TY - JOUR
T1 - Effect of Granulocyte Colony-Stimulating Factor-Combined Conditioning in Cord Blood Transplantation for Myelodysplastic Syndrome and Secondary Acute Myeloid Leukemia
T2 - A Retrospective Study in Japan
AU - The Adult Myelodysplastic Syndrome and Adult Acute Myeloid Leukemia Working Group of the Japan Society for Hematopoietic Cell Transplantation
AU - Konuma, Takaaki
AU - Takahashi, Satoshi
AU - Uchida, Naoyuki
AU - Kuwatsuka, Yachiyo
AU - Yamasaki, Satoshi
AU - Aoki, Jun
AU - Onishi, Yasushi
AU - Aotsuka, Nobuyuki
AU - Ohashi, Kazuteru
AU - Mori, Takehiko
AU - Masuko, Masayoshi
AU - Nakamae, Hirohisa
AU - Miyamura, Kouichi
AU - Kato, Koji
AU - Atsuta, Yoshiko
AU - Kato, Seiko
AU - Asano, Shigetaka
AU - Takami, Akiyoshi
AU - Miyazaki, Yasushi
N1 - Funding Information:
This work was supported in part by Chugai Pharmaceutical . The authors thank all of the physicians and staff at the hospitals and the cord blood banks in Japan for their help in this study and Maki Monna-Oiwa for her secretarial assistance.
Publisher Copyright:
© 2015 American Society for Blood and Marrow Transplantation.
PY - 2015/9/1
Y1 - 2015/9/1
N2 - Granulocyte colony-stimulating factor (G-CSF) increases the susceptibility of dormant malignant or nonmalignant hematopoietic cells to cytarabine arabinoside (Ara-C) through the induction of cell cycle entry. Therefore, G-CSF-combined conditioning before allogeneic stem cell transplantation might positively contribute to decreased incidences of relapse and graft failure without having to increase the dose of cytotoxic drugs. We conducted a retrospective nationwide study of 336 adult patients with myelodysplastic syndrome (MDS) and secondary acute myeloid leukemia (sAML) after single-unit cord blood transplantation (CBT) who underwent 4 different kinds of conditioning regimens: total body irradiation (TBI) ≥ 8 Gy + Ara-C/G-CSF + cyclophosphamide (CY) (n = 65), TBI ≥ 8 Gy + Ara-C + CY (n = 119), TBI ≥ 8 Gy + other (n = 104), or TBI < 8 Gy or non-TBI (n = 48). The TBI ≥ 8 Gy + Ara-C/G-CSF + CY regimen showed significantly higher incidence of neutrophil engraftment (hazard ratio, 1.52; 95% confidence interval [CI], 1.10 to 2.08; P = 009) and lower overall mortality (hazard ratio, .46; 95% CI, .26 to .82; P =008) rates compared with those without a G-CSF regimen. This retrospective study shows that the G-CSF-combined conditioning regimen provides better engraftment and survival results in CBT for adults with MDS and sAML.
AB - Granulocyte colony-stimulating factor (G-CSF) increases the susceptibility of dormant malignant or nonmalignant hematopoietic cells to cytarabine arabinoside (Ara-C) through the induction of cell cycle entry. Therefore, G-CSF-combined conditioning before allogeneic stem cell transplantation might positively contribute to decreased incidences of relapse and graft failure without having to increase the dose of cytotoxic drugs. We conducted a retrospective nationwide study of 336 adult patients with myelodysplastic syndrome (MDS) and secondary acute myeloid leukemia (sAML) after single-unit cord blood transplantation (CBT) who underwent 4 different kinds of conditioning regimens: total body irradiation (TBI) ≥ 8 Gy + Ara-C/G-CSF + cyclophosphamide (CY) (n = 65), TBI ≥ 8 Gy + Ara-C + CY (n = 119), TBI ≥ 8 Gy + other (n = 104), or TBI < 8 Gy or non-TBI (n = 48). The TBI ≥ 8 Gy + Ara-C/G-CSF + CY regimen showed significantly higher incidence of neutrophil engraftment (hazard ratio, 1.52; 95% confidence interval [CI], 1.10 to 2.08; P = 009) and lower overall mortality (hazard ratio, .46; 95% CI, .26 to .82; P =008) rates compared with those without a G-CSF regimen. This retrospective study shows that the G-CSF-combined conditioning regimen provides better engraftment and survival results in CBT for adults with MDS and sAML.
KW - Conditioning regimen
KW - Cord blood transplantation
KW - Granulocyte colony-stimulating factor
KW - Myelodysplastic syndrome
KW - Secondary acute myeloid leukemia
UR - http://www.scopus.com/inward/record.url?scp=84938975394&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84938975394&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2015.05.009
DO - 10.1016/j.bbmt.2015.05.009
M3 - Article
C2 - 25985920
AN - SCOPUS:84938975394
SN - 1083-8791
VL - 21
SP - 1632
EP - 1640
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 9
ER -