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Title: Clinical significance of high-dose cytarabine added to cyclophosphamide/total-body irradiation in bone marrow or peripheral blood stem cell transplantation for myeloid malignancy.
Authors: Arai, Yasuyuki  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-9662-5093 (unconfirmed)
Aoki, Kazunari  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0003-2172-2195 (unconfirmed)
Takeda, June
Kondo, Tadakazu  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-8959-6271 (unconfirmed)
Eto, Tetsuya
Ota, Shuichi
Hashimoto, Hisako
Fukuda, Takahiro
Ozawa, Yukiyasu
Kanda, Yoshinobu
Kato, Chiaki
Kurokawa, Mineo
Iwato, Koji
Onizuka, Makoto
Ichinohe, Tatsuo
Atsuta, Yoshiko
Takami, Akiyoshi
Author's alias: 近藤, 忠一
Issue Date: 4-Sep-2015
Publisher: BioMed Central Ltd.
Journal title: Journal of hematology & oncology
Volume: 8
Thesis number: 102
Abstract: [Background]Addition of high-dose cytarabine (HDCA) to the conventional cyclophosphamide/total-body irradiation (CY/TBI) regimen significantly improved prognosis after cord blood transplantation (CBT) for adult acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS). The efficacy of HDCA in bone marrow or peripheral blood stem cell transplantation (BMT/PBSCT), however, has not yet been elucidated. [Findings]We conducted a cohort study to compare the prognosis of HDCA/CY/TBI (N = 435) and CY/TBI (N = 1667) in BMT/PBSCT for AML/MDS using a Japanese transplant registry database. The median age was 38 years, and 86.0 % of the patients had AML. Unrelated donors comprised 54.6 %, and 63.9 % of donors were human leukocyte antigen (HLA)-matched. Overall survival (OS) was not improved in the HDCA/CY/TBI group (adjusted hazard ratio (HR), 1.14; p = 0.13). Neutrophil engraftment was inferior (HR, 0.80; p < 0.01), and the incidence of hemorrhagic cystitis and thrombotic microangiopathy increased in HDCA/CY/TBI (HR, 1.47 and 1.60; p = 0.06 and 0.04, respectively), leading to significantly higher non-relapse mortality (NRM; HR, 1.48; p < 0.01). Post-transplant relapse and tumor-related mortality were not suppressed by the addition of HDCA. [Conclusions]This study indicated the inefficacy of HDCA/CY/TBI in BMT/PBSCT for AML/MDS. Our results should be validated in large-scale prospective studies.
Rights: © 2015 Arai et al.
Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
URI: http://hdl.handle.net/2433/201900
DOI(Published Version): 10.1186/s13045-015-0201-x
PubMed ID: 26337829
Appears in Collections:Journal Articles

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