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タナカ ジユンジ
TANAKA Junji
田中 淳司 所属 その他 その他 職種 非常勤嘱託 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Decision Analysis for Unrelated Bone Marrow Transplantation or Immediate Cord Blood Transplantation for Patients with Philadelphia Chromosome-Negative Acute Lymphoblastic Leukemia in First Complete Remission. |
| 掲載誌名 | 正式名：Transplantation and cellular therapy 略 称：Transplant Cell Ther ISSNコード：26666367/26666367 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 28(3),pp.161.e1-161.e10 |
| 著者・共著者 | Kako Shinichi†, Hayakawa Fumihiko, Miyamura Koichi, Tanaka Junji, Imai Kiyotoshi, Kanda Junya, Morishima Satoko, Uchida Naoyuki, Doki Noriko, Ikegame Kazuhiro, Ozawa Yukiyasu, Takada Satoru, Usui Noriko, Ohtake Shigeki, Kiyoi Hitoshi, Matsumura Itaru, Miyazaki Yasushi, Ichinohe Tatsuo, Fukuda Takahiro, Atsuta Yoshiko, Kanda Yoshinobu |
| 発行年月 | 2022/03 |
| 概要 | An HLA-matched relative is the first-choice donor for patients with Philadelphia chromosome (Ph)-negative acute lymphoblastic leukemia (ALL) in first complete remission (CR1). The most promising alternative donor is thought to be an HLA-matched unrelated donor (MUD) in patients who do not have an HLA-matched related donor. Cord blood transplantation (CBT) is an alternative option. Higher rates of engraftment failure and nonrelapse mortality (NRM) are significant problems, but the ready availability of cord blood can be an advantage, because patients can immediately undergo transplantation before progression. This study was conducted to identify an appropriate alternative donor in patients with Ph-negative ALL in CR1 who do not have an HLA-matched related donor (MRD). Decision analyses using a Markov model were performed to compare immediate CBT, in which CBT was performed at 1 month after the achievement of CR1, with elective unrelated bone marrow transplantation (uBMT) from an 8/8 MUD (8/8 uBMT) or uBMT from a 7/8 MUD (7/8 uBMT), in which uBMT was performed at 4 months, in patients age 16 to 55 years with Ph-negative ALL in CR1 who did not have an MRD. We constructed a decision tree. The cycle length was set at 3 months, and analyses were performed for 19 cycles for uBMT and 20 cycles for CBT, resulting in evaluation of the 5-year life expectancy after both decisions. Transition probabilities (TPs) and utilities were estimated from prospective and retrospective Japanese studies and the registry database of Japan. Subgroup analyses were performed according to risk stratification based on WBC count and cytogenetics at diagnosis and according to age stratification, with a cutoff of 25 years. One-way sensitivity analyses for TPs and utilities were performed as well. The baseline analyses showed that 8/8 uBMT or 7/8 uBMT had superior results to CBT, with quality-adjusted life years (QALYs) of 2.86 in 8/8 uBMT, 2.84 in 7/8 uBMT, and 2.75 in CBT. One-way sensitivity analy |
| DOI | 10.1016/j.jtct.2021.11.021 |
| PMID | 34875401 |