Intensified conditioning regimens improved disease‐free survival and engraftment after unrelated single‐unit cord blood transplantation but not after matched sibling or matched unrelated donor allogeneic hematopoietic cell transplantation
The impact of conditioning intensity on different donor groups has been unclear in allogeneic transplantation. The objective of this study was to clarify the effect of conditioning intensity on disease‐free survival (DFS), relapse, non‐relapse mortality (NRM), neutrophil engraftment, and graft‐versu...
Gespeichert in:
| Veröffentlicht in: | Hematological oncology 2023-02, Vol.41 (1), p.147-158 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 158 |
|---|---|
| container_issue | 1 |
| container_start_page | 147 |
| container_title | Hematological oncology |
| container_volume | 41 |
| creator | Konuma, Takaaki Kanda, Junya Uchida, Naoyuki Nishijima, Akihiko Tanaka, Masatsugu Ozawa, Yukiyasu Sawa, Masashi Onizuka, Makoto Ota, Shuichi Maruyama, Yumiko Kanda, Yoshinobu Kawakita, Toshiro Ara, Takahide Eto, Tetsuya Nakamae, Hirohisa Kimura, Takafumi Fukuda, Takahiro Atsuta, Yoshiko |
| description | The impact of conditioning intensity on different donor groups has been unclear in allogeneic transplantation. The objective of this study was to clarify the effect of conditioning intensity on disease‐free survival (DFS), relapse, non‐relapse mortality (NRM), neutrophil engraftment, and graft‐versus‐host disease for each donor type. We retrospectively evaluated the effect of conditioning intensity on transplant outcomes for patients with acute leukemia or myelodysplastic syndrome aged between 16 and 60 years in Japan using the transplant conditioning intensity (TCI) scoring system. A total of 8526 patients who received first allogeneic transplantation from 6/6 antigen‐matched sibling donor (MSD, n = 2768), 8/8 allele‐matched unrelated donor (MUD, n = 2357), and unrelated single‐cord blood (UCB, n = 3401) were eligible for the analyses. Compared to conditioning with TCI score 4.0, which was corresponds to conventional myeloablative conditioning, including cyclophosphamide with total body irradiation 12 Gy or busulfan 12.8 mg, and was considered as the reference group in the multivariate analyses, intensified conditioning with TCI score ≥4.5 improved DFS (hazard ratio [HR],0.81, P |
| doi_str_mv | 10.1002/hon.3094 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2727641313</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2771243374</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3494-7c2250ac1aafc941e7a942181b77dff6738da0548a34ac593503ab66b9369b9d3</originalsourceid><addsrcrecordid>eNp1ks1u1DAQgC0EoktB4gmQJS69pPhvk_iIKkorVfQC52gST3ZdOfZiO4t64xF4Rh6BJ8DpDytV4jSy55tvRvYQ8pazU86Y-LAN_lQyrZ6RFWdaV5zV-jlZMdG0FRNSHJFXKd0wVnKsfUmOZC3qdl2rFflz6TP6ZEeLhg7BG5tt8NZvaMSNnUqK2mkXw76kjU0ICX___DVGRJrmuLd7cBS8oeg3EcZcCjItESOdfUQHudSlonNL2extLk2iob0LwdAcwaedA59h6Ur7OVMfHgUT5GF7V967ZaBwuDq4TfDlHpwLG_RoB7rFAoVdsJjLaUDnnrZ5TV6M4BK-eYjH5Nv5p69nF9XV9efLs49X1SCVVlUzCLFmMHCAcdCKYwNaCd7yvmnMONaNbA2wtWpBKhjWWq6ZhL6uey1r3Wsjj8nJvbc83_cZU-4mm5aBwGOYUyca0dSKSy4L-v4JehPm6Mt0hWq4UFI26iAcYkgp4tjtop0g3nacdcsedGUPumUPCvruQTj3E5p_4OPHF6C6B35Yh7f_FXUX11_uhH8BrPPGNw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2771243374</pqid></control><display><type>article</type><title>Intensified conditioning regimens improved disease‐free survival and engraftment after unrelated single‐unit cord blood transplantation but not after matched sibling or matched unrelated donor allogeneic hematopoietic cell transplantation</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Konuma, Takaaki ; Kanda, Junya ; Uchida, Naoyuki ; Nishijima, Akihiko ; Tanaka, Masatsugu ; Ozawa, Yukiyasu ; Sawa, Masashi ; Onizuka, Makoto ; Ota, Shuichi ; Maruyama, Yumiko ; Kanda, Yoshinobu ; Kawakita, Toshiro ; Ara, Takahide ; Eto, Tetsuya ; Nakamae, Hirohisa ; Kimura, Takafumi ; Fukuda, Takahiro ; Atsuta, Yoshiko</creator><creatorcontrib>Konuma, Takaaki ; Kanda, Junya ; Uchida, Naoyuki ; Nishijima, Akihiko ; Tanaka, Masatsugu ; Ozawa, Yukiyasu ; Sawa, Masashi ; Onizuka, Makoto ; Ota, Shuichi ; Maruyama, Yumiko ; Kanda, Yoshinobu ; Kawakita, Toshiro ; Ara, Takahide ; Eto, Tetsuya ; Nakamae, Hirohisa ; Kimura, Takafumi ; Fukuda, Takahiro ; Atsuta, Yoshiko ; Donor/Source Working Group of theJapanese Society for Transplantation and Cellular Therapy ; for the Donor/Source Working Group of theJapanese Society for Transplantation and Cellular Therapy</creatorcontrib><description>The impact of conditioning intensity on different donor groups has been unclear in allogeneic transplantation. The objective of this study was to clarify the effect of conditioning intensity on disease‐free survival (DFS), relapse, non‐relapse mortality (NRM), neutrophil engraftment, and graft‐versus‐host disease for each donor type. We retrospectively evaluated the effect of conditioning intensity on transplant outcomes for patients with acute leukemia or myelodysplastic syndrome aged between 16 and 60 years in Japan using the transplant conditioning intensity (TCI) scoring system. A total of 8526 patients who received first allogeneic transplantation from 6/6 antigen‐matched sibling donor (MSD, n = 2768), 8/8 allele‐matched unrelated donor (MUD, n = 2357), and unrelated single‐cord blood (UCB, n = 3401) were eligible for the analyses. Compared to conditioning with TCI score 4.0, which was corresponds to conventional myeloablative conditioning, including cyclophosphamide with total body irradiation 12 Gy or busulfan 12.8 mg, and was considered as the reference group in the multivariate analyses, intensified conditioning with TCI score ≥4.5 improved DFS (hazard ratio [HR],0.81, P < 0.001) and relapse rate (HR, 0.70, P < 0.001) but only after UCB transplants and not MSD and MUD transplants. In contrast, NRM was higher after intensified conditioning with TCI score ≥4.5 for MSD (HR, 1.39, P = 0.008) and MUD (HR, 1.47, P = 0.002) transplants but not UCB transplants (HR, 1.12, P = 0.240). Neutrophil engraftment was also significantly higher after intensified conditioning with TCI score ≥4.5 but only for UCB transplants (HR, 1.24, P < 0.001), whereas it was significantly lower after reduced‐intensity conditioning with TCI score ≤3.5 for MSD transplants only (HR, 0.82, P < 0.001). These data demonstrated that an intensified conditioning regimen improved survival and engraftment rate only after a UCB transplants. Therefore, TCI scoring system could enable the optimization of conditioning intensity according to donor type, particularly in terms of survival and engraftment.</description><identifier>ISSN: 0278-0232</identifier><identifier>EISSN: 1099-1069</identifier><identifier>DOI: 10.1002/hon.3094</identifier><identifier>PMID: 36268564</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adolescent ; Adult ; allogeneic hematopoietic cell transplantation ; Antigens ; Blood ; Busulfan ; Conditioning ; conditioning regimen ; Cord blood ; Cord Blood Stem Cell Transplantation ; Cyclophosphamide ; Disease-Free Survival ; Graft vs Host Disease - etiology ; Hematopoietic Stem Cell Transplantation ; Humans ; Irradiation ; Leukemia ; Leukemia, Myeloid, Acute ; Leukocytes (neutrophilic) ; matched sibling donor ; matched unrelated donor ; Middle Aged ; Mud ; Myelodysplastic syndrome ; Myelodysplastic syndromes ; Neutrophils ; Optimization ; Radiation ; Retrospective Studies ; Siblings ; Stem cell transplantation ; Survival ; transplant conditioning intensity ; Transplantation ; Transplantation Conditioning ; Transplants ; Transplants & implants ; unrelated cord blood ; Unrelated Donors ; Young Adult</subject><ispartof>Hematological oncology, 2023-02, Vol.41 (1), p.147-158</ispartof><rights>2022 John Wiley & Sons Ltd.