Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Allografting

Unrelated donor bone marrow transplantation for 100 pediatric patients: a single institute's experience

Summary:

In all, 100 unrelated donor bone marrow transplantations (UD-BMT) were performed in our institute between October 1993 and January 2003. Of 93 evaluable patients, 73 patients had hematological malignancy, 13 had nonmalignancy and seven had lymphoproliferative disease. The estimated 9-year event-free survival (EFS) rate was 57.1±5.5% in all patients. In the following analyses of the patients with hematological malignancy, the standard group had significantly better EFS than the high-risk group (61.5±7.0 vs 35.6±9.7%, P=0.02), and the EFS rate of the tacrolimus (FK-506)+methotrexate (MTX)±methylprednisolone prophylactic group for graft-versus-host disease was superior to that of the FK-506 without MTX group (75.7±8.0 vs 55.8±7.6%, P=0.02). When we compared the EFS rates of the FK506+MTX±methylprednisolone (mPSL) group and the HLA-matched related donor BMT group in our institute, these were almost similar (75.7±8.1 vs 68.4±9.3%). Therefore, UD-BMT using FK-506+MTX±mPSL is a safe and useful method for children with hematological malignancy who require allogeneic BMT.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Sasazuki T, Juji T, Morishima Y et al. Effect of matching of class I HLA alleles on clinical outcome after transplantation of hematopoietic stem cells from an unrelated donor. N Eng J Med 1998; 339: 1177–1185.

    Article  CAS  Google Scholar 

  2. Kino T, Hatanaka H, Miyata S et al. FK-506, a novel immunosuppressant isolated from a streptomyces. II. Immunosuppressive effect of FK506 in vitro. J Antibiot 1987; 40: 1256–1265.

    CAS  Google Scholar 

  3. Hamazaki T, Yagi K, Inoue M et al. Prophylaxis with FK-506 for graft-versus-host disease after transplantation of bone marrow from unrelated donors. Jpn J Clin Hematol 2000; 41: 430–436.

    CAS  Google Scholar 

  4. Balduzzi A, Gooley T, Anasetti C et al. Unrelated donor marrow transplantation in children. Blood 1995; 86: 3247–3256.

    CAS  PubMed  Google Scholar 

  5. Dini G, Cancedda R, Giolgiani G et al. Unrelated donor marrow transplantation in children: a report from the Associazione Itariana Ematologia e Oncologia Pediatrica (AIEOP) and the Gruppo Italiano per il Traplanto Midollo Osseo (GITMO). Hematologica 2002; 87: 51–57.

    Google Scholar 

  6. Bunin N, Carston M, Wall D et al. Unrelated marrow transplantation for children with acute lymphoblastic leukemia in second remission. Blood 2002; 99: 3151–3157.

    Article  CAS  PubMed  Google Scholar 

  7. Kojima S, Matsuyama T, Kato S et al. Outcome of 154 patients with severe aplastic anemia who received transplants from unrelated donors: the Japan Marrow Donor Program. Blood 2002; 100: 799–803.

    Article  CAS  PubMed  Google Scholar 

  8. Morishima Y, Sasazuki T, Inoko H et al. The clinical significance of human leukocyte antigen (HLA) allele compatibility in patients receiving a marrow transplant from serologically HLA-A, HLA-B, and HLA-DR matched unrelated donors. Blood 2002; 99: 4200–4206.

    Article  CAS  PubMed  Google Scholar 

  9. Masaoka T, Shibata H, Kakishita A et al. Phase II study of FK 506 for allogeneic bone marrow transplantation. Transplant Proc 1991; 23: 3228–3231.

    CAS  PubMed  Google Scholar 

  10. Ratanatharathorm V, Nash RA, Przepiorka D et al. Phase III study comparing methotrexate and tacrolimus (Prograf, FK506) with methotrexate and cyclosporine for graft-versus-host disease prophylaxis after HLA-identical sibling bone marrow transplantation. Blood 1998; 92: 2303–2314.

    Google Scholar 

  11. Przepiorka WM, Ippoliti D, Warkentin D et al. Toxicities of tacrolimus and cyclosporine A after allogeneic blood stem cell transplantation. Bone Marrow Transplant 1997; 20: 1095–1098.

    Article  PubMed  Google Scholar 

  12. Sarkodee-Adoo C, Sctirescu D, Senenbrenner L et al. Thrombotic microangiopathy in blood and marrow transplant patients receiving tacrolimus or cyclosporine A. Transplantation 2003; 43: 78–84.

    CAS  Google Scholar 

  13. Oliverlo PJ, Restrepo L, Mitchell SA et al. Reversible tacrolimus-induced neurotoxicity isolated to the brain stem. Am J Neuroradiol 2000; 21: 1251–1254.

    Google Scholar 

  14. Przepiorka D, Ippoliti C, Khouri I et al. Tacrolimus and minidose methotrexate for prevention of acute graft-versus-host disease after matched unrelated donor marrow transplantation. Blood 1996; 88: 4383–4389.

    CAS  PubMed  Google Scholar 

  15. Antin JH, Kim HT, Cutler C et al. Sirolimus, tacrolimus, and low-dose methotrexate for graft-versus-host disease prophylaxis in mismatched related donor or unrelated donor transplantation. Blood 2003; 102: 1601–1605.

    Article  CAS  PubMed  Google Scholar 

  16. Slavin S, Nagler A, Naparstek E et al. Nonmyeloablative stem cell transplantation and cell therapy as an alternative to conventional bone marrow transplantation with lethal cytoreduction for the treatment of malignant and nonmalignant diseases. Blood 1998; 91: 756–763.

    CAS  PubMed  Google Scholar 

  17. Toro GD, Satwani P, Harrison L et al. A pilot study of reduced intensity conditioning and allogeneic stem cell transplantation from unrelated cord blood and matched family donors in children and adolescent recipients. Bone Marrow Transplant 2004; 33: 613–622.

    Article  PubMed  Google Scholar 

  18. Jacobsohn DA, Duerst R, Tse W, Kletzel M . Reduced intensity hemopoietic stem-cell transplantation for treatment of non-malignant disease in children. Lancet 2004; 364: 156–162.

    Article  PubMed  Google Scholar 

  19. Hongeng S, Krance RA, Bowman LC et al. Outcomes of transplantation with matched-sibling and unrelated-donor bone marrow in children with leukemia. Lancet 1997; 350: 767–771.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to K Yumura-Yagi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yumura-Yagi, K., Inoue, M., Sakata, N. et al. Unrelated donor bone marrow transplantation for 100 pediatric patients: a single institute's experience. Bone Marrow Transplant 36, 307–313 (2005). https://doi.org/10.1038/sj.bmt.1705056

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1705056

Keywords

Search

Quick links