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Cord Blood Stem Cells

Long-term outcome of cord blood transplantation from unrelated donors as an initial transplantation procedure for children with AML in Japan

Bone Marrow Transplantation volume 45, pages 69–77 (2010)Cite this article

Abstract

To assess the outcome of unrelated umbilical cord blood transplantation (UCBT), 141 children with AML who underwent UCBT (39 in first CR (CR1), 33 in CR2, 4 in CR3 and 65 at more advanced stages (not in CR)) were analyzed in a retrospective multicenter study in Japan. Short-term MTX was used for prophylaxis of acute GVHD in 80 cases (57%). The cumulative incidences of neutrophil recovery, platelet recovery and acute GVHD (grades 2–4) were 78.7, 62.4 and 40.1%, respectively, and the 100-day transplantation-related mortality (TRM) was 10.8%. Multivariate analysis showed that an infused CD34+ cell dose of 1.35 × 105 cells per kg or more was associated with favorable neutrophil and platelet recovery, and that short-term MTX was associated with a lower 100-day TRM. The 6-year relapse rate was 38.8% and was associated with disease status. Six-year overall survival was 45.8% (70.4±8.3% in CR1, 59.3±11.3% in CR2, 75.5±21% in CR3 and 20.6±6.2% for children with non-CR). We conclude that the results of UCBT are particularly promising for children with a karyotype suggesting a poor prognosis, and for those who receive transplants in CR2 and CR3 after an early relapse.

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Acknowledgements

This study was supported in part by a research grant on Tissue Engineering (H17-014) and a research grant on Allergic Disease and Immunology (H20-015) from the Japanese Ministry of Health, Labour and Welfare. We thank Vipul N Mankad, MD (the former Senior Vice-President and Chief Medical Officer), Children's Hospital and Research Center Oakland, CA, USA for editorial assistance and critical comments.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Showa University Fujigaoka Hospital, Kanagawa, Japan

    K Isoyama

  2. Kanagawa Cord Blood Bank, Kanagawa, Japan

    K Isoyama

  3. Chugoku-Shikoku Cord Blood Bank, Okayama, Japan

    M Oda

  4. Department of Pediatrics, Okayama University Graduate School of Health Sciences, Okayama, Japan

    M Oda

  5. Division of Hematology/Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Aichi, Japan

    K Kato

  6. Tokai Cord Blood Bank, Aichi, Japan

    K Kato

  7. Department of Cell Processing and Transfusion, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan

    T Nagamura-Inoue

  8. Tokyo Cord Blood Bank, Tokyo, Japan

    T Nagamura-Inoue

  9. Department of Transfusion Medicine, Hyogo College of Medicine, Hyogo, Japan

    S Kai

  10. Hyogo Cord Blood Bank, Hyogo, Japan

    S Kai

  11. Division of Hemato-Oncology/Regulation Medicine, Kanagawa Children's Medical Center, Kanagawa, Japan

    H Kigasawa

  12. Department of Pediatrics, Sapporo Hokuyu Hospital, Hokkaido, Japan

    R Kobayashi

  13. Division of Hematology/Oncology, Shizuoka Children's Medical Center, Shizuoka, Japan

    J Mimaya

  14. Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan

    M Inoue

  15. Division of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan

    A Kikuchi

  16. Department of Cell Transplantation and Regenerative Medicine, Tokai University School of Medicine, Kanagawa, Japan

    S Kato

  17. Tokai University Cord Blood Bank, Kanagawa, Japan

    S Kato

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Appendix

Appendix

Transplant Centers

Transplant centers that performed CBT by the JCBBN coordination and produced follow-up reports are: Division of Hematology/Oncology, Shizuoka Children's Medical Center, Shizuoka; Department of Pediatrics, Dokkyo Medical University, Mibu; Department of Pediatrics, Mie University School of Medicine, Mie; Department of Pediatrics, Kobe City Medical Center General Hospital, Kobe; Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo; Department of Pediatrics, Okayama University Graduate School of Medicine and Dentistry, Okayama; Department of Pediatrics, Ibaraki Children's Hospital, Mito; Department of Pediatrics, Yamagata University School of Medicine, Yamagata; Division of Haemato-Oncology/Regulation Medicine, Kanagawa Children's Medical Center, Yokohama; Division of Pediatric Hematology/Oncology, Nagoya Japanese Red Cross First Hospital, Nagoya; Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka; Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto; Department of Pediatrics, Yokohama City University School of Medicine, Yokohama; Division of Pediatric Oncology, National Cancer Center Hospital, Tokyo; Department of Hematology, Toranomon Hospital, Tokyo; Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo; Department of Pediatric Hematology and Oncology, Tohoku University School of Medicine, Sendai; Department of Pediatrics, Niigata Cancer Center Hospital, Niigata; Department of Pediatrics, Yamaguchi University School of Medicine, Ube; Department of Pediatrics, Shizuoka Red Cross Hospital, Shizuoka; Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu; Department of Pediatrics, Osaka City University Graduate School of Medicine, Osaka; Department of Pediatrics, Nippon Medical School, Tokyo; Department of Pediatrics, Graduate School of Medicine, Fukui University, Fukui; Department of Pediatrics, Keio University School of Medicine, Tokyo; Department of Pediatrics, Osaka University Graduate School of Medicine, Suita; Department of Pediatrics, Tokushima University School of Medicine, Tokushima; Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya; Department of Pediatrics, Shiga University of Medical Science, Otsu; Department of Pediatrics, Kagawa University Faculty of Medicine, Kagawa; Department of Pediatrics, Nihon University School of Medicine, Tokyo; Department of Pediatrics, Tokai University School of Medicine, Hatano; Division of Pediatrics, Iwate Prefectural Kitakami Hospital, Kitakami; Division of Hematology, National Center for Child Medical Health and Development, Tokyo; Division of Hematology/Oncology, Saitama Children's Medical Center, Iwatsuki; Department of Pediatrics, Matsushita Memorial Hospital, Moriguchi; Department of Pediatrics, Hamanomachi Hospital, Fukuoka; Department of Pediatrics, School of Medicine, University of Yamanashi, Yamanashi; Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo; Department of Pediatrics, Saga University, Saga; Department of Pediatrics, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University, Kumamoto; Department of Pediatrics, Hyogo Children Hospital, Hyogo; Department of Pediatrics, Hirosaki University School of Medicine, Hirosaki; Department of Pediatrics, Hyogo Medical University, Hyogo; Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics, Ehime University, Toon; Department of Hematology and Oncology, Chiba Children's Hospital, Chiba; Department of Pediatrics, Iwate Medical University School of Medicine, Morioka; Division of Pediatric Hematology/Oncology, Japanese Red Cross Nagoya Second Hospital, Nagoya; Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe; Department of Pediatrics, Faculty of Medicine, University of the Ryukyus, Nishihara; Division of Hematology and Oncology, Seirei Hamamatsu General Hospital, Hamamatsu; Department of Pediatrics, Kagoshima University Graduate School of Medicine, Kagoshima; Department of Pediatrics, Saitama Medical University, Moroyama; Department of Pediatrics, St Luke's International Hospital, Tokyo; Division of Pediatrics, Osaka City General Hospital, Osaka; Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya; Division of Hematology/Oncology, Nagano Children's Hospital, Azumino; Division of Hematology, Saiseikai Maebashi Hospital, Maebashi.

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Isoyama, K., Oda, M., Kato, K. et al. Long-term outcome of cord blood transplantation from unrelated donors as an initial transplantation procedure for children with AML in Japan. Bone Marrow Transplant 45, 69–77 (2010). https://doi.org/10.1038/bmt.2009.93

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