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Cord Blood Stem Cells

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 volume 43, pages 207–215 (2009)Cite this article

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 × 107/kg and CD34+ count 1.9 × 105/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 × 105/kg. Our results support selection of cord units with CD34 cell doses ⩾1.7 × 105/kg to promote faster engraftment, improve survival and lower TRM.

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Acknowledgements

We thank each of the individual paediatric transplant centers including the nursing, allied health and medical staff for their outstanding support and care. We also acknowledge the tremendous contribution from all the data managers in each center involved.

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Authors and Affiliations

  1. Centre for Children's Cancer & Blood Disorders, Sydney Children's Hospital, Sydney, New South Wales, Australia

    T E Petterson, M Gabriel, C Oswald, M R Vowels & T A O'Brien

  2. The Royal Children's Hospital, Melbourne, Victoria, Australia

    K Tiedemann

  3. Starship Children's Hospital, Auckland, New Zealand

    L Teague

  4. The Children's Hospital at Westmead, Sydney, New South Wales, Australia

    P J Shaw

  5. Princess Margaret Hospital, Perth, Western Australia

    D Baker

  6. The Royal Children's Hospital, Brisbane, Queensland, Australia

    R Bolton-Jones

  7. Adelaide Women's & Children's Hospital, Adelaide, South Australia

    H Tapp

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  1. T E Petterson
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Correspondence to T A O'Brien.

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Petterson, T., Gabriel, M., Tiedemann, K. et al. 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 Transplant 43, 207–215 (2009). https://doi.org/10.1038/bmt.2008.314

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