title: Long-term outcomes of granulocyte colony-stimulating factor-combined conditioning in allogeneic hematopoietic stem cell transplantation from HLA-identical family donors for myeloid malignancies.
abstract: Dormant leukemia cells, which might escape the cytotoxic effect of conditioning before hematopoietic stem cell transplantation (HSCT), could be induced to enter the cell cycle by granulocyte colony-stimulating factor (G-CSF) and become more susceptible to the cell-cycle-specific agent cytarabine arabinoside (Ara-C). Based on this effect, we have utilized G-CSF-combined high-dose Ara-C in myeloablative conditioning for allogeneic bone marrow or peripheral blood stem cell transplantation from HLA-identical family donors since 1988. We report on the long-term outcomes of allogeneic HSCT using a conditioning regimen of 12Gy total body irradiation and G-CSF-combined high-dose Ara-C in 89 adult patients with acute myeloid leukemia, chronic myelogenous leukemia, or myelodysplastic syndrome. With a median follow-up of 135 months, the probability of overall survival and cumulative incidence of relapse at 5 years were 67.8% and 19.4%, respectively. In multivariate analysis, disease status at HSCT was associated with survival and relapse. These data demonstrate that G-CSF-combined myeloablative conditioning could be safely and effectively used for patients with myeloid malignancies.
authors.affiliation: Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan. Electronic address: tkonuma@ims.u-tokyo.ac.jp.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Konuma
authors.affiliation: Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Seiko
authors.initials: S
authors.lastname: Kato
authors.affiliation: Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Ishii
authors.affiliation: Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Oiwa-Monna
authors.affiliation: System Medical Biology Laboratory, School of Advanced Science and Engineering, Waseda University, Tokyo, Japan.
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Asano
authors.affiliation: Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Arinobu
authors.initials: A
authors.lastname: Tojo
authors.affiliation: Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D016026:Bone Marrow Transplantation; D003561:Cytarabine / Q000008:administration & dosage; D018572:Disease-Free Survival; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D006680:HLA Antigens; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000401:mortality / Q000628:therapy; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000628:therapy; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000401:mortality / Q000628:therapy; D036102:Peripheral Blood Stem Cell Transplantation; D015996:Survival Rate; D019172:Transplantation Conditioning; D014916:Whole-Body Irradiation
chemical_list: D000964:Antimetabolites, Antineoplastic; D006680:HLA Antigens; D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor
keywords: Allogeneic hematopoietic stem cell transplantation; Conditioning regimen; Cytarabine arabinoside; Granulocyte colony-stimulating factor; Myelodysplastic syndrome; Myeloid leukemia