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Cord Blood Stem Cells

Transplantation of unrelated donor umbilical cord blood utilizing double-unit grafts for five teenagers with transfusion-dependent thalassemia

Bone Marrow Transplantation volume 40, pages 307–311 (2007)Cite this article

Abstract

To augment graft cell dose, we evaluated the safety of the combined transplantation of two partially HLA-matched umbilical cord blood (UCB) units. Five patients with transfusion-dependent thalassemia, median age 11.1 years (range 10–13.1), received 2 UCB units after myeloablative conditioning. Cord blood units were a 4/6-HLA-match or better with the recipient, and contained a minimum combined pre-freeze CD34 cell dose of 3.0 × 105/kg. All patients engrafted at a median of 15 days (range 12–19). Four patients with durable trilineage engraftment showed acute grade I–III GVHD; none developed extensive chronic GVHD until the date of last contact. The median times to red blood cell transfusion independence and platelet engraftment were 32 and 49 days after transplant, respectively. With a median follow-up of 18.5 months (range 11–32), four patients transplanted with UCB from two different partially HLA-matched donors were transfusion-independent. Therefore, transfusion of two partially HLA-matched UCB units is safe, and may overcome the cell-dose barrier that limits the use of UCB in long-term recipients of multiple transfusions for thalassemia.

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Acknowledgements

We are indebted to the patients and their caretakers for participating in the externally audited results. We would like to thank Professor Delon Wu for his continued support of this program. This work was supported in part by grants from Chang Gung Memorial Hospital (CMRP G33020) and National Science Council (95-2314-B-182A-106).

Material contained in this paper has been presented at the following meetings:

1. Jaing TH. Unrelated cord blood transplantation for hemoglobinopathies. 4th Annual International Umbilical Cord Blood Transplantation Symposium; Los Angeles, CA, USA; May 19–20, 2006.

2. Jaing TH, Tan P, Chan LL, Rosenthal J, Wang B, Gjertson D, Petz L, Chow R. Unrelated Cord Blood Transplantation for Hemoglobinopathy. 11th Congress of the Asia Pacific Bone Marrow Transplantation; Nagoya, Japan; October 27–29, 2006.

3. Jaing TH, Tan P, Rosenthal J, Wang B, Gjertson D, Petz L, Chow R. Unrelated Cord Blood Transplantation (CBT) for Thalassemia. 48th American Society of Hematology Annual Meeting, Orlando, FL, USA; December 9–12, 2006.

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Authors and Affiliations

  1. Divisions of Hematology and Oncology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, Taoyuan, Taiwan

    T-H Jaing, C-P Yang, I-J Hung & S-H Chen

  2. Department of Clinical Pathology, Chang Gung Memorial Hospital, Taoyuan, Taiwan

    C-F Sun

  3. StemCyte Taiwan National Cord Blood Center, Linko, Taiwan

    R Chow

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  1. T-H Jaing
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Correspondence to T-H Jaing.

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Jaing, TH., Yang, CP., Hung, IJ. et al. Transplantation of unrelated donor umbilical cord blood utilizing double-unit grafts for five teenagers with transfusion-dependent thalassemia. Bone Marrow Transplant 40, 307–311 (2007). https://doi.org/10.1038/sj.bmt.1705737

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