title: Reduced-intensity unrelated donor bone marrow transplantation for hematologic malignancies.
abstract: 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.
authors.affiliation: Hematology and Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Sung-Won
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
authors.forename: Keitaro
authors.initials: K
authors.lastname: Matsuo
authors.affiliation: Hematology and Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fukuda
authors.affiliation: Department of Hematology, Ehime Prefectural Central Hospital, Matsuyama, Japan.
authors.forename: Masamichi
authors.initials: M
authors.lastname: Hara
authors.affiliation: Division of Hematology/Oncology, Kameda Medical Center, Kamogawa, Japan.
authors.forename: Kosei
authors.initials: K
authors.lastname: Matsue
authors.affiliation: Department of Hematology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Taniguchi
authors.affiliation: Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Eto
authors.affiliation: Department of Hematology and Oncology, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.
authors.forename: Mitsune
authors.initials: M
authors.lastname: Tanimoto
authors.affiliation: Department of Hematology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Wake
authors.affiliation: Department of Internal Medicine, Rinku General Medical Center, Izumisano, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hatanaka
authors.affiliation: Department of Hematology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Nakao
authors.affiliation: Division of Hematology/Oncology, Iwate Medical University School of Medicine, Morioka, Japan.
authors.forename: Yoji
authors.initials: Y
authors.lastname: Ishida
authors.affiliation: Department of Medicine and Biosystemic Science, Kyushu University, Fukuoka, Japan.
authors.forename: Mine
authors.initials: M
authors.lastname: Harada
authors.affiliation: Department of Internal Medicine, Imamura Bun-in Hospital, Kagoshima, Japan.
authors.forename: Atae
authors.initials: A
authors.lastname: Utsunomiya
authors.affiliation: Department of Hematology and Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Imamura
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
authors.affiliation: Department of Internal Medicine, National Hospital Organization Okayama Medical Center, Okayama, Japan.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Sunami
authors.affiliation: Department of Internal Medicine, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Kawano
authors.affiliation: Hematology and Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Takaue
authors.affiliation: 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.
authors.forename: Takanori
authors.initials: T
authors.lastname: Teshima
mesh_terms: 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
chemical_list: D019653:Myeloablative Agonists
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