Successful engraftment after reduced-intensity umbilical cord blood transplantation for myelofibrosis.
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.
Takagi
Shinsuke
S
Department of Hematology, Toranomon Hospital, Toranomon, Minato-ku, Tokyo, Japan. shinsuke-takagi@umin.net
Ota
Yasunori
Y
Uchida
Naoyuki
N
Takahashi
Koichi
K
Ishiwata
Kazuya
K
Tsuji
Masanori
M
Yamamoto
Hisashi
H
Asano-Mori
Yuki
Y
Matsuno
Naofumi
N
Masuoka
Kazuhiro
K
Wake
Atsushi
A
Miyakoshi
Shigesaburo
S
Ohashi
Kenichi
K
Taniguchi
Shuichi
S
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
D019653:Myeloablative Agonists; D014740:Vidarabine; D002066:Busulfan; C024352:fludarabine; D008558:Melphalan