A phase I/II trial of intrabone marrow cord blood transplantation and comparison of the hematological recovery with the Japanese nationwide database

被引：12

作者：

Kurita, N. ^{[1
]}

Gosho, M. ^{[2
]}

Yokoyama, Y. ^{[1
]}

Kato, T. ^{[1
]}

Obara, N. ^{[1
]}

Sakata-Yanagimoto, M. ^{[1
]}

Hasegawa, Y. ^{[1
]}

Uchida, N. ^{[3
]}

Takahashi, S. ^{[4
]}

Kouzai, Y. ^{[5
]}

Atsuta, Y. ^{[6
,7
]}

Kurata, M. ^{[6
]}

Ichinohe, T. ^{[8
]}

Chiba, S. ^{[1
]}

机构：

[1] Univ Tsukuba, Dept Hematol, Fac Med, Tennodai 1-1-1, Tsukuba, Ibaraki 3058575, Japan

[2] Univ Tsukuba, Dept Clin Trial & Clin Epidemiol, Fac Med, Tsukuba, Ibaraki, Japan

[3] Federat Natl Publ Serv Personnel Mutual Aid Assoc, Dept Hematol, Tokyo, Japan

[4] Univ Tokyo, Inst Med Sci, Div Mol Therapy, Adv Clin Res Ctr, Tokyo, Japan

[5] Tokyo Metropolitan Tama Med Ctr, Dept Transfus Med, Tokyo, Japan

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

[7] Nagoya Univ, Dept Healthcare Adm, Grad Sch Med, Nagoya, Aichi, Japan

[8] Hiroshima Univ, Res Inst Radiat Biol & Med, Dept Hematol & Oncol, Hiroshima, Japan

来源：

BONE MARROW TRANSPLANTATION | 2017年 / 52卷 / 04期

关键词：

STEM-CELL TRANSPLANTATION; TREATMENT-RELATED MORTALITY; HUMAN HEMATOPOIETIC-CELLS; BONE-MARROW; UNRELATED DONORS; INTRAVENOUS-INJECTION; SEEDING EFFICIENCY; PLATELET RECOVERY; ACUTE-LEUKEMIA; GRAFT FAILURE;

D O I：

10.1038/bmt.2016.319

中图分类号：

Q6 [生物物理学];

学科分类号：

071011 ;

摘要：

Intrabone marrow cord blood transplantation (IB-CBT) was proposed as a promising treatment modality to improve hematological recovery. However, clinical advantages of IB-CBT over conventional IV CBT have been unclear. We conducted a prospective single-center trial of IB-CBT to evaluate its safety and superiority in terms of hematological recovery. Fifteen adults with hematological malignancies were enrolled. A thawed and unwashed single cord blood unit was injected into the bilateral superior-posterior iliac crests under local anesthesia. Engraftments of neutrophils and platelets were achieved in 13 cases, with medians of 17 and 45 days, respectively. For the control, we extracted data from the Japanese nationwide database and compared the hematological recovery of contemporaneously transplanted 1135 CBT cases. Multivariate analysis revealed that IB-CBT enhanced platelet recovery (hazard ratio, 2.13; P = 0.007), but neutrophil recovery did not differ significantly (hazard ratio, 1.70; P = 0.19). Better donor chimerism was seen in the bone marrow of the ilium than of the sternum on day 14, suggesting that the local hematopolesis at the injected site was established earlier than that at the remote bone marrow site. Collectively, IB-CBT was well tolerated and may enhance local engraftment, which promotes prompter platelet recovery than does IV-CBT.

引用

页码：574 / 579

页数：6

共 41 条

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