Cord Blood Transplantation from Unrelated Donors for Children with Acute Lymphoblastic Leukemia in Japan: The Impact of Methotrexate on Clinical Outcomes

Cord blood transplantation (CBT) from an unrelated donor is recognized as one of the major treatment modalities in allogeneic stem cell transplantation (SCT) for children with hematologic malignancies. We analyzed the clinical outcomes of CBT for children with acute lymphoblastic leukemia (ALL) in Japan and identified the risk factors for the transplant outcomes. From 1997 to 2006, 332 children with ALL underwent CBT from unrelated donors, 270 of which had no prior transplant. Their disease statuses at transplant were first complete remission (CR) (n = 120), second CR (n = 71), and more advanced stages (n = 75). As preconditioning for SCT, total body irradiation (TBI) was given to 194 patients and, for the prophylaxis of graft-versus-host disease (GVHD), methotrexate (MTX) was given to 159 patients. The cumulative incidents of neutrophil and platelet recovery (>20 K) were 88.5% and 78.4%, respectively. The incidents of grade II-IV, III-IV acute GVHD (aGVHD), and chronic GVHD (cGVHD) were 45.6%, 20.4%, and 19.2%, respectively, and treatment-related mortality was 22.6%. The 5-year event-free survival (EFS) and overall survival (OS) at CR1, CR2, and advanced status were 47.4%, 45.5%, 15.0%, and 63.7%, 59.7%, and 20.7%, respectively. Multivariate analysis revealed that MTX with calcineurin inhibitor (CNI) was associated with decreased incidence of grade II-IV GVHD (CNI alone: hazard ratio [HR] = 1.74, 95% confidence interval [CI] = 1.06-2.83, P = .027; CNI + prednisolone (PSL), HR = 1.61, 95% CI = 1.03-2.50, P = .036), III-IV aGVHD (CNI alone: HR = 3.02, 95% CI = 1.55-5.91, P = 0.001; CNI + PSL, HR = 1.89, 95% CI = 0.93-3.83, P = .078), or cGVHD (CNI alone: HR = 1.78, 95% CI = 0.83-3.82, P = .143; CNI + PSL, HR = 2.44, 95% CI = 1.24-4.82, P = .01), compared with CNI alone or CNI + PSL. At an advanced stage of disease, GVHD prophylaxis with MTX + CNI is associated with improved OS compared with CNI alone (CNI alone: HR = 3.20, 95% CI = 1.43-7.15, P = .005; CNI + PSL, HR = 1.47, CI = 0.67-3.20, P = .332). Our retrospective study showed that CBT for children with ALL is feasible and GVHD prophylaxis with MTX + CNI is associated with significant favorable outcomes in prevention of aGVHD and cGVHD as well as survival advantage in advanced cases

Eeffect of the Miyagiken-oki Earthquake of June 12, 1978, on Sewerage Systems

1978年宮城県沖地震による下水道施設の被害および復旧の概略をガス，上水道，電力(生産研究31巻2号，4号，6号)の各施設に続き報告する

Reconnaissance report on the 2000 Tottori-ken Seibu Earthquake

金沢大学理工研究域地球社会基盤学系Damage done to civil structures by the 2000 Tottori-ken Seibu Earthquake was investigated. Field surveys were made from October 8-10 by eight members dispatched by the JSCE in cooperation with other researchers. Descriptions are given of the earthquake, seismic ground motion; the damage done to such civil structures as roads, road bridges, lifelines, dams, port facilities; slope failures; and public risk management. Although peak ground accelerations were extremely intensive, structural damage was not as severe as compared with the average damage caused by past earthquakes in Japan. Such disaster responses as search and rescue activities, emergency responses, disaster information communication, and victim supports are discussed

Reconnaissance report on the 2000 Tottori-ken Seibu Earthquake

金沢大学理工研究域地球社会基盤学系Damage done to civil structures by the 2000 Tottori-ken Seibu Earthquake was investigated. Field surveys were made from October 8-10 by eight members dispatched by the JSCE in cooperation with other researchers. Descriptions are given of the earthquake, seismic ground motion; the damage done to such civil structures as roads, road bridges, lifelines, dams, port facilities; slope failures; and public risk management. Although peak ground accelerations were extremely intensive, structural damage was not as severe as compared with the average damage caused by past earthquakes in Japan. Such disaster responses as search and rescue activities, emergency responses, disaster information communication, and victim supports are discussed