학술논문
Outcome following unrelated cord blood transplant in 136 patients with malignant and non-malignant diseases: a report from the Australian and New Zealand childrenʼs haematology and oncology group
Document Type
Academic Journal
Author
Source
Bone Marrow Transplantation. Feb 01, 2009 43(3):207-215
Subject
Language
English
ISSN
0268-3369
Abstract
Unrelated umbilical cord blood (UCB) is an alternative stem cell source for paediatric patients lacking a matched related or unrelated marrow donor. We report the results of all paediatric unrelated UCB transplants performed in Australia and New Zealand over a 10-year period. A total of 135 patients were transplanted, 100 for malignant disease (74%) and 35 for non-malignant disorders. The majority (88%) of patients received an HLA-mismatched graft. The median infused total nucleated cell dose was 4.7 × 10/kg and CD34 + count 1.9 × 10/kg. Neutrophil engraftment occurred in 83% of patients by day 42 (median 23 days) and platelet engraftment in 55% by day 60 (median 56 days). Grades II-IV and III-IV acute GVHD occurred in 41 and 18% of patients, respectively. TRM and overall survival 1-year post transplant were 32 and 61%, respectively. A higher probability of neutrophil recovery (P = 0.004) and faster time to recovery (median 18 days vs 26 days, P = 0.008) were observed in recipients of a cord unit with a CD34 cell dose ≥ 1.7 × 10/kg. Our results support selection of cord units with CD34 cell doses ≥ 1.7 × 10/kg to promote faster engraftment, improve survival and lower TRM.