Abstract
Umbilical cord blood (UCB) has emerged as an appealing alternative source of hematopoietic stem cells for unrelated donor transplantation. Shorter time to transplant and an improved chance of finding a suitable graft are evident advantages over bone marrow transplantation from unrelated donors. The majority of UCB transplants from unrelated donors have been performed in children, but the number in adults has been growing steadily in recent years. We review herein the reported experience with that source of hematopoietic stem cells in adults with hematological malignancies. The available data support the use of UCB transplantation from unrelated donors for young adults with hematological malignancies and no appropriate bone marrow donor, especially for those requiring urgent transplantation.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
National Marrow Donor Program www.nmdp.org
Gluckman E, Broxmeyer HE, Auerbach AD, Friedman H, Douglas G, Devergie A, Esperou H, Thierry D, Socie G, Lehn P, Cooper S, English D, Kurtzberg J, Bard J, Boyse E . Hematopoietic reconstitution in a patient with Fanconi's anemia by means of umbilical-cord blood from an HLA-identical sibling N Engl J Med 1989 321: 1174–1178
Barker JN, Krepski TP, DeFor T, Wagner JE, Weisdorf DJ . Searching for unrelated donor hematopoietic stem cell grafts: availability and speed of umbilical cord blood versus bone marrow Blood 2001 98 (Suppl. 1): 665a
Stagno S, Pass RF, Cloud G, Britt WJ, Henderson RE, Walton PD, Veren DA, Page F, Alford CA . Primary cytomegalovirus infection in pregnancy. Incidence, transmission to fetus and clinical outcome J Am Med Assoc 1986 256: 1904–1908
Stagno S, Pass RF, Dworsky ME, Henderson RE, Moore EG, Walton PD, Alford CA . Congenital cytomegalovirus infection. The relative importance of primary and recurrent maternal infection N Engl J Med 1982 306: 945–949
Chang RS, Seto DS . Perinatal infection by Epstein–Barr virus Lancet 1979 2: 201
Mayani H, Lansdorp PM . Thy-1 expression is linked to functional properties of primitive hematopoietic progenitor cells from human umbilical cord blood Blood 1994 83: 2410–2417
Vaziri H, Dragowska W, Allsopp RC, Thomas TE, Harley CB, Lansdorp PM . Evidence for a mitotic clock in human hematopoietic stem cells: loss of telomeric DNA with age Proc Natl Acad Sci USA 1994 91: 9857–9860
Gluckman E, Rocha V, Boyer-Chammard A, Locatelli F, Arcese W, Pasquini R, Ortega J, Souillet G, Ferreira E, Laporte JP, Fernandez M, Chastang C . Outcome of cord blood transplantation from related and unrelated donors. Eurocord Transplant Group and the European Blood and Marrow Transplantation Group N Engl J Med 1997 337: 373–381
Rubinstein P, Carrier C, Scaradavou M, Kurtzberg J, Adamson J, Migliaccio AR, Berkowitz RL, Cabbad M, Dobrila NL, Taylor PE, Rosenfield RE, Stevens CE . Outcomes among 562 recipients of placental blood transplants from unrelated donors N Engl J Med 1998 339: 1565–1577
Laughlin MJ, Barker J, Bambach B, Koc ON, Rizzieri DA, Wagner JE, Gerson SL, Lazarus HM, Cairo M, Stevens CE, Rubinstein P, Kurtzberg J . Hematopoietic engraftment and survival in adult recipients of umbilical-cord blood from unrelated donors N Engl J Med 2001 344: 1815–1822
Sanz GF, Saavedra S, Planelles D, Senent L, Cervera J, Barragan E, Jimenez C, Larrea L, Martin G, Martinez J, Jarque I, Moscardo F, Plume G, Andreu R, Regadera AI, Garcia I, Molla S, Solves P, de La Rubia J, Bolufer P, Benlloch L, Soler MA, Marty ML, Sanz MA . Standardized, unrelated donor cord blood transplantation in adults with hematologic malignancies Blood 2001 98: 2332–2338
Iseki T, Ooi J, Tomonari A, Takahashi T, Ishii K, Uchimaru K, Sekine R, Ishikawa K, Ebihara Y, Tsuruta T, Manabe A, Tojo A, Tsuji K, Tani K, Asano S . Unrelated cord blood transplantation in adult patients with hematological malignancy: a single institution experience Blood 2001 98 (Suppl. 1): 665a
