Intrabone Transplantation of a Single Cord Blood Unit Using Non-Irradiated Reduced-Intensity Conditioning
Introduction: Cord blood transplantation (CBT) is a treatment option for patients with hematological disorder. Recent development of reduced-intensity conditioning (RIC) allows elderly patients and those with comorbidities to benefit from CBT. However, RIC-CBT has not been optimized in part due to g...
Saved in:
Published in | Blood Vol. 128; no. 22; p. 3390 |
---|---|
Main Authors | , , , , , , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Elsevier Inc
02.12.2016
|
Online Access | Get full text |
Cover
Loading…
Abstract | Introduction: Cord blood transplantation (CBT) is a treatment option for patients with hematological disorder. Recent development of reduced-intensity conditioning (RIC) allows elderly patients and those with comorbidities to benefit from CBT. However, RIC-CBT has not been optimized in part due to graft failure or delayed engraftment. Intrabone infusion of cord blood cells has the potential to ensure engraftment and shorten the time of hematological recovery (Lancet Oncol 2008;9:831-9). The aim of this phase II study was to examine the efficacy and safety of intrabone transplantation of a single cord blood unit using non-irradiated RIC.
Patients and Methods: Patients were eligible for the study if they had hematological malignancy, needed CBT, were ≥55 years or 16 to 54 years with hematopoietic stem cell transplantation-specific comorbidity index ≥1, and had an available cord blood unit with serological HLA-A, B, and DR ≥4/6 match and with cryopreserved total nucleated cells (TNCs) at least 2×107/kg. Cord blood units were thawed, washed with a saline solution plus dextran and human albumin, resuspended in approximately 10 ml of the solution, and aliquoted in two to four syringes. After local anesthesia, standard bone marrow aspiration needles were inserted into iliac bone. Approximately 5 ml of cord blood cell suspension was gently infused. This procedure was repeated for all the remaining aliquots across the iliac crest. All patients received tacrolimus and short-term methotrexate as graft-versus-host disease (GVHD) prophylaxis and granulocyte colony-stimulating factor after transplantation. The primary endpoint was the probability of survival with neutrophil engraftment on day 60 after transplantation. This study was approved by the ethical committee of each institute.
Results: Of the 22 enrolled patients, one was not assessable because the patient did not receive intrabone CBT due to the worsening of general condition after the enrollment. The age of 21 evaluable patients ranged 38 to 66 years (median, 57 years). The diagnosis included leukemia (n = 14), lymphoma (n = 6), and myelodysplastic syndromes (n = 1). All patients received fludarabine 150 to 180 mg/m2 and cyclophosphamide 60 to 120 mg/kg with the exception of a patient who received fludarabine 125 mg/m2 and melphalan 140 mg/m2. The number of cryopreserved TNCs ranged 2.0 to 4.9×107/kg (median, 2.7×107/kg), and the number of cryopreserved CD34 positive cells ranged 0.44 to 3.14×105/kg (median, 0.92×105/kg). Mild swelling of skin at the injection site was observed in one patient, however it resolved spontaneously. No other complications occurred during or after the intrabone infusion of cells. The cumulative incidences of neutrophil (≥0.5×109/L), reticulocyte (≥1%), platelet (≥20×109/L) recoveries were 76.2%, 71.4%, and 76.2%, respectively. For those who achieved hematopoietic recovery, the median time to neutrophil, reticulocyte, and platelet recoveries were 17 days, 28 days, and 32 days, respectively. One patient died of veno-occlusive disease on day 42 with achievement of neutrophil recovery. Accordingly, the probability of survival with neutrophil engraftment on day 60 after transplantation (primary endpoint) was 71.4% (95%CI, 51.8 to 88.3%). Of evaluable 16 patients, seven (43.8%) and three (18.8%) developed grade II-IV and III-IV acute GVHD, respectively. No patients developed chronic GVHD. There was a significant difference in the incidence of neutrophil recovery between patients receiving ≤2.7×107/kg TNCs (n = 11) and those receiving >2.7×107/kg TNCs (n = 10) (55% vs. 100%, P = 0.035). Meanwhile, there was a significant difference in the time to neutrophil recovery between patients receiving ≤0.92×105/kg CD34 positive cells (n = 11) and those receiving >0.92×105/kg CD34 positive cells (n = 10) (median, 18 days vs. 16 days; range, 16 to 25 days vs. 14 to 19 days; P= 0.014). Overall survival at 1 year after transplantation was 52.4% (95%CI, 29.7 to 70.9%).
