Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review
  • Published:

Pediatric related and unrelated cord blood transplantation for malignant diseases

Bone Marrow Transplantation volume 44, pages 653–659 (2009)Cite this article

Abstract

The use of umbilical or placental donor cord blood transplantation (CBT) in children with malignant and non-malignant diseases has witnessed important progress, mainly because of better cord blood donor choice and patient selection translating into better patient outcome. Approximately 2000 children with malignant diseases (about 75 % with acute leukemias) have been transplanted with a related (n=199) or unrelated CBT (UCBT, n=1663) and reported to Eurocord registry from 1990–2008. Disease-specific studies have been carried out after UCBT for acute lymphoblastic and myeloid leukemia and myelodysplastic syndromes in others to identify the risk factors that may improve outcomes. Outcomes after CBT have been compared with other alternative allogeneic hematopoietic SCT (HSCT) donors. Briefly, after CBT, myeloid engraftment is delayed, acute and chronic GVHD decreased and disease-free survival was not statistically different when compared with HLA identical and other alternative HSCT donor. Therefore, any physician has to carefully evaluate, for each single pediatric patient in need of an allograft, all the possible alternatives in order to choose the best hematopoietic stem cell donor, taking into account type of disease, urgency of transplantation, donor characteristics and center experience. This review will analyze the current results of CBT for pediatric patients with malignant diseases and the advantages and limitations of using this stem cell source.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. Gluckman E, Broxmeyer HE, Auerbach AD, Friedman HS, Douglas GW, Devergie A et al. 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.

    Article  CAS  Google Scholar 

  2. Gluckman E, Rocha V, Boyer-Chammard A, Locatelli F, Arcese W, Pasquini R et al. 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.

    Article  CAS  Google Scholar 

  3. Rocha V, Chastang C, Souillet G, Pasquini R, Plouvier E, Nagler A et al. Related cord blood transplants: the Eurocord experience from 78 transplants. Eurocord Transplant Group. Bone Marrow Transplant 1998; 21: S59–S62.

    Article  Google Scholar 

  4. Locatelli F, Rocha V, Chastang C, Arcese W, Michel G, Abecasis M et al. Factors associated with outcome after cord blood transplantation in children with acute leukemia. Eurocord-Cord Blood Transplant Group. Blood 1999; 93: 3662–3671.

    CAS  PubMed  Google Scholar 

  5. Locatelli F, Rocha V, Reed W, Bernaudin F, Ertem M, Grafakos S et al. Related umbilical cord blood transplant in patients with thalassemia and sickle cell disease. Blood 2003; 101: 2137–2143.

    Article  CAS  Google Scholar 

  6. Rubinstein P, Carrier C, Scaradavou A, Kurtzberg J, Adamson J, Migliaccio AR et al. Outcomes among 562 recipients of placental-blood transplants from unrelated donors. N Engl J Med 1998; 339: 1565–1577.

    Article  CAS  Google Scholar 

  7. Wagner JE, Barker JN, DeFor TE, Baker KS, Blazar BR, Eide C et al. Transplantation of unrelated donor umbilical cord blood in 102 patients with malignant and nonmalignant diseases: influence of CD34 cell dose and HLA disparity on treatment-related mortality and survival. Blood 2002; 100: 1611–1618.

    CAS  PubMed  Google Scholar 

  8. Rocha V, Wagner JE, Sobocinski KA, Klein JP, Zhang MJ, Horowitz MM et al. Graft-versus-host disease in children who have received a cord blood or bone marrow transplant from an HLA-identical sibling. N Engl J Med 2000; 342: 1846–1854.

    Article  CAS  Google Scholar 

  9. Rocha V, Cornish J, Sievers E, Filipovich A, Locatelli F, Peters C et al. Comparison of outcomes of unrelated bone marrow and umbilical cord blood transplants in children with acute leukemia. Blood 2001; 97: 2962–2971.

    Article  CAS  Google Scholar 

  10. Barker JN, Davies SM, DeFor T, Ramsay NK, 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.

    Article  CAS  Google Scholar 

  11. Dalle JH, Duval M, Moghrabi A, Wagner JE, Vachon MF, Barrette S et al. Results of an unrelated transplant search strategy using partially HLA-mismatched cord blood as an immediate alternative to HLA-matched bone marrow. Bone Marrow Transplant 2004; 33: 605–611.

    Article  CAS  Google Scholar 

  12. Eapen M, Rubinstein P, Zhang MJ, Stevens C, Kurtzberg J, Scaradavou A et al. Outcomes of transplantation of unrelated donor umbilical cord blood and bone marrow in children with acute leukaemia: a comparison study. Lancet 2007; 369: 1947–1954.

    Article  Google Scholar 

  13. Michel G, Rocha V, Chevret S, Arcese W, Chan KW, Filipovich A et al. Unrelated cord blood transplantation for childhood acute myeloid leukemia: a Eurocord group analysis. Blood 2003; 102: 4290–4297.

