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Arai Y, Kondo T, Shigematsu A, Tanaka J, Ohashi K, Fukuda T, Kawakita T, Mori T, Hoshino T, Onizuka M, Ozawa Y, Yoshida S, Ueda Y, Mizuno I, Atsuta Y, Mizuta S. Increased non-relapse mortality due to high-dose cytarabine plus CY/TBI in BMT/PBSCT for acute lymphoblastic leukaemia in adults. Br J Haematol 2017; 178:106-111. [PMID: 28439877 DOI: 10.1111/bjh.14652] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 01/09/2017] [Indexed: 11/30/2022]
Abstract
The efficacy of high-dose cytarabine (HDCA) plus cyclophosphamide/total-body irradiation (CY/TBI) has been proved in cord blood transplantation (CBT) for acute lymphoblastic leukaemia (ALL), but not in bone marrow or peripheral blood stem cell transplantation (BMT/PBSCT). In this cohort study, we compared the prognosis of CY/TBI (N = 1244) and HDCA/CY/TBI (N = 316) regimens in BMT/PBSCT for ALL. The addition of HDCA decreased post-transplant relapse, while significantly increasing non-relapse mortality (risk ratio, 1·33), and overall survival was not improved. The positive effects of HDCA reported in CBT cannot be extrapolated to BMT/PBSCT, and HDCA may not be recommended in these procedures.
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Affiliation(s)
- Yasuyuki Arai
- Department of Haematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Laboratory of Host Defences, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Tadakazu Kondo
- Department of Haematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akio Shigematsu
- Department of Haematology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Junji Tanaka
- Department of Haematology, Tokyo Women's Medical University, Tokyo, Japan
| | - Kazuteru Ohashi
- Haematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan
| | - Takahiro Fukuda
- Department of Haematopoietic Stem Cell Transplantation, National Cancer Centre Hospital, Tokyo, Japan
| | - Toshiro Kawakita
- Department of Haematology, National Hospital Organization Kumamoto Medical Centre, Kumamoto, Japan
| | - Takehiko Mori
- Division of Haematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takumi Hoshino
- Leukaemia Research Centre, Saiseikai Maebashi Hospital, Maebashi, Japan
| | - Makoto Onizuka
- Department of Haematology/Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Yukiyasu Ozawa
- Department of Haematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Shuro Yoshida
- Department of Haematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Yasunori Ueda
- Department of Haematology/Oncology and Transfusion and Haemapheresis Centre, Kurashiki Central Hospital, Kurashiki, Japan
| | - Ishikazu Mizuno
- Department of Haematology, Hyogo Cancer Centre, Akashi, Japan
| | - Yoshiko Atsuta
- Japanese Data Centre for Haematopoietic Cell Transplantation, Nagoya, Japan.,Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shuichi Mizuta
- Department of Haematology, National Hospital Organization Toyohashi Medical Centre, Toyohashi, Japan
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