title: Single-unit cord blood transplantation after granulocyte colony-stimulating factor-combined myeloablative conditioning for myeloid malignancies not in remission.
abstract: High disease burden in myeloablative allogeneic hematopoietic stem cell transplantation is associated with adverse outcomes in patients with acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS). Quiescent leukemia stem cells could be induced to enter cell cycle by granulocyte colony-stimulating factor (G-CSF) administration and become more susceptible to chemotherapy. We report on the outcome of unrelated cord blood transplantation (CBT) using a conditioning regimen of 12 Gy total body irradiation, G-CSF-combined high-dose cytarabine, and cyclophosphamide in 61 adult patients with AML or advanced MDS not in remission. With a median follow-up of 97 months, the probability of overall survival and cumulative incidence of relapse at 7 years were 61.4% and 30.5%, respectively. In multivariate analysis, poor-risk cytogenetics and high lactate dehydrogenase values at CBT were independently associated with inferior survival. These data demonstrate that CBT after G-CSF-combined myeloablative conditioning is a promising curative option for patients with myeloid malignancies not in remission.
authors: Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan. Electronic address: tkonuma@ims.u-tokyo.ac.jp.
authors: Takaaki
authors: T
authors: Konuma
authors: Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors: Seiko
authors: S
authors: Kato
authors: Department of Hematology/Oncology, Teikyo University School of Medicine, Tokyo, Japan.
authors: Jun
authors: J
authors: Ooi
authors: Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors: Maki
authors: M
authors: Oiwa-Monna
authors: Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors: Yasuhiro
authors: Y
authors: Ebihara
authors: Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors: Shinji
authors: S
authors: Mochizuki
authors: Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors: Koichiro
authors: K
authors: Yuji
authors: Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors: Nobuhiro
authors: N
authors: Ohno
authors: Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors: Toyotaka
authors: T
authors: Kawamata
authors: Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors: Norihide
authors: N
authors: Jo
authors: Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors: Kazuaki
authors: K
authors: Yokoyama
authors: Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors: Kaoru
authors: K
authors: Uchimaru
authors: System Medical Biology Laboratory, School of Advanced Science and Engineering, Waseda University, Tokyo, Japan.
authors: Shigetaka
authors: S
authors: Asano
authors: Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors: Arinobu
authors: A
authors: Tojo
authors: Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors: Satoshi
authors: S
authors: Takahashi
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D036101:Cord Blood Stem Cell Transplantation; D003520:Cyclophosphamide / Q000627:therapeutic use; D003561:Cytarabine / Q000627:therapeutic use; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods; D006412:Hematopoietic Stem Cells / Q000187:drug effects; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D015470:Leukemia, Myeloid, Acute / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000627:therapeutic use*; D009190:Myelodysplastic Syndromes / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous
chemical_list: D015415:Biomarkers; D019653:Myeloablative Agonists; D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D003520:Cyclophosphamide; D007770:L-Lactate Dehydrogenase
keywords: Acute myelogenous leukemia; Cord blood transplantation; Granulocyte colony-stimulating factor; Myelodysplastic syndrome; not in remission