PMID- 26284307
OWN - NLM
STAT- MEDLINE
DCOM- 20160208
LR  - 20151102
IS  - 1873-2399 (Electronic)
IS  - 0301-472X (Linking)
VI  - 43
IP  - 11
DP  - 2015 Nov
TI  - HLA haploidentical peripheral blood stem cell transplantation using reduced dose 
      of posttransplantation cyclophosphamide for poor-prognosis or refractory leukemia 
      and myelodysplastic syndrome.
PG  - 921-929.e1
LID - S0301-472X(15)00568-8 [pii]
LID - 10.1016/j.exphem.2015.07.006 [doi]
AB  - Nonmyeloablative, human leukocyte antigen (HLA) haploidentical, T-cell-replete 
      bone marrow transplantation followed by high-dose posttransplantation 
      cyclophosphamide (PT/Cy) has recently been developed. This transplantation milieu 
      has resulted in favorable outcomes with low transplantation-related mortality, 
      owing to a low incidence of graft-versus-host disease (GVHD), without increased 
      infectious complications. However, the high relapse rate remains a major concern. 
      We therefore performed a prospective pilot study of HLA haploidentical peripheral 
      blood stem cell transplantation (PBSCT) with intensified conditioning, followed 
      by two lower doses of PT/Cy. A total of 20 patients with refractory or 
      poor-prognosis myelodysplastic syndrome (MDS) and leukemia were enrolled in the 
      study. A trend toward a lower incidence of grade III-IV acute GVHD at day 100 in 
      the group receiving 25 mg/kg x 2 doses of PT/Cy, compared with the group 
      receiving 25 mg/kg of PT/Cy (9.1% vs. 33%, p = 0.20), was noted. However, the 
      cumulative incidence of chronic GVHD was low, at 10% irrespective of PT/Cy dose. 
      The number of infused CD34(+) cells significantly correlated with the grade of 
      acute GVHD (p = 0.004). In addition, the occurrence of BK virus hemorrhagic 
      cystitis was significantly more common in the double-dose PT/Cy group (25% vs. 
      0%, p = 0.043), especially when combined with busulfan. The probability of 
      overall survival at 1 year in the double-dose group tended to be better compared 
      with that in the single-dose group (64% vs. 44%, respectively; p = 0.20). In 
      conclusion, HLA haploidentical, T-cell-replete PBSCT with 25 mg/kg x 2 doses of 
      PT/Cy might be a feasible option for treating high-risk leukemia and MDS.
CI  - Copyright (c) 2015 ISEH - International Society for Experimental Hematology. 
      Published by Elsevier Inc. All rights reserved.
FAU - Nakamae, Hirohisa
AU  - Nakamae H
AD  - Department of Hematology, Graduate School of Medicine, Osaka City University, 
      Osaka, Japan. Electronic address: hirohisa@msic.med.osaka-cu.ac.jp.
FAU - Koh, Hideo
AU  - Koh H
AD  - Department of Hematology, Graduate School of Medicine, Osaka City University, 
      Osaka, Japan.
FAU - Katayama, Takako
AU  - Katayama T
AD  - Department of Hematology, Graduate School of Medicine, Osaka City University, 
      Osaka, Japan.
FAU - Nishimoto, Mitsutaka
AU  - Nishimoto M
AD  - Department of Hematology, Graduate School of Medicine, Osaka City University, 
      Osaka, Japan.
FAU - Hayashi, Yoshiki
AU  - Hayashi Y
AD  - Department of Hematology, Graduate School of Medicine, Osaka City University, 
      Osaka, Japan.
FAU - Nakashima, Yasuhiro
AU  - Nakashima Y
AD  - Department of Hematology, Graduate School of Medicine, Osaka City University, 
      Osaka, Japan.
FAU - Nakane, Takahiko
AU  - Nakane T
AD  - Department of Hematology, Graduate School of Medicine, Osaka City University, 
      Osaka, Japan.
FAU - Nakamae, Mika
AU  - Nakamae M
AD  - Department of Hematology, Graduate School of Medicine, Osaka City University, 
      Osaka, Japan.
FAU - Hirose, Asao
AU  - Hirose A
AD  - Department of Hematology, Graduate School of Medicine, Osaka City University, 
      Osaka, Japan.
FAU - Hino, Masayuki
AU  - Hino M
AD  - Department of Hematology, Graduate School of Medicine, Osaka City University, 
      Osaka, Japan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150815
PL  - Netherlands
TA  - Exp Hematol
JT  - Experimental hematology
JID - 0402313
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - G1LN9045DK (Busulfan)
SB  - IM
MH  - Acute Disease
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Busulfan/administration & dosage
MH  - Cyclophosphamide/administration & dosage
MH  - Disease-Free Survival
MH  - Female
MH  - Graft vs Host Disease/mortality/prevention & control
MH  - Humans
MH  - Incidence
MH  - Leukemia/*mortality/*therapy
MH  - Male
MH  - Middle Aged
MH  - Myelodysplastic Syndromes/*mortality/*therapy
MH  - *Peripheral Blood Stem Cell Transplantation
MH  - Pilot Projects
MH  - Prospective Studies
MH  - Survival Rate
EDAT- 2015/08/19 06:00
MHDA- 2016/02/09 06:00
CRDT- 2015/08/19 06:00
PHST- 2015/04/18 00:00 [received]
PHST- 2015/07/06 00:00 [revised]
PHST- 2015/07/31 00:00 [accepted]
PHST- 2015/08/19 06:00 [entrez]
PHST- 2015/08/19 06:00 [pubmed]
PHST- 2016/02/09 06:00 [medline]
AID - S0301-472X(15)00568-8 [pii]
AID - 10.1016/j.exphem.2015.07.006 [doi]
PST - ppublish
SO  - Exp Hematol. 2015 Nov;43(11):921-929.e1. doi: 10.1016/j.exphem.2015.07.006. Epub 
      2015 Aug 15.