title: Cord Blood Transplantation for Multiple Myeloma: A Study from the Multiple Myeloma Working Group of the Japan Society for Hematopoietic Cell Transplantation.
abstract: Cord blood has been investigated as an alternative source for hematopoietic stem cell transplantation, but information about its use for multiple myeloma is limited. The purpose of this study was to evaluate the feasibility of cord blood transplantation (CBT) for patients with multiple myeloma. Eighty-six patients with multiple myeloma who underwent a first CBT between 2001 and 2011 were included in this retrospective study. Sixty-two of them had received other types of stem cell transplantation before CBT. The cumulative incidences of neutrophil engraftment at day 50, grade II to IV acute graft-versus-host disease (GVHD), and chronic GVHD were 81.4%, 39.0%, and 19.5%, respectively. The incidence of nonrelapse mortality at 2 years was 39.0%, but it was only 6.2% in patients who underwent planned tandem autologous/reduced-intensity conditioning CBT (auto/RIC-CBT). Progression-free survival (PFS) and overall survival (OS) at 6 years were 13.0% and 15.2%, respectively. Less than a partial response before CBT and lack of prior transplantation were independent significant adverse factors for PFS, whereas the presence of prior transplantation and planned tandem transplantation were associated with better OS. OS at 6 years in patients who underwent auto/RIC-CBT was 45.9%. In addition, the development of chronic GVHD was associated with superior PFS. In conclusion, we demonstrated that cord blood is feasible as an alternative graft source for myeloma patients. Although CBT provided long-term survival for a fraction of patients, optimal use of this graft requires further clinical studies.
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Kawamura
authors.affiliation: Cellular Transplantation Biology, Kanazawa University, Kanazawa, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takamatsu
authors.affiliation: Division of Hematology and Stem Cell Transplantation, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ikeda
authors.affiliation: Department of Hematology, Tsukuba Memorial Hospital, Tsukuba, Japan.
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Komatsu
authors.affiliation: Division of Hematology-Oncology, Japanese Red Cross Society Narita Hospital, Narita, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Aotsuka
authors.affiliation: Department of Hematology and Respiratory, Nara Medical University Hospital, Kashihara, Japan.
authors.forename: Itsuto
authors.initials: I
authors.lastname: Amano
authors.affiliation: Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan.
authors.forename: Go
authors.initials: G
authors.lastname: Yamamoto
authors.affiliation: Department of Hematology/Oncology/Infectious Diseases, Saiseikai Central Hospital, Tokyo, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Department of Internal Medicine, Kitakyushu Municipal Medical Center, Kitakyushu, Japan.
authors.forename: Yuju
authors.initials: Y
authors.lastname: Ohno
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Kameda Medical Center, Kamogawa, Japan.
authors.forename: Kosei
authors.initials: K
authors.lastname: Matsue
authors.affiliation: Department of Transfusion Medicine, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.
authors.forename: Yasuji
authors.initials: Y
authors.lastname: Kouzai
authors.affiliation: Division of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tsukada
authors.affiliation: Department of Hematology, Kanazawa University Hospital, Kanazawa, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Ishiyama
authors.affiliation: Department of Hematology and Oncology, Takatsuki Red Cross Hospital, Takatsuki, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Anzai
authors.affiliation: Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Kato
authors.affiliation: Department of Hematopoietic Stem Cell Transplantation Data Management/Biostatistics, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Ritsuro
authors.initials: R
authors.lastname: Suzuki
authors.affiliation: Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Sunami
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan. Electronic address: ycanda-tky@umin.ac.jp.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000276:immunology / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007564:Japan; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D019653:Myeloablative Agonists / Q000627:therapeutic use*; D009504:Neutrophils / Q000276:immunology; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D019172:Transplantation Conditioning; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D019653:Myeloablative Agonists
keywords: Chronic graft-versus-host disease; Cord blood transplantation; Multiple myeloma; Tandem transplantation