title: Peripheral blood as a preferable source of stem cells for salvage transplantation in patients with graft failure after cord blood transplantation: a retrospective analysis of the registry data of the Japanese Society for Hematopoietic Cell Transplantation.
abstract: To compare the different stem cell sources used in salvage transplantation for graft failure (GF) after cord blood transplantation (CBT), we retrospectively analyzed data of 220 patients who developed GF after undergoing CBT between January 2001 and December 2007 and underwent a second hematopoietic stem cell transplantation (HSCT) within 3 months. The donor sources for salvage HSCT were cord blood (n = 180), peripheral blood stem cells (PBSCs; n = 24), and bone marrow (BM; n = 16). The cumulative incidence of neutrophil engraftment on day 30 after the second HSCT was 39% with CB, 71% with PBSCs, and 75% with BM. Multivariate analysis revealed that PBSC and BM grafts were associated with a significantly higher engraftment rate than CB (hazard ratio [HR], 7.77; P < .001 and HR, 2.81; P = .016, respectively). Although the incidence of grade II-IV acute graft-versus-host disease was significantly higher in the PBSC group than in the CB group (HR, 2.83; P = .011), the incidence of 1-year nonrelapse mortality was lower in the PBSC group than in the CB group (HR, 0.43; P = .019), and 1-year overall survival was superior in the PBSC group compared with the CB group (HR, 0.45; P = .036). Our results suggest that PBSC is the preferable source of stem cells in salvage HSCT for GF after CBT.
authors.affiliation: Department of Hematology, NTT West Japan Osaka Hospital, Osaka, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Fuji
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Nakamura
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hatanaka
authors.forename: Shuichi
authors.initials: S
authors.lastname: Taniguchi
authors.forename: Maho
authors.initials: M
authors.lastname: Sato
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Mori
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sakamaki
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Yabe
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Heiwa
authors.initials: H
authors.lastname: Kanamori
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Ueda
authors.forename: Keisei
authors.initials: K
authors.lastname: Kawa
authors.forename: Koji
authors.initials: K
authors.lastname: Kato
authors.forename: Ritsuro
authors.initials: R
authors.lastname: Suzuki
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Atsuta
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Tamaki
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D036101:Cord Blood Stem Cell Transplantation; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control*; D006086:Graft vs Host Disease / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007564:Japan; D007938:Leukemia / Q000276:immunology / Q000401:mortality / Q000628:therapy; D008223:Lymphoma / Q000276:immunology / Q000401:mortality / Q000628:therapy; D008297:Male; D015999:Multivariate Analysis; D009504:Neutrophils / Q000276:immunology; D036102:Peripheral Blood Stem Cell Transplantation; D012008:Recurrence; D012042:Registries; D012189:Retrospective Studies; D012955:Societies, Medical; D016019:Survival Analysis; D019172:Transplantation Conditioning