Prospective observational study on the first 51 cases of peripheral blood stem cell transplantation from unrelated donors in Japan

• Published in: International journal of hematology Vol. 107; no. 2; pp. 211 - 221
• Main Authors: Goto, Tatsunori, Tanaka, Takashi, Sawa, Masashi, Ueda, Yasunori, Ago, Hiroatsu, Chiba, Shigeru, Kanamori, Heiwa, Nishikawa, Akinori, Nougawa, Masaharu, Ohashi, Kazuteru, Okumura, Hirokazu, Tanimoto, Mitsune, Fukuda, Takahiro, Kawashima, Naomi, Kato, Tomonori, Okada, Kazuya, Nagafuji, Koji, Okamoto, Shin-ichiro, Atsuta, Yoshiko, Hino, Masayuki, Tanaka, Junji, Miyamura, Koichi
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.02.2018; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Bone marrow; Bone marrow transplantation; Chronic Disease; Feasibility Studies; Follow-Up Studies; Graft vs Host Disease - epidemiology; Graft vs Host Disease - prevention & control; Graft-versus-host reaction; Health risks; Hematologic Neoplasms - therapy; Hematology; Hematopoietic stem cells; Histocompatibility antigen HLA; Humans; Immunosuppressive Agents - administration & dosage; Incidence; Japan; Male; Medicine; Medicine & Public Health; Middle Aged; Observational studies; Oncology; Original Article; Patients; Peripheral blood; Peripheral Blood Stem Cell Transplantation; Prophylaxis; Prospective Studies; Quality; Stem cell transplantation; Stem cells; Survival; Tacrolimus; Tacrolimus - administration & dosage; Time Factors; Transplantation; Transplantation Conditioning - methods; Unrelated Donors; Young Adult; Japan; Peripheral blood stem cell; Unrelated donor; Allogeneic hematopoietic cell transplantation
• ISSN: 0925-5710; 1865-3774
• DOI: 10.1007/s12185-017-2341-y

The Japan Marrow Donor Program (JMDP) has facilitated unrelated peripheral blood stem cell transplantation (URPBSCT) since 2010. We conducted a prospective multicenter observational study to evaluate the feasibility of such transplantation. Between 2011 and 2014, 51 patients underwent URPBSCT from 8/8 allele-matched donors for hematological malignancies. The median age of the patients was 50 years; 21 had high-risk disease. Myeloablative conditioning regimens were used in 31 patients, and tacrolimus based graft-versus-host disease (GVHD) prophylaxis was used for all patients. The cumulative rate of engraftment was 96%. With a median follow-up period of 610 days for survivors, 100-day and 1-year overall survival rates were 86 and 59%, respectively. The cumulative incidence of non-relapse mortality and relapse at 1 year were 14 and 35%, respectively. The incidence of grade II to IV acute GVHD at 100 days and extensive type of chronic GVHD at 1 year were 25 and 32%, respectively. The probability of overall survival was comparable with that of bone marrow transplantation from HLA matched-unrelated donors in Japan, although the incidence of chronic GVHD was higher. Further follow-up with more patients is clearly warranted to establish the optimal use of URPBSCT together with the approaches of minimizing chronic GVHD.