</rights><rights>2023 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3494-7c2250ac1aafc941e7a942181b77dff6738da0548a34ac593503ab66b9369b9d3</citedby><cites>FETCH-LOGICAL-c3494-7c2250ac1aafc941e7a942181b77dff6738da0548a34ac593503ab66b9369b9d3</cites><orcidid>0000-0002-4866-9307 ; 0000-0002-1953-8463</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fhon.3094$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fhon.3094$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36268564$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Konuma, Takaaki</creatorcontrib><creatorcontrib>Kanda, Junya</creatorcontrib><creatorcontrib>Uchida, Naoyuki</creatorcontrib><creatorcontrib>Nishijima, Akihiko</creatorcontrib><creatorcontrib>Tanaka, Masatsugu</creatorcontrib><creatorcontrib>Ozawa, Yukiyasu</creatorcontrib><creatorcontrib>Sawa, Masashi</creatorcontrib><creatorcontrib>Onizuka, Makoto</creatorcontrib><creatorcontrib>Ota, Shuichi</creatorcontrib><creatorcontrib>Maruyama, Yumiko</creatorcontrib><creatorcontrib>Kanda, Yoshinobu</creatorcontrib><creatorcontrib>Kawakita, Toshiro</creatorcontrib><creatorcontrib>Ara, Takahide</creatorcontrib><creatorcontrib>Eto, Tetsuya</creatorcontrib><creatorcontrib>Nakamae, Hirohisa</creatorcontrib><creatorcontrib>Kimura, Takafumi</creatorcontrib><creatorcontrib>Fukuda, Takahiro</creatorcontrib><creatorcontrib>Atsuta, Yoshiko</creatorcontrib><creatorcontrib>Donor/Source Working Group of theJapanese Society for Transplantation and Cellular Therapy</creatorcontrib><creatorcontrib>for the Donor/Source Working Group of theJapanese Society for Transplantation and Cellular Therapy</creatorcontrib><title>Intensified conditioning regimens improved disease‐free survival and engraftment after unrelated single‐unit cord blood transplantation but not after matched sibling or matched unrelated donor allogeneic hematopoietic cell transplantation</title><title>Hematological oncology</title><addtitle>Hematol Oncol</addtitle><description>The impact of conditioning intensity on different donor groups has been unclear in allogeneic transplantation. The objective of this study was to clarify the effect of conditioning intensity on disease‐free survival (DFS), relapse, non‐relapse mortality (NRM), neutrophil engraftment, and graft‐versus‐host disease for each donor type. We retrospectively evaluated the effect of conditioning intensity on transplant outcomes for patients with acute leukemia or myelodysplastic syndrome aged between 16 and 60 years in Japan using the transplant conditioning intensity (TCI) scoring system. A total of 8526 patients who received first allogeneic transplantation from 6/6 antigen‐matched sibling donor (MSD, n = 2768), 8/8 allele‐matched unrelated donor (MUD, n = 2357), and unrelated single‐cord blood (UCB, n = 3401) were eligible for the analyses. Compared to conditioning with TCI score 4.0, which was corresponds to conventional myeloablative conditioning, including cyclophosphamide with total body irradiation 12 Gy or busulfan 12.8 mg, and was considered as the reference group in the multivariate analyses, intensified conditioning with TCI score ≥4.5 improved DFS (hazard ratio [HR],0.81, P < 0.001) and relapse rate (HR, 0.70, P < 0.001) but only after UCB transplants and not MSD and MUD transplants. In contrast, NRM was higher after intensified conditioning with TCI score ≥4.5 for MSD (HR, 1.39, P = 0.008) and MUD (HR, 1.47, P = 0.002) transplants but not UCB transplants (HR, 1.12, P = 0.240). Neutrophil engraftment was also significantly higher after intensified conditioning with TCI score ≥4.5 but only for UCB transplants (HR, 1.24, P < 0.001), whereas it was significantly lower after reduced‐intensity conditioning with TCI score ≤3.5 for MSD transplants only (HR, 0.82, P < 0.001). These data demonstrated that an intensified conditioning regimen improved survival and engraftment rate only after a UCB transplants. Therefore, TCI scoring system could enable the optimization of conditioning intensity according to donor type, particularly in terms of survival and engraftment.