Conclusion: The present data suggest that intrabone transplantation of a single cord blood unit using non-irradiated RIC provides an opportunity for patients who are unable to be exposed to irradiation at the time of pre-transplant conditioning for several reasons, including preservation of fertility, and exposure to the upper limit of irradiation before transplantation, to receive RIC-CBT. Further studies in a larger series of patients are required.
Maeda:Mundipharma KK: Research Funding. Onishi:SymBio Pharmaceuticals: Research Funding. Matsushita:KaketsuKen: Honoraria, Research Funding; Bayer: Honoraria, Membership on an entity’s Board of Directors or advisory committees, Research Funding; Biogen: Honoraria, Membership on an entity’s Board of Directors or advisory committees, Research Funding; Novo Nordisk: Honoraria, Membership on an entity’s Board of Directors or advisory committees, Research Funding; Baxalta: Honoraria, Membership on an entity’s Board of Directors or advisory committees, Research Funding; CSL Behring: Honoraria, Research Funding; Chugai: Honoraria, Research Funding; JB: Honoraria, Research Funding; Octapharma: Honoraria, Membership on an entity’s Board of Directors or advisory committees. Kiyoi:Yakult Honsha Co.,Ltd.: Research Funding; AlexionpharmaLLC.: Research Funding; Sumitomo Dainippon Pharma Co., Ltd.: Research Funding; Novartis Pharma K.K.: Research Funding; Phizer Japan Inc.: Research Funding; JCR Pharmaceutlcals Co.,Ltd.: Research Funding; Mochida Pharmaceutical Co., Ltd.: Research Funding; Fujifilm Corporation: Patents & Royalties, Research Funding; Nippon Boehringer Ingelheim Co., Ltd.: Research Funding; Toyama Chemikal Co.,Ltd.: Research Funding; Alexion Pharmaceuticals: Research Funding; Zenyaku Kogyo Co.LTD.: Research Funding; Takeda Pharmaceutical Co., Ltd.: Research Funding; Celgene Corporation: Consultancy; Chugai Pharmaceutical Co. LTD.: Research Funding; Kyowa-Hakko Kirin Co.LTD.: Research Funding; Nippon Shinyaku Co., Ltd.: Research Funding; Astellas Pharma Inc.: Consultancy, Research Funding; Eisai Co., Ltd.: Research Funding; MSD K.K.: Research Funding. Naoe:TOYAMA CHEMICAL CO.,LTD.: Research Funding; Otsuka Pharmaceutical Co.,Ltd.: Honoraria, Research Funding; Amgen Astellas BioPharma K.K.: Honoraria; Pfizer Inc.: Research Funding; Kyowa-Hakko Kirin Co.,Ltd.: Honoraria, Patents & Royalties, Research Funding; Sumitomo Dainippon Pharma Co.,Ltd.: Honoraria, Research Funding; Bristol-Myers Squibb: Honoraria; Celgene K.K.: Honoraria, Research Funding; Chugai Pharmaceutical Co.,LTD.: Honoraria, Patents & Royalties; CMIC Co., Ltd.: Research Funding; Nippon Boehringer Ingelheim Co., Ltd.: Honoraria, Research Funding; Fujifilm Corporation: Honoraria, Patents & Royalties, Research Funding; Astellas Pharma Inc.: Research Funding. |
---|---|
AbstractList | Introduction: Cord blood transplantation (CBT) is a treatment option for patients with hematological disorder. Recent development of reduced-intensity conditioning (RIC) allows elderly patients and those with comorbidities to benefit from CBT. However, RIC-CBT has not been optimized in part due to graft failure or delayed engraftment. Intrabone infusion of cord blood cells has the potential to ensure engraftment and shorten the time of hematological recovery (Lancet Oncol 2008;9:831-9). The aim of this phase II study was to examine the efficacy and safety of intrabone transplantation of a single cord blood unit using non-irradiated RIC.
