Tamura Kazuo, Kawano Fumio, Etoh Tetsuya, Utsunomiya Atae, Imamura Yutaka, Okamura Seiichi, Tsukada Junich, Uike Naokuni, Takamatsu Yasushi
Department of Internal Medicine, Fukuoka University Hospital, Japan.
Fukuoka Igaku Zasshi. 2006 Jun;97(6):175-82.
The Japan Cord Blood Network was established in 1999 and 8 institutions from the Kyushu Hematology Organization Study Group had performed cord blood transplantation (CBT) 67 times on 62 patients with advanced hematological malignancies from 1999 to 2004, which included acute and chronic leukemias in 34 patients, non-Hodgkin's lymphoma in 14, adult T-cell leukemia in 11 and others in 3 patients. The median age was 44 and disease status was no remission on 50 patients prior to CBT. Myeloablative conditioning regimens were used in 27 patients while 35 patients received non-myeloablatives. Engraftment could not be determined in 25 patients and the median survival time was 70 days. Thirteen patients were alive from 288 to 1277 days and 49 had been expired. The causes of death were the underlying disease in 19 patients, severe infection in 14 and graft-versus-host disease in 3 and miscellaneous in the remaining patients. This retrospective study shows that some patients with far-advanced hematological malignances could be successfully treated with CBT at the expense of many early deaths due to early relapse and severe infection. It is of importance that the appropriate indication for CBT should be discussed between transplant experts and patients and their families in each case.
日本脐血网络于1999年成立，1999年至2004年期间，来自九州血液学组织研究小组的8家机构对62例晚期血液系统恶性肿瘤患者进行了67次脐血移植（CBT），其中包括34例急性和慢性白血病患者、14例非霍奇金淋巴瘤患者、11例成人T细胞白血病患者和3例其他患者。中位年龄为44岁，50例患者在进行CBT前疾病处于未缓解状态。27例患者采用了清髓性预处理方案，35例患者接受了非清髓性预处理方案。25例患者的植入情况无法确定，中位生存时间为70天。13例患者存活288至1277天，49例患者已死亡。死亡原因包括19例患者的基础疾病、14例患者的严重感染、3例患者的移植物抗宿主病以及其余患者的其他原因。这项回顾性研究表明，一些晚期血液系统恶性肿瘤患者可以通过CBT成功治疗，但代价是许多患者因早期复发和严重感染而过早死亡。在每种情况下，移植专家与患者及其家属之间讨论CBT的适当适应症非常重要。