</description><subject>Adolescent</subject><subject>Adult</subject><subject>allogeneic hematopoietic cell transplantation</subject><subject>Antigens</subject><subject>Blood</subject><subject>Busulfan</subject><subject>Conditioning</subject><subject>conditioning regimen</subject><subject>Cord blood</subject><subject>Cord Blood Stem Cell Transplantation</subject><subject>Cyclophosphamide</subject><subject>Disease-Free Survival</subject><subject>Graft vs Host Disease - etiology</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>Humans</subject><subject>Irradiation</subject><subject>Leukemia</subject><subject>Leukemia, Myeloid, Acute</subject><subject>Leukocytes (neutrophilic)</subject><subject>matched sibling donor</subject><subject>matched unrelated donor</subject><subject>Middle Aged</subject><subject>Mud</subject><subject>Myelodysplastic syndrome</subject><subject>Myelodysplastic syndromes</subject><subject>Neutrophils</subject><subject>Optimization</subject><subject>Radiation</subject><subject>Retrospective Studies</subject><subject>Siblings</subject><subject>Stem cell transplantation</subject><subject>Survival</subject><subject>transplant conditioning intensity</subject><subject>Transplantation</subject><subject>Transplantation Conditioning</subject><subject>Transplants</subject><subject>Transplants & implants</subject><subject>unrelated cord blood</subject><subject>Unrelated Donors</subject><subject>Young Adult</subject><issn>0278-0232</issn><issn>1099-1069</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1ks1u1DAQgC0EoktB4gmQJS69pPhvk_iIKkorVfQC52gST3ZdOfZiO4t64xF4Rh6BJ8DpDytV4jSy55tvRvYQ8pazU86Y-LAN_lQyrZ6RFWdaV5zV-jlZMdG0FRNSHJFXKd0wVnKsfUmOZC3qdl2rFflz6TP6ZEeLhg7BG5tt8NZvaMSNnUqK2mkXw76kjU0ICX___DVGRJrmuLd7cBS8oeg3EcZcCjItESOdfUQHudSlonNL2extLk2iob0LwdAcwaedA59h6Ur7OVMfHgUT5GF7V967ZaBwuDq4TfDlHpwLG_RoB7rFAoVdsJjLaUDnnrZ5TV6M4BK-eYjH5Nv5p69nF9XV9efLs49X1SCVVlUzCLFmMHCAcdCKYwNaCd7yvmnMONaNbA2wtWpBKhjWWq6ZhL6uey1r3Wsjj8nJvbc83_cZU-4mm5aBwGOYUyca0dSKSy4L-v4JehPm6Mt0hWq4UFI26iAcYkgp4tjtop0g3nacdcsedGUPumUPCvruQTj3E5p_4OPHF6C6B35Yh7f_FXUX11_uhH8BrPPGNw</recordid><startdate>202302</startdate><enddate>202302</enddate><creator>Konuma, Takaaki</creator><creator>Kanda, Junya</creator><creator>Uchida, Naoyuki</creator><creator>Nishijima, Akihiko</creator><creator>Tanaka, Masatsugu</creator><creator>Ozawa, Yukiyasu</creator><creator>Sawa, Masashi</creator><creator>Onizuka, Makoto</creator><creator>Ota, Shuichi</creator><creator>Maruyama, Yumiko</creator><creator>Kanda, Yoshinobu</creator><creator>Kawakita, Toshiro</creator><creator>Ara, Takahide</creator><creator>Eto, Tetsuya</creator><creator>Nakamae, Hirohisa</creator><creator>Kimura, Takafumi</creator><creator>Fukuda, Takahiro</creator><creator>Atsuta, Yoshiko</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7QO</scope><scope>7QP</scope><scope>7T7</scope><scope>7TK</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4866-9307</orcidid><orcidid>https://orcid.org/0000-0002-1953-8463</orcidid></search><sort><creationdate>202302</creationdate><title>Intensified conditioning regimens improved disease‐free survival and engraftment after unrelated single‐unit cord blood transplantation but not after matched sibling or matched unrelated donor allogeneic hematopoietic cell transplantation</title><author>Konuma, Takaaki ; Kanda, Junya ; Uchida, Naoyuki ; Nishijima, Akihiko ; Tanaka, Masatsugu ; Ozawa, Yukiyasu ; Sawa, Masashi ; Onizuka, Makoto ; Ota, Shuichi ; Maruyama, Yumiko ; Kanda, Yoshinobu ; Kawakita, Toshiro ; Ara, Takahide ; Eto, Tetsuya ; Nakamae, Hirohisa ; Kimura, Takafumi ; Fukuda, Takahiro ; Atsuta, Yoshiko</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3494-7c2250ac1aafc941e7a942181b77dff6738da0548a34ac593503ab66b9369b9d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>allogeneic hematopoietic cell transplantation</topic><topic>Antigens</topic><topic>Blood</topic><topic>Busulfan</topic><topic>Conditioning</topic><topic>conditioning regimen</topic><topic>Cord blood</topic><topic>Cord Blood