Patients and Methods: Patients were eligible for the study if they had hematological malignancy, needed CBT, were ≥55 years or 16 to 54 years with hematopoietic stem cell transplantation-specific comorbidity index ≥1, and had an available cord blood unit with serological HLA-A, B, and DR ≥4/6 match and with cryopreserved total nucleated cells (TNCs) at least 2×107/kg. Cord blood units were thawed, washed with a saline solution plus dextran and human albumin, resuspended in approximately 10 ml of the solution, and aliquoted in two to four syringes. After local anesthesia, standard bone marrow aspiration needles were inserted into iliac bone. Approximately 5 ml of cord blood cell suspension was gently infused. This procedure was repeated for all the remaining aliquots across the iliac crest. All patients received tacrolimus and short-term methotrexate as graft-versus-host disease (GVHD) prophylaxis and granulocyte colony-stimulating factor after transplantation. The primary endpoint was the probability of survival with neutrophil engraftment on day 60 after transplantation. This study was approved by the ethical committee of each institute.
Results: Of the 22 enrolled patients, one was not assessable because the patient did not receive intrabone CBT due to the worsening of general condition after the enrollment. The age of 21 evaluable patients ranged 38 to 66 years (median, 57 years). The diagnosis included leukemia (n = 14), lymphoma (n = 6), and myelodysplastic syndromes (n = 1). All patients received fludarabine 150 to 180 mg/m2 and cyclophosphamide 60 to 120 mg/kg with the exception of a patient who received fludarabine 125 mg/m2 and melphalan 140 mg/m2. The number of cryopreserved TNCs ranged 2.0 to 4.9×107/kg (median, 2.7×107/kg), and the number of cryopreserved CD34 positive cells ranged 0.44 to 3.14×105/kg (median, 0.92×105/kg). Mild swelling of skin at the injection site was observed in one patient, however it resolved spontaneously. No other complications occurred during or after the intrabone infusion of cells. The cumulative incidences of neutrophil (≥0.5×109/L), reticulocyte (≥1%), platelet (≥20×109/L) recoveries were 76.2%, 71.4%, and 76.2%, respectively. For those who achieved hematopoietic recovery, the median time to neutrophil, reticulocyte, and platelet recoveries were 17 days, 28 days, and 32 days, respectively. One patient died of veno-occlusive disease on day 42 with achievement of neutrophil recovery. Accordingly, the probability of survival with neutrophil engraftment on day 60 after transplantation (primary endpoint) was 71.4% (95%CI, 51.8 to 88.3%). Of evaluable 16 patients, seven (43.8%) and three (18.8%) developed grade II-IV and III-IV acute GVHD, respectively. No patients developed chronic GVHD. There was a significant difference in the incidence of neutrophil recovery between patients receiving ≤2.7×107/kg TNCs (n = 11) and those receiving >2.7×107/kg TNCs (n = 10) (55% vs. 100%, P = 0.035). Meanwhile, there was a significant difference in the time to neutrophil recovery between patients receiving ≤0.92×105/kg CD34 positive cells (n = 11) and those receiving >0.92×105/kg CD34 positive cells (n = 10) (median, 18 days vs. 16 days; range, 16 to 25 days vs. 14 to 19 days; P= 0.014). Overall survival at 1 year after transplantation was 52.4% (95%CI, 29.7 to 70.9%).
Conclusion: The present data suggest that intrabone transplantation of a single cord blood unit using non-irradiated RIC provides an opportunity for patients who are unable to be exposed to irradiation at the time of pre-transplant conditioning for several reasons, including preservation of fertility, and exposure to the upper limit of irradiation before transplantation, to receive RIC-CBT. Further studies in a larger series of patients are required.
