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Biol Blood Marrow Transplant. 2014 Mar;20(3):396-401. doi: 10.1016/j.bbmt.2013.12.555. Epub 2013 Dec 11.

Single-unit cord blood transplantation after granulocyte colony-stimulating factor-combined myeloablative conditioning for myeloid malignancies not in remission.

Author information

1
Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan. Electronic address: tkonuma@ims.u-tokyo.ac.jp.
2
Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
3
Department of Hematology/Oncology, Teikyo University School of Medicine, Tokyo, Japan.
4
System Medical Biology Laboratory, School of Advanced Science and Engineering, Waseda University, Tokyo, Japan.

Abstract

High disease burden in myeloablative allogeneic hematopoietic stem cell transplantation is associated with adverse outcomes in patients with acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS). Quiescent leukemia stem cells could be induced to enter cell cycle by granulocyte colony-stimulating factor (G-CSF) administration and become more susceptible to chemotherapy. We report on the outcome of unrelated cord blood transplantation (CBT) using a conditioning regimen of 12 Gy total body irradiation, G-CSF-combined high-dose cytarabine, and cyclophosphamide in 61 adult patients with AML or advanced MDS not in remission. With a median follow-up of 97 months, the probability of overall survival and cumulative incidence of relapse at 7 years were 61.4% and 30.5%, respectively. In multivariate analysis, poor-risk cytogenetics and high lactate dehydrogenase values at CBT were independently associated with inferior survival. These data demonstrate that CBT after G-CSF-combined myeloablative conditioning is a promising curative option for patients with myeloid malignancies not in remission.

KEYWORDS:

Acute myelogenous leukemia; Cord blood transplantation; Granulocyte colony-stimulating factor; Myelodysplastic syndrome; not in remission

PMID:
24333750
DOI:
10.1016/j.bbmt.2013.12.555
[Indexed for MEDLINE]
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