Summary:
We report results of unrelated cord blood transplants (UCBT) in 29 pediatric recipients in one center and the risk factors associated with survival. Median age: 9 years (0.5–20); diagnosis: ALL (9), AML (4), CML (1), HD (3), HLH (1), NHL (3), NBL (2); B-thal (1), FA (1), FEL (1), Krabbe (1), WAS (1), SAA (1); median follow-up: 11 months; conditioning: total body irradiation (TBI)-ablative (14), chemotherapy-ablative (6) and reduced intensity chemotherapy (9); GVHD prophylaxis: MMF/FK506 (18), cyclosporin A (CsA)+steroids±MMF (7) or CsA+methotrexate (MTX) (4); median total nucleated cells (TNC): 3.8 × 107/kg (1.1–11); median CD34+: 2.3 × 105/kg (0.2–9.9); and HLA match: 2 (6/6), 5 (5/6), 22 (4/6). Neutrophil engraftment by cumulative incidence curves 63% (median 28 (95% confidence interval (CI) 18–32)). Probability of ⩾grade II acute graft-versus-host disease (aGVHD) by day +60 27%, ⩾grade III aGVHD 20% and chronic graft-versus-host disease 3%. Estimated 1-year overall survival (OS) 46% (95% CI 30–71) and standard risk 60% (95% CI 29–100%). Variables associated with improved survival by multivariate analysis include non-TBI-ablative conditioning (P=0.024), CD34+/kg (P=0.038) and gender (P=0.048). These results suggest that CD34/kg cell dose and non-TBI-ablative conditioning may be important variables influencing OS following UCBT in pediatric recipients. Given the small number of patients, these results should be viewed cautiously.
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Acknowledgements
This work was supported in part by the Pediatric Cancer Research Foundation, Triple C Foundation, Swim Across America and Children's Medical Care Foundation (JS). We thank the nursing staff on 5Tower (Inpatient) and Irving 7 (Outpatient) and the Pediatric BMT Team at the Morgan Stanley Children's Hospital of New York – Presbyterian for their outstanding support and care of our patients. We also like to thank Linda Rahl for her expert editorial assistance in the preparation of this paper.
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Presented in part at the Tandem BMT Meeting, ASBMT, Keystone, Colorado, January 2003
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Styczynski, J., Cheung, YK., Garvin, J. et al. Outcomes of unrelated cord blood transplantation in pediatric recipients. Bone Marrow Transplant 34, 129–136 (2004). https://doi.org/10.1038/sj.bmt.1704537
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DOI: https://doi.org/10.1038/sj.bmt.1704537
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