Peripheral Blood as a Preferable Source of Stem Cells for Salvage Transplantation in Patients with Graft Failure after Cord Blood Transplantation: A Retrospective Analysis of the Registry Data of the Japanese Society for Hematopoietic Cell Transplantation

To compare the different stem cell sources used in salvage transplantation for graft failure (GF) after cord blood transplantation (CBT), we retrospectively analyzed data of 220 patients who developed GF after undergoing CBT between January 2001 and December 2007 and underwent a second hematopoietic...

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Veröffentlicht in:Biology of blood and marrow transplantation 2012-09, Vol.18 (9), p.1407-1414
Hauptverfasser: Fuji, Shigeo, Nakamura, Fumiaki, Hatanaka, Kazuo, Taniguchi, Shuichi, Sato, Maho, Mori, Shin-ichiro, Sakamaki, Hisashi, Yabe, Hiromasa, Miyamoto, Toshihiro, Kanamori, Heiwa, Ueda, Yasunori, Kawa, Keisei, Kato, Koji, Suzuki, Ritsuro, Atsuta, Yoshiko, Tamaki, Toshiharu, Kanda, Yoshinobu
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container_end_page 1414
container_issue 9
container_start_page 1407
container_title Biology of blood and marrow transplantation
container_volume 18
creator Fuji, Shigeo
Nakamura, Fumiaki
Hatanaka, Kazuo
Taniguchi, Shuichi
Sato, Maho
Mori, Shin-ichiro
Sakamaki, Hisashi
Yabe, Hiromasa
Miyamoto, Toshihiro
Kanamori, Heiwa
Ueda, Yasunori
Kawa, Keisei
Kato, Koji
Suzuki, Ritsuro
Atsuta, Yoshiko
Tamaki, Toshiharu
Kanda, Yoshinobu
description To compare the different stem cell sources used in salvage transplantation for graft failure (GF) after cord blood transplantation (CBT), we retrospectively analyzed data of 220 patients who developed GF after undergoing CBT between January 2001 and December 2007 and underwent a second hematopoietic stem cell transplantation (HSCT) within 3 months. The donor sources for salvage HSCT were cord blood (n = 180), peripheral blood stem cells (PBSCs; n = 24), and bone marrow (BM; n = 16). The cumulative incidence of neutrophil engraftment on day 30 after the second HSCT was 39% with CB, 71% with PBSCs, and 75% with BM. Multivariate analysis revealed that PBSC and BM grafts were associated with a significantly higher engraftment rate than CB (hazard ratio [HR], 7.77; P < .001 and HR, 2.81; P = .016, respectively). Although the incidence of grade II-IV acute graft-versus-host disease was significantly higher in the PBSC group than in the CB group (HR, 2.83; P  = .011), the incidence of 1-year nonrelapse mortality was lower in the PBSC group than in the CB group (HR, 0.43; P = .019), and 1-year overall survival was superior in the PBSC group compared with the CB group (HR, 0.45; P = .036). Our results suggest that PBSC is the preferable source of stem cells in salvage HSCT for GF after CBT.
doi_str_mv 10.1016/j.bbmt.2012.02.014
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The donor sources for salvage HSCT were cord blood (n = 180), peripheral blood stem cells (PBSCs; n = 24), and bone marrow (BM; n = 16). The cumulative incidence of neutrophil engraftment on day 30 after the second HSCT was 39% with CB, 71% with PBSCs, and 75% with BM. Multivariate analysis revealed that PBSC and BM grafts were associated with a significantly higher engraftment rate than CB (hazard ratio [HR], 7.77; P &lt; .001 and HR, 2.81; P = .016, respectively). Although the incidence of grade II-IV acute graft-versus-host disease was significantly higher in the PBSC group than in the CB group (HR, 2.83; P  = .011), the incidence of 1-year nonrelapse mortality was lower in the PBSC group than in the CB group (HR, 0.43; P = .019), and 1-year overall survival was superior in the PBSC group compared with the CB group (HR, 0.45; P = .036). 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The donor sources for salvage HSCT were cord blood (n = 180), peripheral blood stem cells (PBSCs; n = 24), and bone marrow (BM; n = 16). The cumulative incidence of neutrophil engraftment on day 30 after the second HSCT was 39% with CB, 71% with PBSCs, and 75% with BM. Multivariate analysis revealed that PBSC and BM grafts were associated with a significantly higher engraftment rate than CB (hazard ratio [HR], 7.77; P &lt; .001 and HR, 2.81; P = .016, respectively). Although the incidence of grade II-IV acute graft-versus-host disease was significantly higher in the PBSC group than in the CB group (HR, 2.83; P  = .011), the incidence of 1-year nonrelapse mortality was lower in the PBSC group than in the CB group (HR, 0.43; P = .019), and 1-year overall survival was superior in the PBSC group compared with the CB group (HR, 0.45; P = .036). Our results suggest that PBSC is the preferable source of stem cells in salvage HSCT for GF after CBT.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>22430086</pmid><doi>10.1016/j.bbmt.2012.02.014</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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subjects Acute Disease
Adolescent
Adult
Bone Marrow Transplantation
Cord Blood Stem Cell Transplantation
Engraftment
Female
Graft Rejection - immunology
Graft Rejection - prevention & control
Graft vs Host Disease - immunology
Graft vs Host Disease - mortality
Graft vs Host Disease - therapy
Hematology, Oncology and Palliative Medicine
Humans
Japan
Leukemia - immunology
Leukemia - mortality
Leukemia - therapy
Lymphoma - immunology
Lymphoma - mortality
Lymphoma - therapy
Male
Multivariate Analysis
Neutrophils - immunology
Peripheral Blood Stem Cell Transplantation
Peripheral blood stem cells
Recurrence
Registries
Retrospective Studies
Second transplant
Societies, Medical
Survival Analysis
Transplantation Conditioning
title Peripheral Blood as a Preferable Source of Stem Cells for Salvage Transplantation in Patients with Graft Failure after Cord Blood Transplantation: A Retrospective Analysis of the Registry Data of the Japanese Society for Hematopoietic Cell Transplantation
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