Stem Cell Transplantation</topic><topic>Cyclophosphamide</topic><topic>Disease-Free Survival</topic><topic>Graft vs Host Disease - etiology</topic><topic>Hematopoietic Stem Cell Transplantation</topic><topic>Humans</topic><topic>Irradiation</topic><topic>Leukemia</topic><topic>Leukemia, Myeloid, Acute</topic><topic>Leukocytes (neutrophilic)</topic><topic>matched sibling donor</topic><topic>matched unrelated donor</topic><topic>Middle Aged</topic><topic>Mud</topic><topic>Myelodysplastic syndrome</topic><topic>Myelodysplastic syndromes</topic><topic>Neutrophils</topic><topic>Optimization</topic><topic>Radiation</topic><topic>Retrospective Studies</topic><topic>Siblings</topic><topic>Stem cell transplantation</topic><topic>Survival</topic><topic>transplant conditioning intensity</topic><topic>Transplantation</topic><topic>Transplantation Conditioning</topic><topic>Transplants</topic><topic>Transplants & implants</topic><topic>unrelated cord blood</topic><topic>Unrelated Donors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Konuma, Takaaki</creatorcontrib><creatorcontrib>Kanda, Junya</creatorcontrib><creatorcontrib>Uchida, Naoyuki</creatorcontrib><creatorcontrib>Nishijima, Akihiko</creatorcontrib><creatorcontrib>Tanaka, Masatsugu</creatorcontrib><creatorcontrib>Ozawa, Yukiyasu</creatorcontrib><creatorcontrib>Sawa, Masashi</creatorcontrib><creatorcontrib>Onizuka, Makoto</creatorcontrib><creatorcontrib>Ota, Shuichi</creatorcontrib><creatorcontrib>Maruyama, Yumiko</creatorcontrib><creatorcontrib>Kanda, Yoshinobu</creatorcontrib><creatorcontrib>Kawakita, Toshiro</creatorcontrib><creatorcontrib>Ara, Takahide</creatorcontrib><creatorcontrib>Eto, Tetsuya</creatorcontrib><creatorcontrib>Nakamae, Hirohisa</creatorcontrib><creatorcontrib>Kimura, Takafumi</creatorcontrib><creatorcontrib>Fukuda, Takahiro</creatorcontrib><creatorcontrib>Atsuta, Yoshiko</creatorcontrib><creatorcontrib>Donor/Source Working Group of theJapanese Society for Transplantation and Cellular Therapy</creatorcontrib><creatorcontrib>for the Donor/Source Working Group of theJapanese Society for Transplantation and Cellular Therapy</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Hematological oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Konuma, Takaaki</au><au>Kanda, Junya</au><au>Uchida, Naoyuki</au><au>Nishijima, Akihiko</au><au>Tanaka, Masatsugu</au><au>Ozawa, Yukiyasu</au><au>Sawa, Masashi</au><au>Onizuka, Makoto</au><au>Ota, Shuichi</au><au>Maruyama, Yumiko</au><au>Kanda, Yoshinobu</au><au>Kawakita, Toshiro</au><au>Ara, Takahide</au><au>Eto, Tetsuya</au><au>Nakamae, Hirohisa</au><au>Kimura, Takafumi</au><au>Fukuda, Takahiro</au><au>Atsuta, Yoshiko</au><aucorp>Donor/Source Working Group of theJapanese Society for Transplantation and Cellular Therapy</aucorp><aucorp>for the Donor/Source Working Group of theJapanese Society for Transplantation and Cellular Therapy</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intensified conditioning regimens improved disease‐free survival and engraftment after unrelated single‐unit cord blood transplantation but not after matched sibling or matched unrelated donor allogeneic hematopoietic cell transplantation</atitle><jtitle>Hematological oncology</jtitle><addtitle>Hematol Oncol</addtitle><date>2023-02</date><risdate>2023</risdate><volume>41</volume><issue>1</issue><spage>147</spage><epage>158</epage><pages>147-158</pages><issn>0278-0232</issn><eissn>1099-1069</eissn><abstract>The impact of conditioning intensity on different donor groups has been unclear in allogeneic transplantation. The objective of this study was to clarify the effect of conditioning intensity on disease‐free survival (DFS), relapse, non‐relapse mortality (NRM), neutrophil engraftment, and graft‐versus‐host disease for each donor type. We retrospectively evaluated the effect of conditioning intensity on transplant outcomes for patients with acute leukemia or myelodysplastic syndrome aged between 16 and 60 years in Japan