title: Successful engraftment after reduced-intensity umbilical cord blood transplantation for myelofibrosis.
abstract: Although allogeneic hematopoietic stem cell transplantation has recently been applied to patients with myelofibrosis with reproducible engraftment and resolution of marrow fibrosis, no data describe the outcomes of umbilical cord blood transplantation. We describe 14 patients with primary (n = 1) and secondary myelofibrosis (n = 13) who underwent reduced-intensity umbilical cord blood transplantation. Conditioning regimens included fludarabine and graft-versus-host disease prophylaxis composed cyclosporine/tacrolimus alone (n = 6) or a combination of tacrolimus and mycophenolate mofetil (n = 8). Thirteen patients achieved neutrophil engraftment at a median of 23 days. The cumulative incidence of neutrophil and platelet engraftment was 92.9% at day 60 and 42.9% at day 100, respectively. Posttransplantation chimerism analysis showed full donor type in all patients at a median of 14 days. The use of umbilical cord blood could be feasible even for patients with severe marrow fibrosis, from the viewpoint of donor cell engraftment.
authors.affiliation: Department of Hematology, Toranomon Hospital, Toranomon, Minato-ku, Tokyo, Japan. shinsuke-takagi@umin.net
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Takagi
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Ota
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Uchida
authors.forename: Koichi
authors.initials: K
authors.lastname: Takahashi
authors.forename: Kazuya
authors.initials: K
authors.lastname: Ishiwata
authors.forename: Masanori
authors.initials: M
authors.lastname: Tsuji
authors.forename: Hisashi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Yuki
authors.initials: Y
authors.lastname: Asano-Mori
authors.forename: Naofumi
authors.initials: N
authors.lastname: Matsuno
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Masuoka
authors.forename: Atsushi
authors.initials: A
authors.lastname: Wake
authors.forename: Shigesaburo
authors.initials: S
authors.lastname: Miyakoshi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Ohashi
authors.forename: Shuichi
authors.initials: S
authors.lastname: Taniguchi
mesh_terms: D000368:Aged; D002066:Busulfan / Q000008:administration & dosage; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006085:Graft Survival; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000008:administration & dosage; D055728:Primary Myelofibrosis / Q000401:mortality / Q000628:therapy*; D011879:Radiotherapy Dosage; D012074:Remission Induction; D016879:Salvage Therapy; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods; D016896:Treatment Outcome; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives; D014916:Whole-Body Irradiation / Q000379:methods
chemical_list: D019653:Myeloablative Agonists; D014740:Vidarabine; D002066:Busulfan; C024352:fludarabine; D008558:Melphalan