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Reduced-intensity unrelated cord blood transplantation for patients with advanced malignant lymphoma.
Authors:Koichiro Yuji  Shigesaburo Miyakoshi  Daisuke Kato  Yuji Miura  Tomohiro Myojo  Naoko Murashige  Yukiko Kishi  Kazuhiro Kobayashi  Eiji Kusumi  Hiroto Narimatsu  Tamae Hamaki  Tomoko Matsumura  Masahiro Kami  Takahiro Fukuda  Shigeru Masuo  Kazuhiro Masuoka  Atsushi Wake  Junichi Ueyama  Akiko Yoneyama  Ko Miyamoto  Haruhisa Nagoshi  Michio Matsuzaki  Shinichi Morinaga  Yoshitomo Muto  Yoichi Takeue  Shuichi Taniguchi
Affiliation:Department of Hematology, Toranomon Hospital, Toranomon, Tokyo, Japan.
Abstract:We report the results of reduced-intensity unrelated cord blood transplantation (RI-UCBT) in patients with advanced malignant lymphoma. Twenty patients (median age, 46.5 years; range, 27-66 years) underwent RI-UCBT with a preparative regimen consisting of fludarabine 125 mg/m2 , melphalan 80 mg/m 2 , and 4 Gy of total body irradiation. The median infused total cell dose was 2.75 x 10(7)/kg (range, 2.3-3.4 x 10(7)/kg). Graft-versus-host disease (GVHD) prophylaxis was composed of cyclosporine or tacrolimus alone. Fifteen patients achieved primary neutrophil engraftment after a median of 20 days. Eight patients developed grade II to IV acute GVHD, and 2 developed chronic GVHD. Of the 16 patients with evaluable disease, 10 achieved a complete response. Primary disease recurred in 1 patient, and transplant-related mortality within 100 days occurred in 8 of 20 patients. The estimated 1-year probability of progression-free survival was 50%. These data suggest that RI-UCBT is a feasible option for patients with refractory lymphoma who lack an HLA-matched donor.
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