Unrelated donor bone marrow transplantation for 100 pediatric patients: a single institute's experience.
In all, 100 unrelated donor bone marrow transplantations (UD-BMT) were performed in our institute between October 1993 and January 2003. Of 93 evaluable patients, 73 patients had hematological malignancy, 13 had nonmalignancy and seven had lymphoproliferative disease. The estimated 9-year event-free survival (EFS) rate was 57.1+/-5.5% in all patients. In the following analyses of the patients with hematological malignancy, the standard group had significantly better EFS than the high-risk group (61.5+/-7.0 vs 35.6+/-9.7%, P=0.02), and the EFS rate of the tacrolimus (FK-506)+methotrexate (MTX)+/-methylprednisolone prophylactic group for graft-versus-host disease was superior to that of the FK-506 without MTX group (75.7+/-8.0 vs 55.8+/-7.6%, P=0.02). When we compared the EFS rates of the FK506+MTX+/-methylprednisolone (mPSL) group and the HLA-matched related donor BMT group in our institute, these were almost similar (75.7+/-8.1 vs 68.4+/-9.3%). Therefore, UD-BMT using FK-506+MTX+/-mPSL is a safe and useful method for children with hematological malignancy who require allogeneic BMT.
Yumura-Yagi
K
K
Department of Pediatrics, Osaka General Medical Center, Osaka, Japan. yagikei@gh.pref.osaka.jp
Inoue
M
M
Sakata
N
N
Okamura
T
T
Yasui
M
M
Sawada
A
A
Sato
E
E
Chayama
K
K
Endo
C
C
Sasabe
M
M
Miyamura
T
T
Park
Y-D
YD
Nakano
T
T
Inagaki
J
J
Kishimoto
T
T
Nomura
K
K
Saito
I
I
Hamada
S
S
Nakano
T
T
Hashii
Y
Y
Kawa
K
K
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000276:immunology / Q000379:methods* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D004359:Drug Therapy, Combination; D005260:Female; D006084:Graft Rejection / Q000209:etiology; D006086:Graft vs Host Disease / Q000139:chemically induced / Q000209:etiology / Q000517:prevention & control; D006402:Hematologic Diseases / Q000150:complications / Q000401:mortality / Q000628:therapy; D006801:Humans; D007223:Infant; D007564:Japan; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008775:Methylprednisolone / Q000627:therapeutic use; D011292:Premedication; D012189:Retrospective Studies; D016559:Tacrolimus / Q000627:therapeutic use / Q000633:toxicity; D014019:Tissue Donors
D016559:Tacrolimus; D008775:Methylprednisolone; D008727:Methotrexate