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Reduced-intensity unrelated donor bone marrow transplantation for hematologic malignancies

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Abstract

To review a current experience of unrelated bone marrow transplantation (BMT) with reduced-intensity conditioning (RIC) regimens, we conducted a nationwide survey with 77 patients (age, 25–68 years). The backbone RIC regimen was a combination of fludarabine or cladribine, busulfan or melphalan and total body irradiation at 2–4 Gy. Five patients died early, but 71 (92%) achieved initial neutrophil recovery. Thereafter, 36 patients (47%) died of therapy-related complications, 23 (30%) of whom died within day 100. Grades II–IV acute graft-versus-host disease (GVHD) occurred in 34 of the 68 evaluable patients (50%). In a multivariate analysis, a regimen containing antithymocyte globulin (ATG) was significantly associated with a decreased risk of acute GVHD (P = 0.041). Thirty-three patients are currently alive with a median follow-up of 439 days (28–2002 days), with an OS of 50% at 1 year. In conclusion, unrelated BMT with RIC regimens can be a curative treatment in a subset of patients.

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Acknowledgments

We would like to thank Michihiro Hidaka, Katsuji Shinagawa, Tomomi Toubai, Yuichiro Nawa, Koichiro Yuji, Akinobu Takami, Nobuharu Fujii, Yoshinobu Takemoto, and Yoshihiro Yamasaki for their aid in collecting data and responding to the queries. This work was supported by grants from the Ministry of Health, Labor and Welfare, Japan (T.T., Y.T.)

Author information

Authors and Affiliations

  1. Hematology and Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan

    Sung-Won Kim, Takahiro Fukuda & Yoichi Takaue

  2. Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan

    Keitaro Matsuo

  3. Department of Hematology, Ehime Prefectural Central Hospital, Matsuyama, Japan

    Masamichi Hara

  4. Division of Hematology/Oncology, Kameda Medical Center, Kamogawa, Japan

    Kosei Matsue

  5. Department of Hematology, Toranomon Hospital, Tokyo, Japan

    Shuichi Taniguchi & Atsushi Wake

  6. Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan

    Tetsuya Eto

  7. Department of Hematology and Oncology, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan

    Mitsune Tanimoto

  8. Department of Internal Medicine, Rinku General Medical Center, Izumisano, Japan

    Kazuo Hatanaka

  9. Department of Hematology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan

    Shinji Nakao

  10. Division of Hematology/Oncology, Iwate Medical University School of Medicine, Morioka, Japan

    Yoji Ishida

  11. Department of Medicine and Biosystemic Science, Kyushu University, Fukuoka, Japan

    Mine Harada

  12. Department of Internal Medicine, Imamura Bun-in Hospital, Kagoshima, Japan

    Atae Utsunomiya

  13. Department of Hematology and Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Masahiro Imamura

  14. Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan

    Yoshinobu Kanda

  15. Department of Internal Medicine, National Hospital Organization Okayama Medical Center, Okayama, Japan

    Kazutaka Sunami

  16. Department of Internal Medicine, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan

    Fumio Kawano

  17. Center for Cellular and Molecular Medicine, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Takanori Teshima

Authors
  1. Sung-Won Kim
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  2. Keitaro Matsuo
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  3. Takahiro Fukuda
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  4. Masamichi Hara
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  5. Kosei Matsue
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  7. Tetsuya Eto
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  8. Mitsune Tanimoto
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  9. Atsushi Wake
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  10. Kazuo Hatanaka
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  11. Shinji Nakao
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  12. Yoji Ishida
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  13. Mine Harada
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  14. Atae Utsunomiya
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  15. Masahiro Imamura
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  16. Yoshinobu Kanda
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  17. Kazutaka Sunami
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  18. Fumio Kawano
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  19. Yoichi Takaue
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  20. Takanori Teshima
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Corresponding author

Correspondence to Takanori Teshima.

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Kim, SW., Matsuo, K., Fukuda, T. et al. Reduced-intensity unrelated donor bone marrow transplantation for hematologic malignancies. Int J Hematol 88, 324–330 (2008). https://doi.org/10.1007/s12185-008-0163-7

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  • DOI: https://doi.org/10.1007/s12185-008-0163-7

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