Danaparoid reduces transplant‐related mortality in stem cell transplantation for children |
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| Authors: | Koji Kato Hirotoshi Sakaguchi Hideki Muramatsu Yuko Sekiya Nozomu Kawashima Atsushi Narita Sayoko Doisaki Nobuhiro Watanabe Nao Yoshida Kimikazu Matsumoto |
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| Affiliation: | 1. Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan;2. Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan;3. Department of Pediatrics, Meitetsu Hospital, Nagoya, Japan;4. Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan |
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| Abstract: | In SCT, death from transplant‐related complications is the major obstacle hindering improvement of transplant outcomes, and proper supportive care is essential to reduce TRM. The transplant outcomes of 210 pediatric patients with malignant and non‐malignant disorders who consecutively underwent SCT in our institution from 2000 to 2013 were analyzed. The transplant years were divided into three periods: A (2000‐2004), B (2005‐2008), and C (2009‐2013), and an improvement in 5‐year OS and a decrease in 5‐year TRM were observed over these time periods; that is, OS was 61.5%, 60.3%, and 79.5% (P = .062), and TRM was 19.9%, 7.9%, and 0.0% (P < .001) in periods A, B, and C, respectively. On multivariate analysis, the prognostic factor for TRM for all patients was administration of danaparoid (HR = 0.109, 95% CI = 0.033‐0.363, P < .001), and for patients with hematological malignancies in allogeneic SCT, the prognostic factors were danaparoid (HR = 0.046, 95% CI = 0.006‐0.326, P = .002) and advanced disease at SCT (HR = 4.802, 95% CI = 1.734‐13.30, P = .003). A reduction in TRM after SCT was observed over the time periods, and supportive care with danaparoid was found to be significantly effective in reducing TRM in SCT for children. |
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| Keywords: | children danaparoid leukemia non‐malignant disorders stem cell transplantation transplant‐related mortality |
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