Unrelated cord blood transplantation after myeloablative conditioning for adult patients with refractory anemia.
We report the results of unrelated cord blood transplantation (CBT) after myeloablative conditioning in 3 patients with myelodysplastic syndrome-refractory anemia (MDS-RA). All patients were treated with total body irradiation, cytosine arabinoside (Ara-C), and cyclophosphamide, followed by unrelated HLA-mismatched CBT. Granulocyte colony-stimulating factor was infused continuously, starting 12 hours before Ara-C therapy and continuing until the end of Ara-C therapy. All patients received standard cyclosporine and methotrexate therapy as graft-versus-host disease prophylaxis. All patients had myeloid reconstitution, and the times to reach an absolute neutrophil count >0.5 x 10(9)/L were 23, 20, and 26 days. All patients showed full donor chimerism at the time of the first bone marrow examination (on day +42, +43, and +62) after CBT. All patients are alive and free of disease at between 17 and 39 months after CBT. These results suggest that adult MDS-RA patients without suitable related or unrelated bone marrow donors should be considered as candidates for CBT.
Ooi
Jun
J
Department of Hematology and Oncology, Institute of Medical Science, University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo 108-8639, Japan. jun-ooi@ims.u-tokyo.ac.jp
Iseki
Tohru
T
Takahashi
Satoshi
S
Tomonari
Akira
A
Takasugi
Kashiya
K
Uchiyama
Michihiro
M
Konuma
Takaaki
T
Fukuno
Kenji
K
Soda
Yasushi
Y
Ohno
Nobuhiro
N
Nagamura
Fumitaka
F
Uchimaru
Kaoru
K
Tojo
Arinobu
A
Asano
Shigetaka
S
D000328:Adult; D000753:Anemia, Refractory / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D018572:Disease-Free Survival; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D016879:Salvage Therapy; D019172:Transplantation Conditioning / Q000379:methods*; D014916:Whole-Body Irradiation