using the transplant conditioning intensity (TCI) scoring system. A total of 8526 patients who received first allogeneic transplantation from 6/6 antigen‐matched sibling donor (MSD, n = 2768), 8/8 allele‐matched unrelated donor (MUD, n = 2357), and unrelated single‐cord blood (UCB, n = 3401) were eligible for the analyses. Compared to conditioning with TCI score 4.0, which was corresponds to conventional myeloablative conditioning, including cyclophosphamide with total body irradiation 12 Gy or busulfan 12.8 mg, and was considered as the reference group in the multivariate analyses, intensified conditioning with TCI score ≥4.5 improved DFS (hazard ratio [HR],0.81, P < 0.001) and relapse rate (HR, 0.70, P < 0.001) but only after UCB transplants and not MSD and MUD transplants. In contrast, NRM was higher after intensified conditioning with TCI score ≥4.5 for MSD (HR, 1.39, P = 0.008) and MUD (HR, 1.47, P = 0.002) transplants but not UCB transplants (HR, 1.12, P = 0.240). Neutrophil engraftment was also significantly higher after intensified conditioning with TCI score ≥4.5 but only for UCB transplants (HR, 1.24, P < 0.001), whereas it was significantly lower after reduced‐intensity conditioning with TCI score ≤3.5 for MSD transplants only (HR, 0.82, P < 0.001). These data demonstrated that an intensified conditioning regimen improved survival and engraftment rate only after a UCB transplants. Therefore, TCI scoring system could enable the optimization of conditioning intensity according to donor type, particularly in terms of survival and engraftment.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>36268564</pmid><doi>10.1002/hon.3094</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-4866-9307</orcidid><orcidid>https://orcid.org/0000-0002-1953-8463</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0278-0232 |
| ispartof | Hematological oncology, 2023-02, Vol.41 (1), p.147-158 |
| issn | 0278-0232 1099-1069 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2727641313 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adolescent Adult allogeneic hematopoietic cell transplantation Antigens Blood Busulfan Conditioning conditioning regimen Cord blood Cord Blood Stem Cell Transplantation Cyclophosphamide Disease-Free Survival Graft vs Host Disease - etiology Hematopoietic Stem Cell Transplantation Humans Irradiation Leukemia Leukemia, Myeloid, Acute Leukocytes (neutrophilic) matched sibling donor matched unrelated donor Middle Aged Mud Myelodysplastic syndrome Myelodysplastic syndromes Neutrophils Optimization Radiation Retrospective Studies Siblings Stem cell transplantation Survival transplant conditioning intensity Transplantation Transplantation Conditioning Transplants Transplants & implants unrelated cord blood Unrelated Donors Young Adult |
| title | Intensified conditioning regimens improved disease‐free survival and engraftment after unrelated single‐unit cord blood transplantation but not after matched sibling or matched unrelated donor allogeneic hematopoietic cell transplantation |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-03T07%3A08%3A36IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Intensified%20conditioning%20regimens%20improved%20disease%E2%80%90free%20survival%20and%20engraftment%20after%20unrelated%20single%E2%80%90unit%20cord%20blood%20transplantation%20but%20not%20after%20matched%20sibling%20or%20matched%20unrelated%20donor%20allogeneic%20hematopoietic%20cell%20transplantation&rft.jtitle=Hematological%20oncology&rft.au=Konuma,%20Takaaki&rft.aucorp=Donor/Source%20Working%20Group%20of%20theJapanese%20Society%20for%20Transplantation%20and%20Cellular%20Therapy&rft.date=2023-02&rft.volume=41&rft.issue=1&rft.spage=147&rft.epage=158&rft.pages=147-158&rft.issn=0278-0232&rft.eissn=1099-1069&rft_id=info:doi/10.1002/hon.3094&rft_dat=%3Cproquest_cross%3E2771243374%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2771243374&rft_id=info:pmid/36268564&rfr_iscdi=true |