Rocha V, Arcese W, Sanz G, Laporte JP, Takahashi T, Fernandez M, Granena A, Chevret S, Gluckman E . Prognostic factors of outcome after unrelated cord blood transplant in adults with hematologic malignancies Blood 2000 96 (Suppl. 1): 587a
Laporte J-P, Gorin N-C, Rubinstein P, Lesage S, Portnoi MF, Barbu V, Lopez M, Douay L, Najman A . Cord-blood transplantation from an unrelated donor in an adult with chronic myelogenous leukemia N Engl J Med 1996 35: 167–170
Lambertenghi Deliliers G, Soligo D, Della Volpe A, Bertolini F, Poli F, Romitti L, Tagliaferri E, Ibatici A, Onida F, Annaloro C, Gattinoni L, Sirchia G . Unrelated mismatched cord blood transplantation in an adult with secondary AML Bone Marrow Transplant 1996 18: 469–472
Gonzalez Barca E, Querol S, Graæena A, Sarra J, Sirchia G, Garcia J . Umbilical cord blood transplantation from an unrelated donor in an adult weighing 90 kilograms. Role of immunosuppression in engraftment Bone Marrow Transplant 1997 20: 333–336
Laporte JP, Lesage S, Portnoi MF, Landman J, Rubinstein P, Najman A, Gorin NC . Unrelated mismatched cord blood transplantation in patients with hematological malignancies: a single institution experience Bone Marrow Transplant 1998 22 (Suppl. 1): S76–77
Laughlin MJ, Rizzieri DA, Smith CA, Moore JO, Lilly S, McGaughey D, Martin P, Carrier C, Stevens CE, Rubinstein P, Buckley R, Kurtzberg J . Hematologic engraftment and reconstitution of immune function post unrelated placental cord blood transplant in an adult with acute lymphocytic leukemia Leuk Res 1998 22: 215–219
Gian VG, Moreb JS, Abdel-Mageed A, Weeks FM, Scornick JC, Wingard JR . Successful salvage using mismatched umbilical cord blood transplant in an adult with recurrent acute myelogenous leukemia failing autologous peripheral blood progenitor cell transplant: a case history and review Bone Marrow Transplant 1998 21: 1197–1200
Nagayama H, Nakayama K, Yasuo K, Tajika K, Dan K, Yamashita N, Asano S, Takahashi TA . Immunological reconstitution after cord blood transplantation for an adult patient Bone Marrow Transplant 1999 24: 211–213
Nieto Y, Russ P, Everson G, Bearman SI, Cagnoni PJ, Jones RB, Shpall EJ . Acute pancreatitis during immunosuppression with tacrolimus following an allogeneic umbilical cord blood transplantation Bone Marrow Transplant 2000 26: 109–111
Mao P, Liao C, Zhu Z, Wang H, Wang S, Xu Y, Mo W, Ying Y, Li Q, Liu B . Umbilical cord blood transplantation from unrelated HLA-matched donor in an adult with severe aplastic anemia Bone Marrow Transplant 2000 26: 1121–1123
Pecora AL, Stiff P, Jennis A, Goldberg S, Rosenbluth R, Price P, Goltry KL, Douville J, Armstrong RD, Smith AK, Preti RA . Prompt and durable engraftment in two older adult patients with high risk chronic myelogenous leukemia (CML) using ex vivo expanded and unmanipulated unrelated umbilical cord blood Bone Marrow Transplant 2000 25: 797–799
Goldberg SL, Pecora AL, Rosenbluth RJ, Jennis AA, Preti RA . Treatment of leukemic relapse following unrelated umbilical cord blood transplantation with interleukin-2: potential for augmenting graft-versus-leukemia and graft-versus-host with cytokines Bone Marrow Transplant 2000 26: 353–355
Lau FY, Wong R, Chui CH, Cheng G . Successful engraftment in two adult patients with severe aplastic anemia using nonmyeloablative conditioning followed by unrelated HLA-mismatched cord blood transplantation J Hematother Stem Cell Res 2001 10: 309–311
Ooi J, Iseki T, Nagayama H, Tomonari A, Ito K, Shirafuji N, Tojo A, Tani K, Asano S . Unrelated cord blood transplantation for adult patients with myelodysplastic syndrome-related secondary acute myeloid leukaemia Br J Haematol 2001 114: 834–836
Sanz GF, Saavedra S, Jimenez C, Senent L, Cervera J, Planelles D, Bolufer P, Larrea L, Martin G, Martinez J, Jarque I, Moscardo F, Plume G, Andreu R, de la Rubia J, Barragan E, Solves P, Soler MA, Sanz MA . Unrelated donor cord-blood transplantation in adults with chronic myelogenous leukemia: results in nine patients from a single institution Bone Marrow Transplant 2001 27: 693–701
