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Graft Source

A phase I/II trial of intrabone marrow cord blood transplantation and comparison of the hematological recovery with the Japanese nationwide database

Bone Marrow Transplantation volume 52, pages 574–579 (2017)Cite this article

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Abstract

Intrabone marrow cord blood transplantation (IB-CBT) was proposed as a promising treatment modality to improve hematological recovery. However, clinical advantages of IB-CBT over conventional IV CBT have been unclear. We conducted a prospective single-center trial of IB-CBT to evaluate its safety and superiority in terms of hematological recovery. Fifteen adults with hematological malignancies were enrolled. A thawed and unwashed single cord blood unit was injected into the bilateral superior-posterior iliac crests under local anesthesia. Engraftments of neutrophils and platelets were achieved in 13 cases, with medians of 17 and 45 days, respectively. For the control, we extracted data from the Japanese nationwide database and compared the hematological recovery of contemporaneously transplanted 1135 CBT cases. Multivariate analysis revealed that IB-CBT enhanced platelet recovery (hazard ratio, 2.13; P=0.007), but neutrophil recovery did not differ significantly (hazard ratio, 1.70; P=0.19). Better donor chimerism was seen in the bone marrow of the ilium than of the sternum on day 14, suggesting that the local hematopoiesis at the injected site was established earlier than that at the remote bone marrow site. Collectively, IB-CBT was well tolerated and may enhance local engraftment, which promotes prompter platelet recovery than does IV-CBT.

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Acknowledgements

This work was supported by a grant from the European Hematology Association-Japanese Society of Hematology Fellowship Exchange Program in 2011, a grant from Tojinkai and a grant from the University of Tsukuba Hospital. We thank Flaminia Miyamasu (Medical English Communications Center, University of Tsukuba) for grammatical review and advice.

Author contributions

NK designed and conducted the study, interpreted the data and wrote the manuscript. MG performed the statistical analysis and provided the tables. YY, TK, NO, MS-Y and YH conducted the study. NU, ST and YK collected the control data. YA, MK and TI assembled and provided the control data. SC directed the study and wrote the manuscript.

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Authors and Affiliations

  1. Department of Hematology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan

    N Kurita, Y Yokoyama, T Kato, N Obara, M Sakata-Yanagimoto, Y Hasegawa & S Chiba

  2. Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan

    M Gosho

  3. Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan

    N Uchida

  4. Division of Molecular Therapy, The Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan

    S Takahashi

  5. Department of Transfusion Medicine, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan

    Y Kouzai

  6. Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan

    Y Atsuta & M Kurata

  7. Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Y Atsuta

  8. Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

    T Ichinohe

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Correspondence to S Chiba.

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Kurita, N., Gosho, M., Yokoyama, Y. et al. A phase I/II trial of intrabone marrow cord blood transplantation and comparison of the hematological recovery with the Japanese nationwide database. Bone Marrow Transplant 52, 574–579 (2017). https://doi.org/10.1038/bmt.2016.319

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