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- Title
Feasibility of reduced-intensity conditioning followed by unrelated cord blood transplantation for primary hemophagocytic lymphohistiocytosis: a nationwide retrospective analysis in Japan.
- Authors
Sawada, Akihisa; Ohga, Shouichi; Ishii, Eiichi; Inoue, Masami; Okada, Keiko; Inagaki, Jiro; Goto, Hiroaki; Suzuki, Nobuhiro; Koike, Kazutoshi; Atsuta, Yoshiko; Suzuki, Ritsuro; Yabe, Hiromasa; Kawa, Keisei; Kato, Koji; Yasutomo, Koji
- Abstract
A nationwide retrospective analysis was performed on patients who received allogeneic hematopoietic stem cell transplantation for primary or familial hemophagocytic lymphohistiocytosis (HLH) in Japan. The present analysis investigated whether reduced-intensity conditioning (RIC) followed by cord blood transplantation (CBT) (RIC-CBT) is feasible, compared to the outcomes of myeloablative conditioning and bone marrow transplantation. Based on the JSHCT data, 53 patients were analyzed. The overall survival rate (OS) was 65.4 ± 6.6 %. RIC-CBT (n = 13) was not inferior to other methods. Patients with a performance status of PS 4 (ECOG scale) with HLH-associated severe organ dysfunction during the initiation of conditioning had extremely poor outcomes. The OS rate in the RIC-CBT patients, excluding those with a performance status 4, was 80.0 ± 12.6 %. RIC may reduce treatment-related mortality; in addition, patients with engraftment failure, which is the main adverse event following RIC-CBT, were successfully rescued with secondary CBT. Unrelated cord blood may represent an alternative source if a patient has no related donor. As a RIC regimen for CBT, 140 mg/m(2) melphalan with fludarabine and anti-lymphocyte globulin or anti-thymocyte globulin may be feasible, but further dosage optimization should be performed in controlled clinical trials.
- Publication
International journal of hematology, 2013, Vol 98, Issue 2, p223
- ISSN
1865-3774
- Publication type
Journal Article
- DOI
10.1007/s12185-013-1391-z