2024-03-28T09:53:36Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:02001431
2023-01-16T05:02:14Z
320:321:322
A multicenter phase II study of intrabone single-unit cord blood transplantation without antithymocyte globulin
Nishida, Tetsuya
Kobayashi, Takeshi
Sawa, Masashi
Masuda, Shinichi
Shibasaki, Yasuhiko
Goto, Tatsunori
Fukuhara, Noriko
Fujii, Nobuharu
Ikegame, Kazuhiro
Sugita, Junichi
Ikeda, Takashi
Kuwatsuka, Yachiyo
Suzuki, Ritsuro
Najima, Yuho
Doki, Noriko
Kato, Tomonori
Inagaki, Yuichiro
Utsu, Yoshikazu
Aotsuka, Nobuyuki
Masuko, Masayoshi
Terakura, Seitaro
Onishi, Yasushi
Maeda, Yoshinobu
Okada, Masaya
Teshima, Takanori
Murata, Makoto
cord blood transplantation
intrabone, engraftment
graft-versus-host disease
antithymocyte globulin
To overcome the delayed or failed engraftment after unrelated cord blood transplantation (CBT), we conducted a multicenter phase II study of intrabone single-unit CBT without antithymocyte globulin (ATG) for adult patients with hematological malignancies (UMIN-CTR, UMIN000020997). Sixty-four patients received an intrabone injection of unwashed (n = 61) or washed (n = 3) cord blood after local anesthesia. All injection-related adverse events were mild and resolved spontaneously. Sixty-two patients were evaluable for the efficacy of intrabone CBT of serological HLA-A, -B, and -DR ≥ 4/6 matched cord blood with a median number of 2.57 × 10^7/kg cryopreserved total nucleated cells. The probability of survival with neutrophil engraftment on day 28 was 77.4% (95% confidence interval, 67.0–85.8%), which exceeded the threshold value. The cumulative incidences of neutrophils ≥ 0.5 × 10^9/L on day 60 was 80.6% (68.2–88.6%), with a median time to recovery of 21 days after transplantation. The cumulative incidences of platelets ≥ 20 × 10^9/L and platelets ≥ 50 × 10^9/L on day 100 were 75.8% (62.6–84.9%) and 72.6% (59.4–82.1%), respectively, with median time to platelets ≥ 20 × 10^9/L and platelets ≥ 50 × 10^9/L of 38 and 45 days after transplantation, respectively. The cumulative incidences of grade II–IV and III–IV acute graft-versus-host disease were 29.0% and 6.5%, respectively. All responded to steroid therapy, and secondary treatments were not required. The present study suggests the efficacy of intrabone single-unit CBT without ATG in terms of early engraftment and controllable acute graft-versus-host disease.
journal article
Springer
2021-03
application/pdf
Annals of Hematology
3
100
743
752
0939-5555
https://nagoya.repo.nii.ac.jp/record/2001431/files/Ann_Hematol_2021.pdf
eng
https://doi.org/10.1007/s00277-020-04365-z