Unrelated donor bone marrow transplantation for 100 pediatric patients: a single institute's experience

Bone Marrow Transplant. 2005 Aug;36(4):307-13. doi: 10.1038/sj.bmt.1705056.

Abstract

In all, 100 unrelated donor bone marrow transplantations (UD-BMT) were performed in our institute between October 1993 and January 2003. Of 93 evaluable patients, 73 patients had hematological malignancy, 13 had nonmalignancy and seven had lymphoproliferative disease. The estimated 9-year event-free survival (EFS) rate was 57.1+/-5.5% in all patients. In the following analyses of the patients with hematological malignancy, the standard group had significantly better EFS than the high-risk group (61.5+/-7.0 vs 35.6+/-9.7%, P=0.02), and the EFS rate of the tacrolimus (FK-506)+methotrexate (MTX)+/-methylprednisolone prophylactic group for graft-versus-host disease was superior to that of the FK-506 without MTX group (75.7+/-8.0 vs 55.8+/-7.6%, P=0.02). When we compared the EFS rates of the FK506+MTX+/-methylprednisolone (mPSL) group and the HLA-matched related donor BMT group in our institute, these were almost similar (75.7+/-8.1 vs 68.4+/-9.3%). Therefore, UD-BMT using FK-506+MTX+/-mPSL is a safe and useful method for children with hematological malignancy who require allogeneic BMT.

MeSH terms

  • Adolescent
  • Adult
  • Bone Marrow Transplantation / adverse effects
  • Bone Marrow Transplantation / immunology
  • Bone Marrow Transplantation / methods*
  • Bone Marrow Transplantation / mortality
  • Child
  • Child, Preschool
  • Disease-Free Survival
  • Drug Therapy, Combination
  • Female
  • Graft Rejection / etiology
  • Graft vs Host Disease / chemically induced
  • Graft vs Host Disease / etiology
  • Graft vs Host Disease / prevention & control
  • Hematologic Diseases / complications
  • Hematologic Diseases / mortality
  • Hematologic Diseases / therapy
  • Humans
  • Infant
  • Japan
  • Male
  • Methotrexate / therapeutic use
  • Methylprednisolone / therapeutic use
  • Premedication
  • Retrospective Studies
  • Tacrolimus / therapeutic use
  • Tacrolimus / toxicity
  • Tissue Donors*

Substances

  • Tacrolimus
  • Methylprednisolone
  • Methotrexate