Clinical outcomes of unrelated donor umbilical cord blood transplantation for 30 adults with hematological malignancies

Koichiro Kobayashi, Yoshinobu Maeda, Yoshitaka Hara, Miyuki Nishie-Kataoka, Hisakazu Nishimori, Haruko Sugiyama, Noriko Namba, Shiro Kubonishi, Masami Niiya, Katsuji Shinagawa, Kazuma Ikeda, Mitsune Tanimoto

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Umbilical cord blood transplantation (CBT) has increasingly been used as a therapeutic option for adult patients for whom allogeneic stem- cell transplantation is not indicated, due to the availability of cord blood. However, myeloablative conditioning regimens are associated with significant mortality, and high relapse rates in reduced-intensity regimens may result in a poor rate of disease-free survival for those with advanced stages of hematological malignancies. Therefore, it remains unknown whether CBT is a truly effective option for such adults with high-risk disease, as well as for those with standard-risk disease. Patients and Methods: Thirty adult patients with a median age of 45 years (range: 16-67) with standard or high-risk disease underwent CBT from unrelated donors at Okayama University Hospital between October 2002 and May 2007. Twenty-one patients had diseases classified as high-risk for transplantation. The median number of nucleated cells in infused cord blood was 2.65×107/kg (range: 1.73-4.87). Results: Twenty-three patients achieved neutrophil engraftment at a median time of 22 days (range: 13-42) after CBT. The cumulative incidence of grade II to IV acute graft-versus-host disease (GVHD) was 53.6%. Out of the 30 patients, 11 were alive and disease-free at a median time of 446 days (range: 124-1153) after CBT. The cumulative 1-year overall survival in patients with standard-risk or high-risk disease was 63.5% and 15.4%, respectively (p=0.01). Conclusion: Although from a retrospective study, these results suggest that unrelated donor CBT could be safe and effective for adult patients with standard-risk disease who cannot find a suitable HLA-matched volunteer marrow or peripheral blood donor.

Original languageEnglish
Pages (from-to)1763-1770
Number of pages8
JournalAnticancer Research
Volume29
Issue number5
Publication statusPublished - May 2009

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Unrelated Donors
Hematologic Neoplasms
Fetal Blood
Transplantation
Stem Cell Transplantation
Graft vs Host Disease
Blood Donors
Disease-Free Survival
Volunteers
Neutrophils
Retrospective Studies
Cell Count
Bone Marrow
Recurrence
Survival
Mortality
Incidence

Keywords

  • Acute graft-versus-host disease
  • Cord blood transplantation
  • Standard-risk disease

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Clinical outcomes of unrelated donor umbilical cord blood transplantation for 30 adults with hematological malignancies. / Kobayashi, Koichiro; Maeda, Yoshinobu; Hara, Yoshitaka; Nishie-Kataoka, Miyuki; Nishimori, Hisakazu; Sugiyama, Haruko; Namba, Noriko; Kubonishi, Shiro; Niiya, Masami; Shinagawa, Katsuji; Ikeda, Kazuma; Tanimoto, Mitsune.

In: Anticancer Research, Vol. 29, No. 5, 05.2009, p. 1763-1770.

Research output: Contribution to journalArticle

Kobayashi, K, Maeda, Y, Hara, Y, Nishie-Kataoka, M, Nishimori, H, Sugiyama, H, Namba, N, Kubonishi, S, Niiya, M, Shinagawa, K, Ikeda, K & Tanimoto, M 2009, 'Clinical outcomes of unrelated donor umbilical cord blood transplantation for 30 adults with hematological malignancies', Anticancer Research, vol. 29, no. 5, pp. 1763-1770.
Kobayashi, Koichiro ; Maeda, Yoshinobu ; Hara, Yoshitaka ; Nishie-Kataoka, Miyuki ; Nishimori, Hisakazu ; Sugiyama, Haruko ; Namba, Noriko ; Kubonishi, Shiro ; Niiya, Masami ; Shinagawa, Katsuji ; Ikeda, Kazuma ; Tanimoto, Mitsune. / Clinical outcomes of unrelated donor umbilical cord blood transplantation for 30 adults with hematological malignancies. In: Anticancer Research. 2009 ; Vol. 29, No. 5. pp. 1763-1770.
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AU - Kobayashi, Koichiro

AU - Maeda, Yoshinobu

AU - Hara, Yoshitaka

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AU - Nishimori, Hisakazu

AU - Sugiyama, Haruko

AU - Namba, Noriko

AU - Kubonishi, Shiro

AU - Niiya, Masami

AU - Shinagawa, Katsuji

AU - Ikeda, Kazuma

AU - Tanimoto, Mitsune

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N2 - Background: Umbilical cord blood transplantation (CBT) has increasingly been used as a therapeutic option for adult patients for whom allogeneic stem- cell transplantation is not indicated, due to the availability of cord blood. However, myeloablative conditioning regimens are associated with significant mortality, and high relapse rates in reduced-intensity regimens may result in a poor rate of disease-free survival for those with advanced stages of hematological malignancies. Therefore, it remains unknown whether CBT is a truly effective option for such adults with high-risk disease, as well as for those with standard-risk disease. Patients and Methods: Thirty adult patients with a median age of 45 years (range: 16-67) with standard or high-risk disease underwent CBT from unrelated donors at Okayama University Hospital between October 2002 and May 2007. Twenty-one patients had diseases classified as high-risk for transplantation. The median number of nucleated cells in infused cord blood was 2.65×107/kg (range: 1.73-4.87). Results: Twenty-three patients achieved neutrophil engraftment at a median time of 22 days (range: 13-42) after CBT. The cumulative incidence of grade II to IV acute graft-versus-host disease (GVHD) was 53.6%. Out of the 30 patients, 11 were alive and disease-free at a median time of 446 days (range: 124-1153) after CBT. The cumulative 1-year overall survival in patients with standard-risk or high-risk disease was 63.5% and 15.4%, respectively (p=0.01). Conclusion: Although from a retrospective study, these results suggest that unrelated donor CBT could be safe and effective for adult patients with standard-risk disease who cannot find a suitable HLA-matched volunteer marrow or peripheral blood donor.

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