title: Unrelated cord blood transplantation after myeloablative conditioning in adults with acute myelogenous leukemia.
abstract: We analyzed the disease-specific outcomes of adult acute myelogenous leukemia (AML) patients treated with unrelated cord blood transplantation (CBT) after myeloablative conditioning. Between August 1998 and February 2008, 77 adult patients with AML were treated with unrelated CBT. All patients received 4 fractionated 12 Gy total body irradiation (TBI) and chemotherapy as myeloablative conditioning. The median age was 45 years, the median weight was 55 kg, the median number of nucleated cells was 2.44 x 10(7)/kg, and the median number of CD34-positive cells was 1.00 x 10(5)/kg. All patients received a single and HLA mismatched cord blood unit. The cumulative incidence of neutrophil recovery at day 50 and platelet recovery at day 200 was 94.8% and 91.7%, respectively. A higher CD34-positive cell dose was associated with faster hematopoietic recovery. The cumulative incidence of grade III to IV acute graft-versus-host disease (aGVHD) and extensive-type chronic GVHD (cGVHD) was 25.1% and 28.6%, respectively. With a median follow-up of 78 months, the probability of event-free survival (EFS) at 5 years was 62.8%. The 5-year cumulative incidence of treatment related-mortality (TRM) and relapse was 9.7%, 25.8%, respectively. In multivariate analyses, the risk factor identified for event free survival (EFS) was disease status and cytogenetics. These results suggest that unrelated CBT after myeloablative conditioning could be safely and effectively used for adult patients with AML.
authors.affiliation: Department of Hematology and Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan. jun-ooi@ims.u-tokyo.ac.jp
authors.forename: Jun
authors.initials: J
authors.lastname: Ooi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Akira
authors.initials: A
authors.lastname: Tomonari
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tsukada
authors.forename: Takaaki
authors.initials: T
authors.lastname: Konuma
authors.forename: Seiko
authors.initials: S
authors.lastname: Kato
authors.forename: Senji
authors.initials: S
authors.lastname: Kasahara
authors.forename: Aki
authors.initials: A
authors.lastname: Sato
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Monma
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Nagamura
authors.forename: Tohru
authors.initials: T
authors.lastname: Iseki
authors.forename: Arinobu
authors.initials: A
authors.lastname: Tojo
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Asano
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D018952:Antigens, CD34; D036101:Cord Blood Stem Cell Transplantation; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000401:mortality / Q000517:prevention & control; D006680:HLA Antigens; D006801:Humans; D015994:Incidence; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D020127:Recovery of Function; D015996:Survival Rate; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous
chemical_list: D018952:Antigens, CD34; D006680:HLA Antigens