A novel reduced-intensity umbilical cord blood transplantation using a recombinant G-CSF combined with high-dose Ara-C for active myeloid malignancies
A novel reduced-intensity umbilical cord blood transplantation using a recombinant G-CSF combined with high-dose Ara-C for active myeloid malignancies
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使用重组 G-CSF 联合高剂量 Ara-C 治疗活动性骨髓恶性肿瘤的新型低强度脐带血移植
DOI：
10.1038/bmt.2014.66
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发表时间：
2014
影响因子：
4.8
通讯作者：
Ohyashiki K
中科院分区：
文献类型：
--
作者：
Gotoh M;Yoshizawa S;Katagiri S;Suguro T;Asano M;Kitahara T;Akahane D;Okabe S;Gotoh A;Tauchi T;Ito Y;Ohyashiki K
未缓解的血液系统髓系恶性肿瘤患者预后较差。为了克服这一问题，我们在一项I/II期研究中探讨了低强度预适应脐血移植(RICBT)联合重组G-CSF(rg-CSF)和大剂量阿糖胞苷、氟达拉滨、马法兰和4GyTBI在非缓解性髓系恶性血液病患者中的应用。纳入13例患者，其中12例为非缓解期AML，1例为急变型CML(CML-BC)。患者的中位年龄为45岁，中位合并症指数为4。所有患者中有4/6的患者接受了4/6的无血缘关系的脐带血。所有患者在RICBT后30天内(中位数20天，范围14-29天)植入，在没有事先造血的情况下获得完全缓解。常见的III级非血液毒性包括8例一过性粘膜炎(62%)和6例发热性中性粒细胞减少(46%)。与移植相关的死亡率为7.7%。未接受RICBT治疗的患者1年总生存率为28.6%，接受RICBT治疗的患者1年总生存率为83.3%。这些数据表明，在活动期AML和CML-BC中，rg-CSF与大剂量Ara-C、氟达拉滨/马法兰/4GyTBI和低强度预适应方案相结合，耐受性好，植入安全，具有显著的抗白血病活性。此外，进行RICBT后治疗可能提供高质量的长期生存和缓解。
Non-remitting patients with hematologic myeloid malignancies have poor prognosis. To overcome this problem, we investigated the use of reduced-intensity preconditioning umbilical cord blood transplantation (RICBT) combined with recombinant G-CSF (rG-CSF) with high-dose Ara-C, fludarabine, melphalan, and 4 Gy of TBI in a phase I/II study in patients with non-remitting myeloid hematologic malignancies. Thirteen patients were enrolled, including 12 with non-remitting AML and one patient with blastic crisis CML (CML-BC). The patients’ median age was 45 years, with a median comorbidity index of 4. All patients received 4/6 serological HLA-antigen matched unrelated umbilical cord blood. All patients were engrafted within 30 days after RICBT (median, 20 days; range, 14–29) and achieved complete remission without prior hematopoiesis. Common grade III non-hematologic toxicities included eight cases of transient mucositis (62%) and six cases of febrile neutropenia (46%). Transplant-related mortality was 7.7%. The 1-year overall survival was 28.6% in cases without post-RICBT treatment and 83.3% in cases with post-RICBT treatment. These data suggest that in active AML and CML-BC, the combination of rG-CSF with high-dose Ara-C and fludarabine/melphalan/4 Gy TBI with a reduced-intensity preconditioning regimen is well tolerated, secures engraftment and has significant anti-leukemia activity. In addition, performing post-RICBT treatment may provide high-quality long-term survival and remission.
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影响因子：
6.2
作者：
Kishi, Y;Kami, M;Taniguchi, S
通讯作者：
Taniguchi, S
影响因子：
20.3
作者：
Carpenter, Paul A.;Snyder, David S.;Radich, Jerald P.
通讯作者：
Radich, Jerald P.
使用粒细胞集落刺激因子联合高剂量阿糖胞苷、氟达拉滨和 TBI 组成的预处理方案治疗 AML 的脐带血移植。
DOI：
--
发表时间：
2006
期刊：
Eur J Haematol (In press)
影响因子：
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作者：
A.Tomonari;A.Tojo;et al.
通讯作者：
et al.
影响因子：
20.3
作者：
Takahashi, Satoshi;Ooi, Jun;Asano, Shigetaka
通讯作者：
Asano, Shigetaka
影响因子：
20.3
作者：
Brunstein, Claudio G.;Barker, Juliet N.;Wagner, John E.
通讯作者：
Wagner, John E.