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High incidence of graft failure in unrelated cord blood transplantation using a reduced-intensity preparative regimen consisting of fludarabine and melphalan

Bone Marrow Transplantation volume 41, pages 753–756 (2008)Cite this article

Preparative regimens for cord blood transplantation (CBT) that use a reduced-intensity preparative regimen (RI-CBT) can consist of fludarabine, alkylating agents and 2–4 Gy total body irradiation (TBI); low-dose TBI is frequently added to overcome a human leucocyte antigen (HLA) barrier.1 However, TBI can increase regimen-related toxicity (RRT), which can cause life-threatening infection and/or organ dysfunction.2

To ameliorate RRT of RI-CBT, conditioning using a non-TBI regimen is being studied.3 We previously reported the safety and feasibility of a preparative regimen consisting of fludarabine 125 mg/m2 and melphalan 180 mg/m2 for unrelated bone marrow transplantation in elderly patients.4 Since 2005, we have been using this non-TBI regimen for RI-CBT. In the present paper, the results of this RI-CBT procedure are reviewed.

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Acknowledgements

We are grateful to Dr Seitaro Terakura and Professor Tomoki Naoe (Nagoya University Graduate School of Medicine) for their critical reading of the paper. We thank all the staff and resident members of the participating institutions.

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Authors and Affiliations

  1. Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    H Narimatsu, K Sugimoto & M Murata

  2. Department of Hematology, Fujita Health University Hospital, Toyoake, Japan

    M Watanabe

  3. Division of Hematology and Oncology, JA Aichi Showa Hospital, Konan, Japan

    A Kohno & Y Morishita

  4. Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Y Kuwatsuka & K Miyamura

  5. Department of Hematology, Nagoya Daini Red Cross Hospital, Nagoya, Japan

    T Uchida

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  1. H Narimatsu
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  2. M Watanabe
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  3. A Kohno
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  4. K Sugimoto
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  5. Y Kuwatsuka
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  6. T Uchida
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  7. M Murata
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  8. K Miyamura
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for the Nagoya Blood and Marrow Transplantation Group (NBMTG)

Corresponding author

Correspondence to H Narimatsu.

Appendix

Appendix

This study was conducted at the following institutions in NBMTG: Nagoya University Hospital, Nagoya; Fujita Health University Hospital, Toyoake; JA Aichi Showa Hospital, Konan; Japanese Red Cross Nagoya First Hospital, Nagoya; and Nagoya Daini Red Cross Hospital, Nagoya, Japan.

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Narimatsu, H., Watanabe, M., Kohno, A. et al. High incidence of graft failure in unrelated cord blood transplantation using a reduced-intensity preparative regimen consisting of fludarabine and melphalan. Bone Marrow Transplant 41, 753–756 (2008). https://doi.org/10.1038/sj.bmt.1705978

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