Prospective observational study on the first 51 cases of peripheral blood stem cell transplantation from unrelated donors in Japan

Springer Science and Business Media LLC - Tập 107 - Trang 211-221 - 2017
Tatsunori Goto1, Takashi Tanaka2, Masashi Sawa3, Yasunori Ueda4, Hiroatsu Ago5, Shigeru Chiba6, Heiwa Kanamori7, Akinori Nishikawa8, Masaharu Nougawa9, Kazuteru Ohashi10, Hirokazu Okumura11, Mitsune Tanimoto12, Takahiro Fukuda2, Naomi Kawashima1, Tomonori Kato3, Kazuya Okada4, Koji Nagafuji13, Shin-ichiro Okamoto14, Yoshiko Atsuta15, Masayuki Hino16, Junji Tanaka17, Koichi Miyamura1
1Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
2Division of Hematopoietic stem cell transplantation, National Cancer Center Hospital, Tokyo, Japan
3Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan
4Department of Hematology/Oncology, Kurashiki Central Hospital, Kurashiki, Japan
5Division of Hematology and Oncology, Shimane Prefectural Central Hospital, Matsue, Japan
6Department of Hematology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
7Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
8Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan
9Division of Hematology, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan
10Division of Hematology, Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Tokyo, Japan
11Hematology Department, Toyama Prefectural Central Hospital, Toyama, Japan
12Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
13Department of Hematology and Oncology, School of Medicine, Kurume University, Kurume, Japan
14Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
15Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan
16Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
17Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan

Tóm tắt

The Japan Marrow Donor Program (JMDP) has facilitated unrelated peripheral blood stem cell transplantation (URPBSCT) since 2010. We conducted a prospective multicenter observational study to evaluate the feasibility of such transplantation. Between 2011 and 2014, 51 patients underwent URPBSCT from 8/8 allele-matched donors for hematological malignancies. The median age of the patients was 50 years; 21 had high-risk disease. Myeloablative conditioning regimens were used in 31 patients, and tacrolimus based graft-versus-host disease (GVHD) prophylaxis was used for all patients. The cumulative rate of engraftment was 96%. With a median follow-up period of 610 days for survivors, 100-day and 1-year overall survival rates were 86 and 59%, respectively. The cumulative incidence of non-relapse mortality and relapse at 1 year were 14 and 35%, respectively. The incidence of grade II to IV acute GVHD at 100 days and extensive type of chronic GVHD at 1 year were 25 and 32%, respectively. The probability of overall survival was comparable with that of bone marrow transplantation from HLA matched-unrelated donors in Japan, although the incidence of chronic GVHD was higher. Further follow-up with more patients is clearly warranted to establish the optimal use of URPBSCT together with the approaches of minimizing chronic GVHD.

Tài liệu tham khảo

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