Maeda:Mundipharma KK: Research Funding. Onishi:SymBio Pharmaceuticals: Research Funding. Matsushita:KaketsuKen: Honoraria, Research Funding; Bayer: Honoraria, Membership on an entity’s Board of Directors or advisory committees, Research Funding; Biogen: Honoraria, Membership on an entity’s Board of Directors or advisory committees, Research Funding; Novo Nordisk: Honoraria, Membership on an entity’s Board of Directors or advisory committees, Research Funding; Baxalta: Honoraria, Membership on an entity’s Board of Directors or advisory committees, Research Funding; CSL Behring: Honoraria, Research Funding; Chugai: Honoraria, Research Funding; JB: Honoraria, Research Funding; Octapharma: Honoraria, Membership on an entity’s Board of Directors or advisory committees. Kiyoi:Yakult Honsha Co.,Ltd.: Research Funding; AlexionpharmaLLC.: Research Funding; Sumitomo Dainippon Pharma Co., Ltd.: Research Funding; Novartis Pharma K.K.: Research Funding; Phizer Japan Inc.: Research Funding; JCR Pharmaceutlcals Co.,Ltd.: Research Funding; Mochida Pharmaceutical Co., Ltd.: Research Funding; Fujifilm Corporation: Patents & Royalties, Research Funding; Nippon Boehringer Ingelheim Co., Ltd.: Research Funding; Toyama Chemikal Co.,Ltd.: Research Funding; Alexion Pharmaceuticals: Research Funding; Zenyaku Kogyo Co.LTD.: Research Funding; Takeda Pharmaceutical Co., Ltd.: Research Funding; Celgene Corporation: Consultancy; Chugai Pharmaceutical Co. LTD.: Research Funding; Kyowa-Hakko Kirin Co.LTD.: Research Funding; Nippon Shinyaku Co., Ltd.: Research Funding; Astellas Pharma Inc.: Consultancy, Research Funding; Eisai Co., Ltd.: Research Funding; MSD K.K.: Research Funding. Naoe:TOYAMA CHEMICAL CO.,LTD.: Research Funding; Otsuka Pharmaceutical Co.,Ltd.: Honoraria, Research Funding; Amgen Astellas BioPharma K.K.: Honoraria; Pfizer Inc.: Research Funding; Kyowa-Hakko Kirin Co.,Ltd.: Honoraria, Patents & Royalties, Research Funding; Sumitomo Dainippon Pharma Co.,Ltd.: Honoraria, Research Funding; Bristol-Myers Squibb: Honoraria; Celgene K.K.: Honoraria, Research Funding; Chugai Pharmaceutical Co.,LTD.: Honoraria, Patents & Royalties; CMIC Co., Ltd.: Research Funding; Nippon Boehringer Ingelheim Co., Ltd.: Honoraria, Research Funding; Fujifilm Corporation: Honoraria, Patents & Royalties, Research Funding; Astellas Pharma Inc.: Research Funding. Abstract Introduction: Cord blood transplantation (CBT) is a treatment option for patients with hematological disorder. Recent development of reduced-intensity conditioning (RIC) allows elderly patients and those with comorbidities to benefit from CBT. However, RIC-CBT has not been optimized in part due to graft failure or delayed engraftment. Intrabone infusion of cord blood cells has the potential to ensure engraftment and shorten the time of hematological recovery (Lancet Oncol 2008;9:831-9). The aim of this phase II study was to examine the efficacy and safety of intrabone transplantation of a single cord blood unit using non-irradiated RIC. Patients and Methods: Patients were eligible for the study if they had hematological malignancy, needed CBT, were ≥55 years or 16 to 54 years with hematopoietic stem cell transplantation-specific comorbidity index ≥1, and had an available cord blood unit with serological HLA-A, B, and DR ≥4/6 match and with cryopreserved total nucleated cells (TNCs) at least 2×107/kg. Cord blood units were thawed, washed with a saline solution plus dextran and human albumin, resuspended in approximately 10 ml of the solution, and aliquoted in two to four syringes. After local anesthesia, standard bone marrow aspiration needles were inserted into iliac