2024-03-28T15:56:08Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:00024931
2023-01-16T04:14:03Z
499:500:501
GvHD prophylaxis after single-unit reduced intensity conditioning cord blood transplantation in adults with acute leukemia
Terakura, Seitaro
74276
Kuwatsuka, Yachiyo
74277
Yamasaki, Satoshi
74278
Wake, Atsushi
74279
Kanda, Junya
74280
Inamoto, Yoshihiro
74281
Mizuta, Shuichi
74282
Yamaguchi, Takuhiro
74283
Uchida, Naoyuki
74284
Kouzai, Yasuji
74285
Aotsuka, Nobuyuki
74286
Ogawa, Hiroyasu
74287
Kanamori, Heiwa
74288
Nishiwaki, Kaichi
74289
Miyakoshi, Shigesaburo
74290
Onizuka, Makoto
74291
Amano, Itsuto
74292
Fukuda, Takahiro
74293
Ichinohe, Tatsuo
74294
Atsuta, Yoshiko
74295
Murata, Makoto
74296
Teshima, Takanori
74297
Graft-versus-host disease
GVHD prophylaxis
immunosuppressant selection
reduced intensity
single-unit umbilical cord blood transplantation
To investigate better GVHD prophylaxis in reduced intensity conditioning umbilical cord blood transplantation (RIC-UCBT), we compared transplant outcomes after UCBT among GvHD prophylaxes using the registry data. We selected patients transplanted for AML or ALL with a calcineurin inhibitor and methotrexate (MTX)/mycophenolate mofetil (MMF) combination. A total of 748 first RIC-UCBT between 2000 and 2012 (MTX+ group, 446, MMF+ group, 302) were included. The cumulative incidence of neutrophil and platelet counts higher than 50 000/μL was significantly better in the MMF+ group (relative risk (RR), 1.55; P<0.001: RR, 1.34; P=0.003, respectively). In multivariate analyses, the risk of grade II–IV and III–IV acute GvHD was significantly higher in the MMF+ group than in the MTX+ group (RR, 1.75; P<0.001: RR, 1.97; P=0.004, respectively). In disease-specific analyses of AML, the risk of relapse of high-risk disease was significantly lower in the MMF+ group (RR, 0.69; P=0.009), whereas no significant difference was observed in the risk of relapse-free and overall survival in high-risk disease. In patients with standard-risk disease, no significant differences were noted in the risk of relapse or survival between the MTX+ and MMF+ groups. Collectively, these results suggest that MMF-containing prophylaxis may be preferable in RIC-UCBT, particularly for high-risk disease.
journal article
nature
2017-06-12
application/pdf
BONE MARROW TRANSPLANTATION
9
52
1261
1267
http://doi.org/10.1038/bmt.2017.116
http://hdl.handle.net/2237/27153
0268-3369
https://nagoya.repo.nii.ac.jp/record/24931/files/18558_1_merged_1491317774.pdf
eng
https://doi.org/10.1038/bmt.2017.116