Decision Analysis for Unrelated Bone Marrow Transplantation or Immediate Cord Blood Transplantation for Patients with Philadelphia Chromosome-Negative Acute Lymphoblastic Leukemia in First Remission

被引：0

作者：

Kako, Shinichi ^{[1
]}

Hayakawa, Fumihiko ^{[2
]}

Miyamura, Koichi ^{[3
]}

Tanaka, Junji ^{[4
]}

Imai, Kiyotoshi ^{[5
]}

Kanda, Junya ^{[6
]}

Morishima, Satoko ^{[7
]}

Uchida, Naoyuki ^{[8
]}

Doki, Noriko ^{[9
]}

Ikegame, Kazuhiro ^{[10
]}

Ozawa, Yukiyasu ^{[3
]}

Takada, Satoru ^{[11
]}

Usui, Noriko ^{[12
]}

Ohtake, Shigeki ^{[13
]}

Kiyoi, Hitoshi ^{[14
]}

Matsumura, Itaru ^{[15
]}

Miyazaki, Yasushi ^{[16
]}

Ichinohe, Tatsuo ^{[17
]}

Fukuda, Takahiro ^{[18
]}

Atsuta, Yoshiko ^{[19
,20
]}

Kanda, Yoshinobu ^{[1
]}

机构：

[1] Jichi Med Univ, Div Hematol, Saitama Med Ctr, Saitama, Japan

[2] Nagoya Univ, Dept Cellular & Genet Sci, Grad Sch Med, Nagoya, Aichi, Japan

[3] Japanese Red Cross Nagoya First Hosp, Dept Hematol, Nagoya, Aichi, Japan

[4] Tokyo Womens Med Univ, Dept Hematol, Tokyo, Japan

[5] Otaru Gen Hosp, Dept Hematol, Otaru, Hokkaido, Japan

[6] Kyoto Univ, Grad Sch Med, Dept Hematol & Oncol, Kyoto, Japan

[7] Univ Ryukyus, Grad Sch Med, Div Endocrinol Diabet & Metab Hematol Rheumatol, Nishihara, Okinawa, Japan

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

[9] Komagome Hosp, Tokyo Metropolitan Canc & Infect Dis Ctr, Hematol Div, Tokyo, Japan

[10] Hyogo Coll Med Hosp, Dept Hematol, Nishinomiya, Hyogo, Japan

[11] Saiseikai Maebashi Hosp, Leukemia Res Ctr, Maebashi, Gumma, Japan

[12] Jikei Univ, Dept Internal Med, Div Clin Oncol & Hematol, Sch Med, Tokyo, Japan

[13] Kanazawa Univ, Kanazawa, Ishikawa, Japan

[14] Nagoya Univ, Dept Hematol & Oncol, Grad Sch Med, Nagoya, Aichi, Japan

[15] Kindai Univ, Dept Hematol Rheumatol, Fac Med, Osaka, Japan

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

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

[18] Natl Canc Ctr, Dept Hematopoiet Stem Cell Transplantat, Tokyo, Japan

[19] Nagoya Univ, Dept Healthcare Adm, Nagoya, Aichi, Japan

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

来源：

TRANSPLANTATION AND CELLULAR THERAPY | 2022年 / 28卷 / 03期

关键词：

Key Decision analysis; Acute lymphoblastic leukemia; Unrelated bone marrow; transplantation; Cord blood transplantation; HEMATOPOIETIC-CELL TRANSPLANTATION; VERSUS-HOST-DISEASE; HEMATOLOGIC MALIGNANCIES; IMPROVES SURVIVAL; ADULT PATIENTS; TRUMP DATA; DONOR; PART; CHEMOTHERAPY; METHOTREXATE;

D O I：

10.1016/j.jtct.2021.11.021

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

An HLA-matched relative is the first-choice donor for patients with Philadelphia chromosome (Ph)-negative acute lymphoblastic leukemia (ALL) in first complete remission (CR1). The most promising alternative donor is thought to be an HLA-matched unrelated donor (MUD) in patients who do not have an HLA-matched related donor. Cord blood transplantation (CBT) is an alternative option. Higher rates of engraftment failure and nonrelapse mortality (NRM) are significant problems, but the ready availability of cord blood can be an advantage, because patients can immediately undergo transplantation before progression. This study was conducted to identify an appropriate alternative donor in patients with Ph-negative ALL in CR1 who do not have an HLA-matched related donor (MRD). Decision analyses using a Markov model were performed to compare immediate CBT, in which CBT was performed at 1 month after the achievement of CR1, with elective unrelated bone marrow transplantation (uBMT) from an 8/8 MUD (8/8 uBMT) or uBMT from a 7/8 MUD (7/8 uBMT), in which uBMT was performed at 4 months, in patients age 16 to 55 years with Ph-negative ALL in CR1 who did not have an MRD. We constructed a decision tree. The cycle length was set at 3 months, and analyses were performed for 19 cycles for uBMT and 20 cycles for CBT, resulting in evaluation of the 5-year life expectancy after both decisions. Transition probabilities (TPs) and

引用

页码：161.e1 / 161.e10

页数：10

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