Reduced-intensity unrelated donor bone marrow transplantation for hematologic malignancies.
To review a current experience of unrelated bone marrow transplantation (BMT) with reduced-intensity conditioning (RIC) regimens, we conducted a nationwide survey with 77 patients (age, 25-68 years). The backbone RIC regimen was a combination of fludarabine or cladribine, busulfan or melphalan and total body irradiation at 2-4 Gy. Five patients died early, but 71 (92%) achieved initial neutrophil recovery. Thereafter, 36 patients (47%) died of therapy-related complications, 23 (30%) of whom died within day 100. Grades II-IV acute graft-versus-host disease (GVHD) occurred in 34 of the 68 evaluable patients (50%). In a multivariate analysis, a regimen containing antithymocyte globulin (ATG) was significantly associated with a decreased risk of acute GVHD (P = 0.041). Thirty-three patients are currently alive with a median follow-up of 439 days (28-2002 days), with an OS of 50% at 1 year. In conclusion, unrelated BMT with RIC regimens can be a curative treatment in a subset of patients.
Kim
Sung-Won
SW
Hematology and Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan.
Matsuo
Keitaro
K
Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
Fukuda
Takahiro
T
Hematology and Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan.
Hara
Masamichi
M
Department of Hematology, Ehime Prefectural Central Hospital, Matsuyama, Japan.
Matsue
Kosei
K
Division of Hematology/Oncology, Kameda Medical Center, Kamogawa, Japan.
Taniguchi
Shuichi
S
Department of Hematology, Toranomon Hospital, Tokyo, Japan.
Eto
Tetsuya
T
Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan.
Tanimoto
Mitsune
M
Department of Hematology and Oncology, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.
Wake
Atsushi
A
Department of Hematology, Toranomon Hospital, Tokyo, Japan.
Hatanaka
Kazuo
K
Department of Internal Medicine, Rinku General Medical Center, Izumisano, Japan.
Nakao
Shinji
S
Department of Hematology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
Ishida
Yoji
Y
Division of Hematology/Oncology, Iwate Medical University School of Medicine, Morioka, Japan.
Harada
Mine
M
Department of Medicine and Biosystemic Science, Kyushu University, Fukuoka, Japan.
Utsunomiya
Atae
A
Department of Internal Medicine, Imamura Bun-in Hospital, Kagoshima, Japan.
Imamura
Masahiro
M
Department of Hematology and Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Kanda
Yoshinobu
Y
Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Sunami
Kazutaka
K
Department of Internal Medicine, National Hospital Organization Okayama Medical Center, Okayama, Japan.
Kawano
Fumio
F
Department of Internal Medicine, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan.
Takaue
Yoichi
Y
Hematology and Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan.
Teshima
Takanori
T
Center for Cellular and Molecular Medicine, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. tteshima@cancer.med.kyushu-u.ac.jp.
D000208:Acute Disease; D000328:Adult; D000368:Aged; D016026:Bone Marrow Transplantation; D003625:Data Collection; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000401:mortality; D019337:Hematologic Neoplasms / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D007564:Japan; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000008:administration & dosage; D012307:Risk Factors; D015996:Survival Rate; D019172:Transplantation Conditioning; D014916:Whole-Body Irradiation
D019653:Myeloablative Agonists
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