Unrelated bone marrow transplantation or immediate umbilical cord blood transplantation for patients with acute myeloid leukemia in first complete remission

被引：14

作者：

Yanada, Masamitsu ^{[1
]}

Kanda, Junya ^{[2
]}

Ohtake, Shigeki ^{[3
]}

Fukuda, Takahiro ^{[4
]}

Sakamaki, Hisashi ^{[5
]}

Miyamura, Koichi ^{[6
]}

Miyawaki, Shuichi ^{[7
,8
]}

Uchida, Naoyuki ^{[9
]}

Maeda, Tomoya ^{[10
]}

Nagamura-Inoue, Tokiko ^{[11
]}

Asou, Norio ^{[10
,12
]}

Morishima, Yasuo ^{[13
]}

Atsuta, Yoshiko ^{[14
,15
]}

Miyazaki, Yasushi ^{[16
]}

Kimura, Fumihiko ^{[17
]}

Kobayashi, Yukio ^{[4
]}

Takami, Akiyoshi ^{[18
]}

Naoe, Tomoki ^{[15
,19
]}

Kanda, Yoshinobu ^{[2
]}

机构：

[1] Fujita Hlth Univ, Sch Med, Toyoake, Aichi, Japan

[2] Jichi Med Univ, Saitama Med Ctr, Saitama, Japan

[3] Kanazawa Univ, Grad Sch Med Sci, Kanazawa, Ishikawa, Japan

[4] Natl Canc Ctr, Tokyo, Japan

[5] Komagome Hosp, Tokyo Metropolitan Canc & Infect Dis Ctr, Tokyo, Japan

[6] Japanese Red Cross Nagoya First Hosp, Nagoya, Aichi, Japan

[7] Tokyo Metropolitan Otsuka Hosp, Tokyo, Japan

[8] Saiseikai Maebashi Hosp, Maebashi, Gunma, Japan

[9] Toranomon Gen Hosp, Tokyo, Japan

[10] Saitama Med Univ, Saitama Int Med Ctr, Hidaka, Japan

[11] Univ Tokyo, Inst Med Sci, Tokyo, Japan

[12] Kumamoto Univ, Sch Med, Kumamoto, Japan

[13] Aichi Canc Ctr Res Inst, Nagoya, Aichi, Japan

[14] Japanese Data Ctr Hematopoiet Cell Transplantat, Nagoya, Aichi, Japan

[15] Nagoya Univ, Grad Sch Med, Nagoya, Aichi, Japan

[16] Nagasaki Univ, Atom Bomb Dis Inst, Nagasaki, Japan

[17] Natl Def Med Coll, Tokorozawa, Saitama, Japan

[18] Aichi Med Univ, Nagakute, Aichi, Japan

[19] Natl Hosp Org Nagoya Med Ctr, Nagoya, Aichi, Japan

来源：

EUROPEAN JOURNAL OF HAEMATOLOGY | 2016年 / 97卷 / 03期

关键词：

acute myeloid leukemia; unrelated bone marrow transplantation; umbilical cord blood transplantation; first complete remission; decision analysis; STEM-CELL TRANSPLANTATION; MATCHED SIBLING DONOR; MYELODYSPLASTIC SYNDROMES; COMPARABLE SURVIVAL; ADULT PATIENTS; RISK; OUTCOMES; JAPAN; RECOMMENDATIONS; INTERMEDIATE;

D O I：

10.1111/ejh.12723

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BackgroundWhile unrelated bone marrow transplantation (UBMT) has been widely used as alternative donor transplantation, the use of umbilical cord blood transplantation (UCBT) is increasing recently. MethodsWe conducted a decision analysis to address which transplantation procedure should be prioritized for younger patients with acute myeloid leukemia (AML) harboring high- or intermediate-risk cytogenetics in first complete remission (CR1), when they lack a matched related donor but have immediate access to a suitable umbilical cord blood unit. Main sources for our analysis comprised the data from three phase III trials for a chemotherapy cohort (n = 907) and the registry data for a transplantation cohort (n = 752). ResultsThe baseline analysis showed that when the 8/8 match was considered for UBMT, the expected 5-year survival rate was higher for UBMT than for UCBT (58.1% vs. 51.8%). This ranking did not change even when the 7/8 match was considered for UBMT. Sensitivity analysis showed consistent superiority of UBMT over UCBT when the time elapsed between CR1 and UBMT was varied within a plausible range of 3-9 months. ConclusionsThese results suggest that 8/8 or 7/8 UBMT is a better transplantation option than UCBT even after allowing time required for donor coordination.

引用

页码：278 / 287

页数：10

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