Fernandez MN, Regidor C, Cabrera R, Garcia-Marco J, Briz M, Fores R, Sanjuan I, McWhinnie A, Querol S, Garcia J, Madrigal A . Cord blood transplants: early recovery of neutrophils from co-transplanted sibling haploidentical progenitor cells and lack of engraftment of cultured cord blood cells, as ascertained by analysis of DNA polymorphisms Bone Marrow Transplant 2001 28: 355–363
Rizzieri DA, Long GD, Vredenburgh JJ, Gasparetto C, Morris A, Stenzel TT, Davis P, Chao NJ . Successful allogeneic engraftment of mismatched unrelated cord blood following a nonmyeloablative preparative regimen Blood 2001 98: 3486–3488
Cairo MS, Wagner JE . Placental and/or umbilical cord blood: an alternative source of hematopoietic stem cells for transplantation Blood 1997 90: 4665–4678
Rocha V, Cornish J, Sievers E, Filipovich A, Locatelli F, Peters C, Remberger M, Michel G, Arcese W, Dallorso S, Tiedemann K, Busca A, Chan KW, Kato S, Ortega J, Vowels M, Zander A, Souillet G, Oakill A, Woolfrey A, Pay AL, Green A, Garnier F, Ionescu I, Wernet P, Sirchia G, Rubinstein P, Chevret S, Gluckman E . Comparison of outcomes of unrelated bone marrow and umbilical cord blood transplants in children with acute leukemia Blood 2001 97: 2962–2971
Migliaccio AR, Adamson JW, Stevens CE, Dobrila NL, Carrier CM, Rubinstein P . Cell dose and speed of engraftment in placental/umbilical cord blood transplantation: graft progenitor cell content is a better predictor than nucleated cell quantity Blood 2000 96: 2717–2722
Papadopoulos EB, Carabasi MH, Castro-Malaspina H, Childs BH, Mackinnon S, Boulad F, Gillio AP, Kernan NA, Small TN, Szabolcs P, Taylor J, Yahalom J, Collins NH, Bleau SA, Black PM, Heller G, O'Reilly RJ, Young JW . T-cell-depleted allogeneic bone marrow transplantation as postremission therapy for acute myelogenous leukemia: freedom from relapse in the absence of graft-versus-host disease Blood 1998 91: 1083–1090
Aversa F, Tabilio A, Velardi A, Cunningham I, Terenzi A, Falzetti F, Ruggeri L, Barbabietola G, Aristei C, Latini P, Reisner Y, Martelli MF . Treatment of high-risk acute leukemia with T-cell-depleted stem cells from related donors with one fully mismatched haplotype N Engl J Med 1998 339: 1186–1193
Locatelli F, Rocha V, Ertem M, Graphacos S, Bernaudin F, Li X, Brichard B, Nagler A, Miniero R, Roberts I, Yaniv I, Lutz P, Will A, Raja T, Garnier F, Gluckman E . Influence of preparative regimen and methotrexate for GVHD prophylaxis on engraftment after related cord blood transplant for patients with hemoglobinopathies Blood 2000 96 (Suppl. 1): 200a
Barker JN, Davies SM, DeFor T, Ramsay NKC, Weisdorf DJ, Wagner JE . Survival after transplantation of unrelated donor umbilical cord blood is comparable to that of human leukocyte antigen-matched unrelated donor bone marrow: results of a matched-pair analysis Blood 2001 97: 2957–2961
Davies SM, Kollman C, Anasetti C, Antin JH, Gajewski J, Casper JT, Nademanee A, Noreen H, King R, Confer D, Kernan NA . Engraftment and survival after unrelated-donor bone marrow transplantation: a report from the national marrow donor program Blood 2000 96: 4096–4102
Hansen JA, Gooley TA, Martin PJ, Appelbaum F, Chauncey TR, Clift RA, Petersdorf EW, Radich J, Sanders JE, Storb RF, Sullivan KM, Anasetti C . Bone marrow transplants from unrelated donors for patients with chronic myeloid leukemia N Engl J Med 1998 338: 962–968
McGlave PB, Shu XO, Wen W, Anasetti C, Nademanee A, Champlin R, Antin JH, Kernan NA, King R, Weisdorf DJ . Unrelated donor marrow transplantation for chronic myelogenous leukemia: 9 years experience of the National Marrow Donor Program Blood 2000 95: 2219–2225
Locatelli F, Rocha V, Chastang C, Arcese W, Michel G, Abecasis M, Messina C, Ortega J, Badell-Serra I, Plouvier E, Souillet G, Jouet JP, Pasquini R, Ferreira E, Garnier F, Gluckman E . Factors associated with outcome after cord blood transplantation in children with acute leukemia. Eurocord Cord Blood Transplant Group Blood 1999 93: 3662–3671
Rubinstein P, Carrier C, Carpenter C, Cheung C, Huang F, Scaradavou A, Dobrila L, Stevens C . Graft selection in unrelated placental/umbilical cord blood (PBC) transplantation: influence and weight of HLA match and cell dose on engraftment and survival Blood 2000 96 (Suppl. 1): 588a
Drobyski WR, Klein J, Flomenberg N, Pietryga D, Vesole DH, Margolis DA, Keever-Taylor CA . Superior survival associated with transplantation of matched unrelated versus one-antigen-mismatched unrelated or highly human leukocyte antigen- disparate haploidentical family donor marrow grafts for the treatment of hematologic malignancies: establishing a treatment algorithm for recipients of alternative donor grafts Blood 2002 99: 806–814
McSweeney PA, Bearman SI, Jones RB, Nieto Y, Cagnoni PJ, McNiece IK, Slat-Vasquez V, Ward V, Shpall EJ . Nonmyeloablative hematopoietic cell transplants using cord blood Blood 2001 98 (Suppl. 1): 666a
Barker JN, DeFor TE, Repka TL, Weisdorf DJ, Wagner JE . Unrelated donor umbilical cord blood transplantation after non-myeloablative conditioning in adults: rapid and complete donor chimerism Blood 2001 98 (Suppl. 1): 814a
Kogler G, Nurnberger W, Fischer J, Niehues T, Somville T, Gobel U, Wernet P . Simultaneous cord blood transplantation of ex vivo expanded together with non-expanded cells for high risk leukemia Bone Marrow Transplant 1999 24: 397–403
Shpall E, Quinones R, Giller R, Jones RB, Bearman SI, Cagnoni P, Nieto Y, McSweeney P, Murphy J, Hogan C, Gocke A, Ward W, Slat-Vasquez V, Russell P, Blunk B, Solzan M, McNiece I . Transplantation of adult and pediatric cancer patients with cord blood progenitors expanded ex vivo Blood 2000 96 (Suppl. 1): 207a
Goldberg SL, Chedid S, Jennis AA, Preti RA, Pecora AL . Unrelated cord blood transplantation in adults: a single institution experience Blood 2000 96 (Suppl. 1): 208a
Guenechea G, Segovia JC, Albella B, Lamana M, Ramirez M, Regidor C, Fernandez MN, Bueren JA . Delayed engraftment of nonobese diabetic/severe combined immunodeficient mice transplanted with ex vivo-expanded human CD34(+) cord blood cells Blood 1999 93: 1097–1105
McNiece IK, Almeida-Porada G, Shpall EJ, Zanjani ED . Ex vivo expanded cord blood cells provide rapid engraftment in fetal sheep but lack long-term engrafting potential Blood 2001 98 (Suppl. 1): 1990a
Barker JN, Weisdorf DJ, DeFor TE, Davies SM, Verfaillie CM, Wagner JE . Impact of multiple unit unrelated donor umbilical cord blood transplantation in adults: preliminary analysis of safety and efficacy Blood 2001 98 (Suppl. 1): 666a
Gryn J, Harris DT, Shadduck RK, Lister J, Raymond J, Ziegler Z, Lech J, Thimmons M . Multiple unmatched umbilical cord units (MUCs) for adult allogeneic transplantation Blood 2001 98 (Suppl. 1): 666a
Acknowledgements
This work was supported in part by Grant No. 01/0066–01 from the Fondo de Investigación Sanitaria (FIS), Ministerio de Sanidad of Spain.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sanz, M., Sanz, G. Unrelated donor umbilical cord blood transplantation in adults. Leukemia 16, 1984–1991 (2002). https://doi.org/10.1038/sj.leu.2402688
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.leu.2402688
Keywords
This article is cited by
-
Effect of graft source on mismatched unrelated donor hemopoietic stem cell transplantation after reduced intensity conditioning
Leukemia (2013)
-
Outcome following unrelated cord blood transplant in 136 patients with malignant and non-malignant diseases: a report from the Australian and New Zealand children's haematology and oncology group
Bone Marrow Transplantation (2009)
-
Haploidentical haematopoietic stem cell transplantation for acute leukaemia in adults: experience in Europe and the United States
Bone Marrow Transplantation (2008)
-
Hematopoietic stem cell transplantation across major genetic barriers
Immunologic Research (2007)
-
Outcomes of unrelated cord blood transplantation in pediatric recipients
Bone Marrow Transplantation (2004)