Unrelated cord blood transplantation in CML: Japan Cord Blood Bank Network analysis.
We analysed 86 patients with CML who received unrelated cord blood transplantation (UCBT), identified through a registry of the Japan Cord Blood Bank Network. At transplantation, the median patient age was 39 years (range, 1-67 years); 38 patients were in chronic phase (CP), 13 in the accelerated phase (AP) and 35 in blast crisis (BC). Median duration from diagnosis to UCBT was 1.5 years (range, 0.2-14.6 years). A nucleated cell (NC) dose of more than 3.0 x 10(7) per kg was sufficient to achieve neutrophil (91%) and platelet recovery (86%), whereas the lower dose of NC achieved only 60 and 61%, respectively. The duration and type of pre-transplant treatment did not affect neutrophil or platelet recovery. Results of multivariate analysis indicated that older patients (>50 years) had a higher incidence of transplant-related mortality. Advanced-disease stage and lower doses of NCs were significantly associated with lower leukaemia-free and event-free survival. At 2-year survival for patients in CP, AP and BC was 71, 59 and 32%, respectively (P=0.0004). A pre-transplant European Group for Blood and Marrow Transplantation scoring system was effective in predicting the outcome of UCBT. We conclude that UCBT is a reasonable alternative therapy for patients with CML.
Department of Cell Processing and Transfusion, Research Hospital, The Institute of Medical Science, University of Tokyo, Tokyo, Japan. tokikoni@ims.u-tokyo.ac.jp
T
T
Nagamura-Inoue
S
S
Kai
H
H
Azuma
M
M
Takanashi
K
K
Isoyama
K
K
Kato
S
S
Takahashi
S
S
Taniguchi
K
K
Miyamura
K
K
Aoki
M
M
Hidaka
F
F
Nagamura
A
A
Tojo
Xm
X
Fang
S
S
Kato
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007223:Infant; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors