Thiotepa/cyclophosphamide/TBI as a Conditioning Regimen for Allogeneic Hematopoietic Stem Cell Transplantation in Patients Aged 50 Years and Over
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概要
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Objective To reduce the relapse rate for hematological malignancies after allogeneic hematopoietic stem cell transplantation, we employed a myeloablative regimen comprising thiotepa 400 mg/m2, cyclophosphamide 3,600 mg/m2 and total body irradiation 10 Gy. Materials and Methods Subjects comprised 17 patients (median age, 53 years; range, 50-56 years) with hematological malignancies who received allogeneic hematopoietic stem cell transplantation from HLA-identical related (n=6), HLA-mismatched family (n=2) or unrelated donors (n=9). Prophylaxis of acute graft-versus-host disease (GVHD) consisted of short-term methotrexate and cyclosporine (n=4) or short-term methotrexate and tacrolimus (n=13). Results No grade IV regimen-related toxicities as determined by Bearmans criteria were encountered. Acute grade II-IV GVHD developed in 7 patients, with chronic GVHD in 11 patients. With a median follow-up of 39 months, 3 years survival rate after transplantation was 59%. Two patients died due to infection by 100 days after transplantation. Only 1 patient with Philadelphia-positive acute lymphoblastic leukemia experienced relapse. Eight patients died of non-leukemic causes (sepsis, n=2; liver dysfunction, n=2; idiopathic interstitial pneumonia, n=1; bacterial pneumonia, n=1; bronchiolitis obliterans resulting from chronic GVHD, n=1; and disseminated infection with varicella zoster virus, n=1). Conclusions This regimen was tolerable, but a large trial is warranted to confirm the efficacy of this conditioning.
著者
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Tanaka Masatsugu
Department Of Hematology Kanagawa Cancer Center
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SAKAI Rika
Department of Hematology, Kanagawa Cancer Center
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Kanamori Heiwa
Department Of Hematology Kanagawa Cancer Center
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Ishigatsubo Yoshiaki
Department Of Internal Medicine And Clinical Immunology Yokohama City University Graduate School Of
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Maruta Atsuo
Department Of Hematology Kanagawa Cancer Center
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Takasaki Hirotaka
Department Of Hematology Kanagawa Cancer Center
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Hyo Rie
Department Of Hematology Yokohama City University Medical Center
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Sakai Rika
Department Of Hematology Kanagawa Cancer Center
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Fujita Hiroyuki
Department Of Environmental Immuno-dermatology Yokohama City University Graduate School Of Medicine
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Fujisawa Shin
Department Of Hematology Yokohama City University Medical Center
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KAWANO Tomoko
Department of Applied Chemistry, Faculty of Engineering, Osaka University
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KANAMORI Heiwa
Department of Hematology, Kanagawa Cancer Center
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FUJIMAKI Katsumichi
Department of Hematology and Immunology, Fujisawa City Hospital
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Fujimaki Katsumichi
Department of Internal Medicine and Clinical Immunology, Yokohama City University School of Medicine
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Fujisawa Shin
Department of Internal Medicine and Clinical Immunology, Yokohama City University School of Medicine
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