    Article  CAS  Google Scholar 

  14. Reed W, Smith R, Dekovic F, Lee JY, Saba JD, Trachtenberg E et al. Comprehensive banking of sibling donor cord blood for children with malignant and nonmalignant disease. Blood 2003; 101: 351–357.

    Article  CAS  Google Scholar 

  15. Kurtzberg J, Prasad VK, Carter SL, Wagner JE, Baxter-Lowe LA, Wall D et al. Results of the Cord Blood Transplantation Study (COBLT): clinical outcomes of unrelated donor umbilical cord blood transplantation in pediatric patients with hematologic malignancies. Blood 2008; 112: 4318–4327.

    Article  CAS  Google Scholar 

  16. Rocha V, Locatelli F . Searching for alternative hematopoietic stem cell donors for pediatric patients. Bone Marrow Transplant 2008; 41: 207–214.

    Article  CAS  Google Scholar 

  17. Locatelli F, Zecca M, Pession A, Maserati E, De Stefano P, Severi F . Myelodysplastic syndromes: the pediatric point of view. Haematologica 1995; 80: 268–279.

    CAS  PubMed  Google Scholar 

  18. Hasle H. Myelodysplastic and myeloproliferative disorders in children. Curr Opin Pediatr 2007; 9: 1–8.

    Article  Google Scholar 

  19. Locatelli F, Zecca M, Niemeyer C, Angelucci E, Arceses G, Bender-Gotze C et al. Role of allogeneic bone marrow transplantation for the treatment of myelodysplastic syndromes in childhood. The European Working Group on Childhood Myelodysplastic Syndrome (EWOG-MDS) and the Austria-Germany-Italy (AGI) Bone Marrow Transplantation Registry. Bone Marrow Transplant 1996; 18: 63–68.

    PubMed  Google Scholar 

  20. Webb DK, Passmore SJ, Hann IM, Harrison G, Wheatley K, Chessells JM . Results of treatment of children with refractory anaemia with excess blasts (RAEB) and RAEB in transformation (RAEBt) in Great Britain 1990-99. Br J Haematol 2002; 117: 33–39.

    Article  Google Scholar 

  21. Barker JN, Krepski TP, DeFor T, Davies SM, Wagner JE, Weisdorf DJ . Searching for unrelated donor hematopoietic stem cell grafts: availability and speed of umbilical cord blood versus bone marrow. Biol Blood Marrow Transplant 2002; 8: 257–260.

    Article  Google Scholar 

  22. Davey S, Armitage S, Rocha V, Garnier F, Brown J, Brown CJ et al. The London Cord Blood Bank: analysis of banking and transplantation outcome. Br J Haematol 2004; 125: 358–365.

    Article  Google Scholar 

  23. Hwang WY, Samuel M, Tan D, Koh LP, Lim W, Linn YC . A meta-analysis of unrelated donor umbilical cord blood transplantation versus unrelated donor bone marrow transplantation in adult and pediatric patients. Biol Blood Marrow Transplant 2007; 13: 444–453.

    Article  Google Scholar 

  24. Rocha V, Gluckman E . Outcomes of transplantation in children with acute leukaemia. Lancet 2007; 369: 1906–1908.

    Article  Google Scholar 

  25. Hough R, Labopin M, Michel G, Locatelli F, Klingebiel T, Arcese W et al. Outcomes of fully haplo-identical haematopoietic stem cell transplantation compared to unrelated cord blood transplantation in children with acute lymphoblastic leukaemia. A retrospective analysis on behalf of Eurocord, PDWP and ALWP of EBMT. Bone Marrow Transplant 2007; 39: S3.

    Google Scholar 

  26. Gluckman E, Rocha V, Arcese W, Michel G, Sanz G, Chan KW et al. Eurocord Group. Factors associated with outcomes of unrelated cord blood transplant: guidelines for donor choice. Exp Hematol 2004; 32: 397–407.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Chair of the Acute Leukaemia Working Party and Scientific Director of Eurocord-Netcord Registry on Behalf of the European Blood and Bone Marrow Transplant Group, Medical Assistant of the HSCT Unit, Hôpital Saint Louis, Paris, France

    V Rocha

  2. Eurocord-Netcord-EBMT office, Hôpital Saint Louis, Paris, France

    N Kabbara, I Ionescu, A Ruggeri, D Purtill & E Gluckman

Authors
  1. V Rocha
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. N Kabbara
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. I Ionescu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A Ruggeri
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D Purtill
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. E Gluckman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to V Rocha.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rocha, V., Kabbara, N., Ionescu, I. et al. Pediatric related and unrelated cord blood transplantation for malignant diseases. Bone Marrow Transplant 44, 653–659 (2009). https://doi.org/10.1038/bmt.2009.291

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2009.291

Keywords

This article is cited by

Search

Advanced search

Quick links