Unrelated Cord Blood Stem Cell Transplantation Using Non-Myeloablative Regimen for Refractory Non-Hodgkin's Lymphoma
We have performed an allogeneic umbilical cord blood stem cell transplant to an 12-year-old male patient with T-cell Non-Hodgkin's lymphoma (NHL). The NHL was refractory to conventional intensive chemotherapy. High-dose chemotherapy and radiation therapy was given, but the patient relapsed 3 ti...
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| Published in | The Japanese Journal of Pediatric Hematology Vol. 18; no. 6; pp. 609 - 613 |
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| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
THE JAPANESE SOCIETY OF PEDIATRIC HEMATOLOGY/ONCOLOGY
2004
特定非営利活動法人 日本小児血液・がん学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0913-8706 1884-4723 |
| DOI | 10.11412/jjph1987.18.6_609 |
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| Abstract | We have performed an allogeneic umbilical cord blood stem cell transplant to an 12-year-old male patient with T-cell Non-Hodgkin's lymphoma (NHL). The NHL was refractory to conventional intensive chemotherapy. High-dose chemotherapy and radiation therapy was given, but the patient relapsed 3 times. He was then treated with allogeneic umbilical cord blood stem cell transplantation (CBSCT) using a fludarabine, and melphalan-based nonmyeloablative conditioning regimen. GVHD prophylaxis was composed of tacrolimus alone. The patient had neutrophil engraftment within 28 days. Investigation by short tandem repeat (STR) showed that 100% of his bone marrow nucleated cells were reconstituted by donor origin since day +28. He is now alive and well and remains disease-free 7 months after transplant. Although the symptom of GVHD is faint, we evaluated that the graft-versus-lymphoma effect is one of the factors contributing to his remission. |
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| AbstractList | We have performed an allogeneic umbilical cord blood stem cell transplant to an 12-year-old male patient with T-cell Non-Hodgkin's lymphoma (NHL). The NHL was refractory to conventional intensive chemotherapy. High-dose chemotherapy and radiation therapy was given, but the patient relapsed 3 times. He was then treated with allogeneic umbilical cord blood stem cell transplantation (CBSCT) using a fludarabine, and melphalan-based nonmyeloablative conditioning regimen. GVHD prophylaxis was composed of tacrolimus alone. The patient had neutrophil engraftment within 28 days. Investigation by short tandem repeat (STR) showed that 100% of his bone marrow nucleated cells were reconstituted by donor origin since day +28. He is now alive and well and remains disease-free 7 months after transplant. Although the symptom of GVHD is faint, we evaluated that the graft-versus-lymphoma effect is one of the factors contributing to his remission. We have performed an allogeneic umbilical cord blood stem cell transplant to an 12-year-old male patient with T-cell Non-Hodgkin's lymphoma (NHL). The NHL was refractory to conventional intensive chemotherapy. High-dose chemotherapy and radiation therapy was given, but the patient relapsed 3 times. He was then treated with allogeneic umbilical cord blood stem cell transplantation (CBSCT) using a fludarabine, and melphalan-based nonmyeloablative conditioning regimen. GVHD prophylaxis was composed of tacrolimus alone. The patient had neutrophil engraftment within 28 days. Investigation by short tandem repeat (STR) showed that 100% of his bone marrow nucleated cells were reconstituted by donor origin since day +28. He is now alive and well and remains disease-free 7 months after transplant. Although the symptom of GVHD is faint, we evaluated that the graft-versus-lymphoma effect is one of the factors contributing to his remission. 頻回再発した非ポジキンリンパ腫 (NHL) に対して骨髄非破壊性前処置を用いて臍帯血移植を施行した1例を報告する.症例は12歳男児.11歳時にT細胞性非ポジキンリンパ腫を発症, JACLS NHL-98プロトコールにていったん寛解を得た.しかし, 維持療法中に中枢神経再発したため再入院し, 化学療法・放射線療法を施行するも計3回の再発を認めた.造血幹細胞移植による治療を計画したが, HLA一致同胞が存在せず, 緊急性があったために移植ソースに同種臍帯血を選択した.また, 度重なる治療による臓器毒性を考慮し, 移植前処置は骨髄非破壊性前処置とした.移植後明らかな臓器毒性, 重症感染やGVHD症状を認めず, 現在寛解を維持している.骨髄非破壊性前処置を用いた造血幹細胞移植のソースとして同種末梢血幹細胞や同種骨髄幹細胞を選択されることが多いが, 同種臍帯血も十分使用可能と考えられた. |
| Author | OHTSUKA, Yoshitoshi KANEDA, Yumi MORITA, Naoko TAKEDA, Hiroki ASANO, Yumi OHTSUKI, Fumiko TANIZAWA, Takakuni YAMAMOTO, Masuji |
| Author_FL | 森田 直子 浅野 由美 大塚 欣敏 大槻 史子 谷澤 隆邦 金田 由美 竹田 洋樹 山本 益嗣 |
