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.
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.
Konuma
Takaaki
T
Department of Hematology/Oncology, University of Tokyo, Tokyo, Japan.
Takahashi
Satoshi
S
Ooi
Jun
J
Tomonari
Akira
A
Tsukada
Nobuhiro
N
Kato
Seiko
S
Sato
Aki
A
Monma
Fumihiko
F
Kasahara
Senji
S
Nagamura-Inoue
Tokiko
T
Uchimaru
Kaoru
K
Iseki
Tohru
T
Tojo
Arinobu
A
Yamaguchi
Takuhiro
T
Asano
Shigetaka
S
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