期刊
BONE MARROW TRANSPLANTATION
卷 52, 期 9, 页码 1261-1267出版社
NATURE PUBLISHING GROUP
DOI: 10.1038/bmt.2017.116
关键词
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资金
- Japan Society for the Promotion of Science (JSPS) [15K09497]
- Grants-in-Aid for Scientific Research [17K08911, 15K09497] Funding Source: KAKEN
To investigate better GVHD prophylaxis in reduced intensity conditioning umbilical cord blood transplantation (RIC-UCBT), we compared transplant outcomes after UCBT among GvHD prophylaxes using the registry data. We selected patients transplanted for AML or ALL with a calcineurin inhibitor and methotrexate (MTX)/mycophenolate mofetil (MMF) combination. A total of 748 first RIC-UCBT between 2000 and 2012 (MTX+ group, 446, MMF+ group, 302) were included. The cumulative incidence of neutrophil and platelet counts higher than 50 000/mu L was significantly better in the MMF+ group (relative risk (RR), 1.55; P < 0.001: RR, 1.34; P = 0.003, respectively). In multivariate analyses, the risk of grade II-IV and III-IV acute GvHD was significantly higher in the MMF+ group than in the MTX+ group (RR, 1.75; P < 0.001: RR, 1.97; P = 0.004, respectively). In disease-specific analyses of AML, the risk of relapse of high-risk disease was significantly lower in the MMF+ group (RR, 0.69; P = 0.009), whereas no significant difference was observed in the risk of relapse-free and overall survival in high-risk disease. In patients with standard-risk disease, no significant differences were noted in the risk of relapse or survival between the MTX+ and MMF+ groups. Collectively, these results suggest that MMF-containing prophylaxis may be preferable in RIC-UCBT, particularly for high-risk disease.
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