| Author_FL_xml | – sequence: 1 fullname: 竹田 洋樹 – sequence: 2 fullname: 山本 益嗣 – sequence: 3 fullname: 大塚 欣敏 – sequence: 4 fullname: 大槻 史子 – sequence: 5 fullname: 森田 直子 – sequence: 6 fullname: 浅野 由美 – sequence: 7 fullname: 金田 由美 – sequence: 8 fullname: 谷澤 隆邦 |
| Author_xml | – sequence: 1 fullname: OHTSUKI, Fumiko organization: Department of Pediatrics, Hyogo College of Medicine – sequence: 1 fullname: YAMAMOTO, Masuji organization: Department of Pediatrics, Hyogo College of Medicine – sequence: 1 fullname: TANIZAWA, Takakuni organization: Department of Pediatrics, Hyogo College of Medicine – sequence: 1 fullname: TAKEDA, Hiroki organization: Department of Pediatrics, Hyogo College of Medicine – sequence: 1 fullname: MORITA, Naoko organization: Department of Pediatrics, Hyogo College of Medicine – sequence: 1 fullname: KANEDA, Yumi organization: Department of Pediatrics, Hyogo College of Medicine – sequence: 1 fullname: OHTSUKA, Yoshitoshi organization: Department of Pediatrics, Hyogo College of Medicine – sequence: 1 fullname: ASANO, Yumi organization: Department of Pediatrics, Hyogo College of Medicine |
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| References | 7) Miyakoshi S, Yuji K, Kami M, et al : Successful engraftment after reduced-intensity umbilical cord blood transplantation for adult patients with advanced hematological diseases. Clin Cancer Res 10 : 3586-3592, 2004 3) Michallet M, Bilger K, Garban F, et al : Allogeneic hematopoietic stem-cell transplantation after nonmyeloablative preparative regimens : Impact of pretransplantation and posttransplantation factors on outcome. J Clin Oncol 19 : 3340-3349, 2001 1) 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 non malignant hematologic diseases. Blood 91 : 756-763, 1998 2) Childs R, Clave E, Contentin N, et al : Engraftment kinetics after non-myeloablative allogeneic peripheral blood stem cell transplantation : Full donor T-cell chimerism precedes alloimmune responses. Blood 94 : 3234-3241, 1999 4) Yazaki M, Takahashi T, Ito Y, et al : Generation of HLAA2 subtype specific cytotoxic T lymphocytes from cord blood used for cord blood stem cell transplantation. Bone Marrow Transplant 26 : 451-453, 2000 6) Khee WH, Chye PT, Hoe TC, et al : Autologous recovery with protractedly undetectable donor chimerisms can precede stable donor engraftment in a nonmyeloablative cord blood transplant. Int J Hematol 78 : 73-75, 2003 5) Rizzieri DA, Long GD, Vredenburgh JJ, et al : Successful allogeneic engraftment of mismatched unrelated cord blood following a nonmyeloablative preparative regimen. Blood 98 : 3486-3488, 2001 |
| References_xml | – reference: 4) Yazaki M, Takahashi T, Ito Y, et al : Generation of HLAA2 subtype specific cytotoxic T lymphocytes from cord blood used for cord blood stem cell transplantation. Bone Marrow Transplant 26 : 451-453, 2000 – reference: 1) 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 non malignant hematologic diseases. Blood 91 : 756-763, 1998 – reference: 5) Rizzieri DA, Long GD, Vredenburgh JJ, et al : Successful allogeneic engraftment of mismatched unrelated cord blood following a nonmyeloablative preparative regimen. Blood 98 : 3486-3488, 2001 – reference: 3) Michallet M, Bilger K, Garban F, et al : Allogeneic hematopoietic stem-cell transplantation after nonmyeloablative preparative regimens : Impact of pretransplantation and posttransplantation factors on outcome. J Clin Oncol 19 : 3340-3349, 2001 – reference: 2) Childs R, Clave E, Contentin N, et al : Engraftment kinetics after non-myeloablative allogeneic peripheral blood stem cell transplantation : Full donor T-cell chimerism precedes alloimmune responses. Blood 94 : 3234-3241, 1999 – reference: 6) Khee WH, Chye PT, Hoe TC, et al : Autologous recovery with protractedly undetectable donor chimerisms can precede stable donor engraftment in a nonmyeloablative cord blood transplant. Int J Hematol 78 : 73-75, 2003 – reference: 7) Miyakoshi S, Yuji K, Kami M, et al : Successful engraftment after reduced-intensity umbilical cord blood transplantation for adult patients with advanced hematological diseases. Clin Cancer Res 10 : 3586-3592, 2004 |
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| SubjectTerms | cord blood stem cell transplantation non-Hodgkin's lymphoma non-myeloablative regimen |
| Title | Unrelated Cord Blood Stem Cell Transplantation Using Non-Myeloablative Regimen for Refractory Non-Hodgkin's Lymphoma |
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