. We studied the clinical outcomes of 113 adult patients with hematologic malignancies who received unrelated BM transplants (n = 45) or unrelated CB transplants (n = 68). We analyzed the hematopoietic recovery, rates of graft-versus-host disease (GVHD), risks of transplantation-related mortality (TRM) and relapse, and disease-free survival (DFS) using Cox proportional hazards models. The time from donor search to transplantation was significantly shorter among CB transplant recipients (median, 2 months) than BM transplant recipients (median, 11 months; P &lt; .01). Multivariate analysis demonstrated slow neutrophil (P &lt; .01) and platelet (P &lt; .01) recoveries in CBT patients compared with BMT patients. Despite rapid tapering of immunosuppressants after transplantation and infrequent use of steroids to treat severe acute GVHD, there were no GVHD-related deaths among CB transplant recipients compared with 10 deaths of 24 among BM transplant recipients. Unrelated CBT showed better TRM and DFS results compared with BMT (P = .02 and P &lt; .01, respectively), despite the higher human leukocyte antigen mismatching rate and lower number of infused cells. These data strongly suggest that CBT could be safely and effectively used for adult patients with hematologic malignancies.</jats:p>

収録刊行物

  • Blood

    Blood 104 (12), 3813-3820, 2004-12-01

    American Society of Hematology

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