bone. Approximately 5 ml of cord blood cell suspension was gently infused. This procedure was repeated for all the remaining aliquots across the iliac crest. All patients received tacrolimus and short-term methotrexate as graft-versus-host disease (GVHD) prophylaxis and granulocyte colony-stimulating factor after transplantation. The primary endpoint was the probability of survival with neutrophil engraftment on day 60 after transplantation. This study was approved by the ethical committee of each institute. Results: Of the 22 enrolled patients, one was not assessable because the patient did not receive intrabone CBT due to the worsening of general condition after the enrollment. The age of 21 evaluable patients ranged 38 to 66 years (median, 57 years). The diagnosis included leukemia (n = 14), lymphoma (n = 6), and myelodysplastic syndromes (n = 1). All patients received fludarabine 150 to 180 mg/m2 and cyclophosphamide 60 to 120 mg/kg with the exception of a patient who received fludarabine 125 mg/m2 and melphalan 140 mg/m2. The number of cryopreserved TNCs ranged 2.0 to 4.9×107/kg (median, 2.7×107/kg), and the number of cryopreserved CD34 positive cells ranged 0.44 to 3.14×105/kg (median, 0.92×105/kg). Mild swelling of skin at the injection site was observed in one patient, however it resolved spontaneously. No other complications occurred during or after the intrabone infusion of cells. The cumulative incidences of neutrophil (≥0.5×109/L), reticulocyte (≥1%), platelet (≥20×109/L) recoveries were 76.2%, 71.4%, and 76.2%, respectively. For those who achieved hematopoietic recovery, the median time to neutrophil, reticulocyte, and platelet recoveries were 17 days, 28 days, and 32 days, respectively. One patient died of veno-occlusive disease on day 42 with achievement of neutrophil recovery. Accordingly, the probability of survival with neutrophil engraftment on day 60 after transplantation (primary endpoint) was 71.4% (95%CI, 51.8 to 88.3%). Of evaluable 16 patients, seven (43.8%) and three (18.8%) developed grade II-IV and III-IV acute GVHD, respectively. No patients developed chronic GVHD. There was a significant difference in the incidence of neutrophil recovery between patients receiving ≤2.7×107/kg TNCs (n = 11) and those receiving >2.7×107/kg TNCs (n = 10) (55% vs. 100%, P = 0.035). Meanwhile, there was a significant difference in the time to neutrophil recovery between patients receiving ≤0.92×105/kg CD34 positive cells (n = 11) and those receiving >0.92×105/kg CD34 positive cells (n = 10) (median, 18 days vs. 16 days; range, 16 to 25 days vs. 14 to 19 days; P= 0.014). Overall survival at 1 year after transplantation was 52.4% (95%CI, 29.7 to 70.9%). Conclusion: The present data suggest that intrabone transplantation of a single cord blood unit using non-irradiated RIC provides an opportunity for patients who are unable to be exposed to irradiation at the time of pre-transplant conditioning for several reasons, including preservation of fertility, and exposure to the upper limit of irradiation before transplantation, to receive RIC-CBT. Further studies in a larger series of patients are required. Disclosures Maeda: Mundipharma KK: Research Funding. Onishi:SymBio Pharmaceuticals: Research Funding. Matsushita:KaketsuKen: Honoraria, Research Funding; Bayer: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Biogen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Novo Nordisk: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Baxalta: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; CSL Behring: Honoraria, Research Funding; Chugai: Honoraria, Research Funding; JB: Honoraria, Research Funding; Octapharma: Honoraria, Membership on an entity's Board of Directors or advisory committees. Kiyoi:Yakult Honsha Co.,Ltd.: Research Funding; AlexionpharmaLLC.: Research Funding; Sumitomo Dainippon Pharma Co., Ltd.: Research Funding; Novartis Pharma K.K.: Research Funding; Phizer Japan Inc.: Research Funding; JCR Pharmaceutlcals Co.,Ltd.: Research Funding; Mochida Pharmaceutical Co., Ltd.: Research Funding; Fujifilm Corporation: Patents & Royalties, Research Funding; Nippon Boehringer Ingelheim Co., Ltd.: Research Funding; Toyama Chemikal Co.,Ltd.: Research Funding; Alexion Pharmaceuticals: Research Funding; Zenyaku Kogyo Co.LTD.: Research Funding; Takeda Pharmaceutical Co., Ltd.: Research Funding; Celgene Corporation: Consultancy; Chugai Pharmaceutical Co. LTD.: Research Funding; Kyowa-Hakko Kirin Co.LTD.: Research Funding; Nippon Shinyaku Co., Ltd.: Research Funding; Astellas Pharma Inc.: Consultancy, Research Funding; Eisai Co., Ltd.: Research Funding; MSD K.K.: Research Funding. Naoe:TOYAMA CHEMICAL CO.,LTD.: Research Funding; Otsuka Pharmaceutical Co.,Ltd.: Honoraria, Research Funding; Amgen Astellas BioPharma K.K.: Honoraria; Pfizer Inc.: Research Funding; Kyowa-Hakko Kirin Co.,Ltd.: Honoraria, Patents & Royalties, Research Funding; Sumitomo Dainippon Pharma Co.,Ltd.: Honoraria, Research Funding; Bristol-Myers Squibb: Honoraria; Celgene K.K.: Honoraria, Research Funding; Chugai Pharmaceutical Co.,LTD.: Honoraria, Patents & Royalties; CMIC Co., Ltd.: Research Funding; Nippon Boehringer Ingelheim Co., Ltd.: Honoraria, Research Funding; Fujifilm Corporation: Honoraria, Patents & Royalties, Research Funding; Astellas Pharma Inc.: Research Funding. |
Author | Ishikawa, Yuichi Tanimoto, Mitsune Kobayashi, Hironori Endo, Tomoyuki Masuko, Masayoshi Goto, Tatsunori Suzuki, Ritsuro Fukuhara, Noriko Kiyoi, Hitoshi Kodera, Yoshihisa Shibasaki, Yasuhiko Iriyama, Chisako Inamoto, Yoshihiro Ushijima, Yoko Murata, Makoto Matsushita, Tadashi Onishi, Yasushi Terakura, Seitaro Naoe, Tomoki Nishida, Tetsuya Maeda, Yoshinobu Fujii, Nobuharu |
Author_xml | – sequence: 1 givenname: Makoto surname: Murata fullname: Murata, Makoto organization: Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan – sequence: 2 givenname: Yoshinobu surname: Maeda fullname: Maeda, Yoshinobu organization: Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan – sequence: 3 givenname: Masayoshi surname: Masuko fullname: Masuko, Masayoshi organization: Department of Stem Cell Transplantation, Niigata University Hospital, Niigata, Japan – sequence: 4 givenname: Yasushi surname: Onishi fullname: Onishi, Yasushi organization: Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan – sequence: 5 givenname: Tomoyuki surname: Endo fullname: Endo, Tomoyuki organization: Department of Hematology, Hokkaido University Graduate School of Medicine, Sapporo, Japan – sequence: 6 givenname: Seitaro surname: Terakura fullname: Terakura, Seitaro organization: Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan – sequence: 7 givenname: Yuichi surname: Ishikawa fullname: Ishikawa, Yuichi organization: Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan – sequence: 8 givenname: Chisako surname: Iriyama fullname: Iriyama, Chisako organization: Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan – sequence: 9 givenname: Yoko surname: Ushijima fullname: Ushijima, Yoko organization: Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan – sequence: 10 givenname: Tatsunori surname: Goto fullname: Goto, Tatsunori organization: Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan – sequence: 11 givenname: Nobuharu surname: