title: Myeloablative unrelated cord blood transplantation for acute leukemia patients between 50 and 55 years of age: single institutional retrospective comparison with patients younger than 50 years of age.
abstract: Increasing recipient age is a well-known risk factor for graft-versus-host disease (GVHD) and treatment-related mortality (TRM) and has a negative impact on allogeneic hematopoietic stem cell transplantation. Since the incidence of severe GVHD after cord blood transplantation (CBT) is lower than that after transplants using bone marrow or mobilized peripheral blood grafts from adult cells, we should expect better outcomes from CBT in older patients. To evaluate the feasibility and efficacy of myeloablative unrelated CBT in patients aged between 50 and 55 years, we performed a retrospective comparison of 100 patients with acute leukemia who received cord blood grafts at our institution. Nineteen older patients (median age, 52; range, 50-55) and 81 younger patients (median, 36; range, 16-49) received a myeloablative conditioning regimen including 12 Gy of total body irradiation and chemotherapy. GVHD prophylaxis included cyclosporine with (n = 96) or without (n = 4) methotrexate. There were no significant differences in the incidences of grades II to IV acute GVHD, extensive-type chronic GVHD, TRM, and the probability of overall and disease-free survival between these groups. These results suggest that, in patients with acute leukemia, myeloablative CBT might be as safe and effective in patients aged between 50 and 55 years as in younger patients.
authors.affiliation: Department of Hematology/Oncology, University of Tokyo, Tokyo, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Konuma
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Jun
authors.initials: J
authors.lastname: Ooi
authors.forename: Akira
authors.initials: A
authors.lastname: Tomonari
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tsukada
authors.forename: Seiko
authors.initials: S
authors.lastname: Kato
authors.forename: Aki
authors.initials: A
authors.lastname: Sato
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Monma
authors.forename: Senji
authors.initials: S
authors.lastname: Kasahara
authors.forename: Tokiko
authors.initials: T
authors.lastname: Nagamura-Inoue
authors.forename: Kaoru
authors.initials: K
authors.lastname: Uchimaru
authors.forename: Tohru
authors.initials: T
authors.lastname: Iseki
authors.forename: Arinobu
authors.initials: A
authors.lastname: Tojo
authors.forename: Takuhiro
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Asano
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D036101:Cord Blood Stem Cell Transplantation; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease; D042381:Granulocyte Precursor Cells; D006801:Humans; D007938:Leukemia / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome