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Unit selection for umbilical cord blood transplantation for adults with acute myeloid leukemia in complete remission: a Japanese experience

Bone Marrow Transplantation volume 54, pages 1789–1798 (2019)Cite this article

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Abstract

To investigate optimal unit selection for umbilical cord blood transplantation (UCBT), we conducted a registry-based study of 1355 adults with acute myeloid leukemia in first or second complete remission who underwent single-unit UCBT. To be eligible for analysis, UCB units had to contain a total nucleated cell (TNC) dose of 2.0 × 107/kg or higher and present at least a 4/6-match for HLA-A, -B, and -DR antigens in line with clinical practice in Japan, both of which are less stringent criteria than those used in Western countries. Neither TNC dose nor the degree of HLA matching affected survival (P = 0.138 and P = 0.696, respectively). As for HLA-A, -B antigens and -DRB1 allele, better HLA matching was associated with lower non-relapse mortality (P = 0.011) but higher relapse (P = 0.046), resulting in no improvement in survival (P = 0.680). Taking the allele level for each HLA-A, -B, and -DRB1 into consideration was less useful for predicting non-relapse mortality (P = 0.198). These findings suggest that the less stringent criteria for UCB unit selection are acceptable for Japanese patient population and perhaps even more beneficial in terms of providing a better chance to find a suitable UCB unit.

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Acknowledgements

This work was supported in part by a grant provided by the Practical Research Project for Allergic Diseases and Immunology (Research Technology of Medical Transplantation) from the Japan Agency for Medical Research and Development (AMED) under the grant number 18ek0510023h0002.

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Authors and Affiliations

  1. Aichi Cancer Center, Nagoya, Japan

    Masamitsu Yanada

  2. The Institute of Medical Science, The University of Tokyo, Tokyo, Japan

    Takaaki Konuma & Satoshi Takahashi

  3. Nagoya University Hospital, Nagoya, Japan

    Yachiyo Kuwatsuka

  4. Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Tadakazu Kondo, Takahito Kawata & Junya Kanda

  5. Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan

    Takahito Kawata

  6. Toranomon Hospital, Tokyo, Japan

    Naoyuki Uchida

  7. Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan

    Shigesaburo Miyakoshi

  8. Kanagawa Cancer Center, Yokohama, Japan

    Masatsugu Tanaka

  9. Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Yukiyasu Ozawa

  10. Anjo Kosei Hospital, Anjo, Japan

    Masashi Sawa

  11. Graduate School of Medicine, Osaka City University, Osaka, Japan

    Hirohisa Nakamae

  12. Japanese Red Cross Narita Hospital, Narita, Japan

    Nobuyuki Aotsuka

  13. Japanese Red Cross Society, Tokyo, Japan

    Minoko Takanashi

  14. Jichi Medical University, Shimotsuke, Japan

    Yoshinobu Kanda

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

    Yoshiko Atsuta

  16. Nagoya University Graduate School of Medicine, Nagoya, Japan

    Yoshiko Atsuta

  17. The Jikei University School of Medicine, Tokyo, Japan

    Shingo Yano

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  1. Masamitsu Yanada
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Correspondence to Masamitsu Yanada.

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Yanada, M., Konuma, T., Kuwatsuka, Y. et al. Unit selection for umbilical cord blood transplantation for adults with acute myeloid leukemia in complete remission: a Japanese experience. Bone Marrow Transplant 54, 1789–1798 (2019). https://doi.org/10.1038/s41409-019-0539-8

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