Fujii fullname: Fujii, Nobuharu organization: Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan – sequence: 12 givenname: Mitsune surname: Tanimoto fullname: Tanimoto, Mitsune organization: Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan – sequence: 13 givenname: Hironori surname: Kobayashi fullname: Kobayashi, Hironori organization: Department of Hematology, Endocrinology and Metabolism, Niigata University Graduate School of Medical and Dental Science, Niigata, Japan – sequence: 14 givenname: Yasuhiko surname: Shibasaki fullname: Shibasaki, Yasuhiko organization: Division of Stem Cell Transplantation, Niigata University Medical and Dental Hospital, Niigata, Japan – sequence: 15 givenname: Noriko surname: Fukuhara fullname: Fukuhara, Noriko organization: Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan – sequence: 16 givenname: Yoshihiro surname: Inamoto fullname: Inamoto, Yoshihiro organization: Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan – sequence: 17 givenname: Ritsuro surname: Suzuki fullname: Suzuki, Ritsuro organization: Department of HSCT Data Management and Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan – sequence: 18 givenname: Tadashi surname: Matsushita fullname: Matsushita, Tadashi organization: Department of Transfusion Medicine, Nagoya University Hospital, Nagoya, Japan – sequence: 19 givenname: Yoshihisa surname: Kodera fullname: Kodera, Yoshihisa organization: Department of Promotion for Blood and Marrow Transplantation, Aichi Medical University School of Medicine, Nagakute, Japan – sequence: 20 givenname: Hitoshi surname: Kiyoi fullname: Kiyoi, Hitoshi organization: Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan – sequence: 21 givenname: Tomoki surname: Naoe fullname: Naoe, Tomoki organization: Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan – sequence: 22 givenname: Tetsuya surname: Nishida fullname: Nishida, Tetsuya organization: Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan |
BookMark | eNqFkN1OwzAMhSM0JDbgGcgLtDhpm7aXY-Jn0gQSbNxGaeOioJJMSUDa25Nu3HNjS5bP5-OzIDPrLBJywyBnrOG33eiczt8Zb3LO86Jo4VjOyJxVvMkAOMzIHABEVrY1uyCLED4BWFnwak7M2kavuoSkW69s2I_KRhWNs9QNVNE3Yz9GpCvnNb2bLtGdNZHuQprTZ2eztfdKGxVR01fU3z3qLCHRBhMPSWa1mWBp-4qcD2oMeP3XL8nu4X67eso2L4_r1XKT9QwEZFw1VTLX1lgywQrRoRKiF0xBB0OHTLW9KJsWO96IEutGFwqG9AqvWM01U8UlqU_c3rsQPA5y782X8gfJQE6JyWNickpMci6nsI4lKZcnJSZ7Pwa9DL1Bm14yHvsotTP_Mn4B4rp4xw |
ContentType | Journal Article |
Copyright | 2016 American Society of Hematology |
Copyright_xml | – notice: 2016 American Society of Hematology |
DBID | 6I. AAFTH AAYXX CITATION |
DOI | 10.1182/blood.V128.22.3390.3390 |
DatabaseName | ScienceDirect Open Access Titles Elsevier:ScienceDirect:Open Access CrossRef |
DatabaseTitle | CrossRef |
DatabaseTitleList | CrossRef |
DeliveryMethod | fulltext_linktorsrc |
Discipline | Medicine Chemistry Biology Anatomy & Physiology |
EISSN | 1528-0020 |
EndPage | 3390 |
ExternalDocumentID | 10_1182_blood_V128_22_3390_3390 S0006497119333919 |
GroupedDBID | --- -~X .55 1CY 23N 2WC 34G 39C 4.4 53G 5GY 5RE 5VS 6I. 6J9 AAEDW AAFTH AAXUO ABOCM ABVKL ACGFO ADBBV AENEX AFOSN AHPSJ ALMA_UNASSIGNED_HOLDINGS BAWUL BTFSW CS3 DIK DU5 E3Z EBS EJD EX3 F5P FDB FRP GS5 GX1 IH2 K-O KQ8 L7B LSO MJL N9A OK1 P2P R.V RHF RHI ROL SJN THE TR2 TWZ W2D W8F WH7 WOQ WOW X7M YHG YKV ZA5 0R~ 0SF AALRI AAYXX ADVLN AFETI AITUG AKRWK AMRAJ CITATION H13 |
ID | FETCH-LOGICAL-c1060-2a8501497e416136bea66c61a0b0fbe1a9c6489eb2864e78d3a0f32525172d1a3 |
IEDL.DBID | ABVKL |
ISSN | 0006-4971 |
IngestDate | Thu Sep 12 19:56:57 EDT 2024 Fri Feb 23 02:36:04 EST 2024 |
IsDoiOpenAccess | true |
IsOpenAccess | true |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 22 |
Language | English |
License | This article is made available under the Elsevier license. |
LinkModel | DirectLink |
MergedId | FETCHMERGED-LOGICAL-c1060-2a8501497e416136bea66c61a0b0fbe1a9c6489eb2864e78d3a0f32525172d1a3 |
OpenAccessLink | https://www.sciencedirect.com/science/article/pii/S0006497119333919 |
PageCount | 1 |
ParticipantIDs | crossref_primary_10_1182_blood_V128_22_3390_3390 elsevier_sciencedirect_doi_10_1182_blood_V128_22_3390_3390 |
PublicationCentury | 2000 |
PublicationDate | 2016-12-02 |
PublicationDateYYYYMMDD | 2016-12-02 |
PublicationDate_xml | – month: 12 year: 2016 text: 2016-12-02 day: 02 |
PublicationDecade | 2010 |
PublicationTitle | Blood |
PublicationYear | 2016 |
Publisher | Elsevier Inc |
Publisher_xml | – name: Elsevier Inc |
SSID | ssj0014325 |
Score | 2.2579582 |
Snippet | Introduction: Cord blood transplantation (CBT) is a treatment option for patients with hematological disorder. Recent development of reduced-intensity... Abstract Introduction: Cord blood transplantation (CBT) is a treatment option for patients with hematological disorder. Recent development of reduced-intensity... |
SourceID | crossref elsevier |
SourceType | Aggregation Database Publisher |
StartPage | 3390 |
Title | Intrabone Transplantation of a Single Cord Blood Unit Using Non-Irradiated Reduced-Intensity Conditioning |
URI | https://dx.doi.org/10.1182/blood.V128.22.3390.3390 |
Volume | 128 |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1LS8QwEB50xcdFdFV8k4N4626atN3U2-6i-AafeCtJm8LC2pVlPfjvnUlTURA8eCmlMCVkwsz3ZV4AR1aLXIZGBTE1q4zKggeIisrAhmkcx4Us4oIKnG9uk_On6PIlfpmDYVMLQ2mV3vbXNt1Za_-l63ez-zYaUY0vutO0FyIEkTKl1p8LgsJMLVjoD56vrr-CCZEU9SADJM8k4NO8EFl3XXZ45xmNdEeIDv6Gu8fvTuqb4zlbg1WPGFm_XtQ6zNmqDRv9Ctny6wc7Zi6H012Ot2Fx0LwtD5tJbm1YuvEB9A0YXdBlrplUltVtzce6rj2q2KRkmj2gJxtbNkRKyga0akaglLnEAnY7qYKL6ZS6GSBOZffU9dUWgc-Cn32gGAXA6xveTXg6O30cngd-2kKQIy3kgdCKYoxpzxLnkYmxOknyJNTc8NLYUKd5EqkUmbhKIttThdS8xJ2lnmeiCLXcglaFy98GlluTFsj7EpFGUW64LgXiSKWVLJURJt8B3mxv9lY31cgcGVEicxrJSCOZEBkpwz124KRRQ_bjfGRo-v8S3v2P8B6sIEhyw4q42IfWbPpuDxCIzMyhP2iHMH91pz4BV_naPw |
link.rule.ids | 315,786,790,27600,27955,27956,45696 |
linkProvider | Elsevier |
linkToHtml | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV3Na9swFH-Ulq27lC3d6Mc-dCi9OZEl25F6S8JKsiY5dG3pTUi2DIHOKSE99L_ve7I8OhjssIsxhmeEnnjv99P7AjjzVpQydSrJqVllVlc8QVRUJz7VeZ5XssorKnBeLIvpbfbjPr_fgUlXC0NpldH2tzY9WOv4ZRB3c_C4WlGNL7pTPUwRgkipqfXnHqIBjcd8bzS-u5r_DiZkUrSDDJA8k0BM80JkPQjZ4f07NNJ9Ifr4Gx4ef3dSrxzP5Xs4iIiRjdpFfYAd3_TgcNQgW_71zM5ZyOEMl-M9eDPu3vYn3SS3HrxdxAD6IaxmdJnr1o1nbVvzB9vWHjVsXTPLfqIne_BsgpSUjWnVjEApC4kFbLluktlmQ90MEKeya-r66qskZsFvn1GMAuDtDe9HuL38fjOZJnHaQlIiLeSJsIpijHroifPIwnlbFGWRWu547XxqdVlkSiMTV0Xmh6qSlte4s9TzTFSplZ9gt8HlHwErvdMV8r5C6CwrHbe1QByprJK1csKVx8C77TWPbVMNE8iIEiZoxJBGjBCGlBEex3DRqcH8cT4Mmv5_CZ_8j_A32J_eLOZmPltencI7BExhcBEXn2F3u3nyXxCUbN3XeOheALKo3EM |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Intrabone+Transplantation+of+a+Single+Cord+Blood+Unit+Using+Non-Irradiated+Reduced-Intensity+Conditioning&rft.jtitle=Blood&rft.au=Murata%2C+Makoto&rft.au=Maeda%2C+Yoshinobu&rft.au=Masuko%2C+Masayoshi&rft.au=Onishi%2C+Yasushi&rft.date=2016-12-02&rft.issn=0006-4971&rft.eissn=1528-0020&rft.volume=128&rft.issue=22&rft.spage=3390&rft.epage=3390&rft_id=info:doi/10.1182%2Fblood.V128.22.3390.3390&rft.externalDBID=n%2Fa&rft.externalDocID=10_1182_blood_V128_22_3390_3390 |
thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0006-4971&client=summon |
thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0006-4971&client=summon |
thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0006-4971&client=summon |