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.

  • Original Article
  • Published:

Cord Blood Stem Cells

Results of an unrelated transplant search strategy using partially HLA-mismatched cord blood as an immediate alternative to HLA-matched bone marrow

Summary:

Cord blood (CB) is an alternative to other sources of stem cells for transplantation. However, the impact of including CB in the initial strategy of unrelated graft search in a cohort of patients has been the object of limited analysis. Here, we report the results of such a strategy in 91 consecutive children. Absence of mismatch was required for adult donors, and up to two mismatches were allowed for CB grafts, with a nucleated cell dose over 2.5 × 107 cells/kg. A graft was found for 84 of the 85 children who remained available for a 3-month search. In all, 64 patients were transplanted, 36 with CB and 28 with bone marrow (BM). Primary graft failure, acute grade II–IV and extensive chronic graft-versus-host disease occurred in five, five and zero CB, and in three, one and two BM patients, respectively. The 3-year survival was 59% in CB and 57% in BM patients. Accepting CB as a source of stem cells offers a graft to almost every child in need of an unrelated transplantation, with a probability of survival similar to that of unrelated BM transplantation.

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

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

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

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Gluckman E, Rocha V, Boyer-Chammard A 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 

  2. Rubinstein P, Carrier C, Scaradavou A 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 

  3. Barker JN, Krepski TP, DeFor TE et al. Searching for unrelated donor hematopoietic stem cells: availability and speed of umbilical cord blood vs bone marrow. Biol Blood Marrow Transplant 2002; 8: 257–260.

    Article  Google Scholar 

  4. Giraud P, Thuret I, Reviron D et al. Immune reconstitution and outcome after unrelated cord blood transplantation: a single paediatric institution experience. Bone Marrow Transplant 2000; 25: 53–57.

    Article  CAS  Google Scholar 

  5. Locatelli F, Rocha V, Chastang C et al. Cord blood transplantation for children with acute leukemia. Eurocord Transplant Group. Bone Marrow Transplant 1998; 21 (Suppl. 3): S63–S65.

    PubMed  Google Scholar 

  6. Locatelli F, Rocha V, Chastang C 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 

  7. Locatelli F, Giorgiani G, Giraldi E et al. Cord blood transplantation in childhood. Haematologica 2000; 85: 26–29.

    CAS  PubMed  Google Scholar 

  8. Rocha V, Cornish J, Sievers EL 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 

  9. Zecca M, Prete A, Rondelli R et al. Chronic graft-versus-host disease in children: incidence, risk factors, and impact on outcome. Blood 2002; 100: 1192–1200.

    Article  CAS  Google Scholar 

  10. Rubinstein P, Dobrila L, Rosenfield RE et al. Processing and cryopreservation of placental/umbilical cord blood for unrelated bone marrow reconstitution. Proc Natl Acad Sci USA 1995; 92: 10119–10122.

    Article  CAS  Google Scholar 

  11. Przepiorka D, Weisdorf D, Martin P et al. 1994 Consensus Conference on Acute GVHD Grading. Bone Marrow Transplant 1995; 15: 825–828.

    CAS  PubMed  Google Scholar 

  12. Shulman HM, Sullivan KM, Weiden PL et al. Chronic graft-versus-host syndrome in man. A long-term clinicopathologic study of 20 Seattle patients. Am J Med 1980; 69: 204–217.

    Article  CAS  Google Scholar 

  13. Pedron B, Duval M, Elbou OM et al. Common genomic HLA haplotypes contributing to successful donor search in unrelated hematopoietic transplantation. Bone Marrow Transplant 2003; 31: 423–427.

    Article  CAS  Google Scholar 

  14. Champagne MA, Vachon MF, Roy G et al. Cord blood banking for potential use in a pediatric population. J Pediatr Hematol Oncol 1999; 21.

  15. Grewal SS, Barker JN, Davies SM et al. Unrelated donor hematopoietic cell transplantation: marrow or umbilical cord blood? Blood 2003; 101: 4233–4244.

    Article  CAS  Google Scholar 

  16. Beatty PG, Mori M, Milford E . Impact of racial genetic polymorphism on the probability of finding an HLA-matched donor. Transplantation 1995; 60: 778–783.

    Article  CAS  Google Scholar 

  17. Brown J, Poles A, Brown CJ et al. HLA-A, -B and -DR antigen frequencies of the London Cord Blood Bank units differ from those found in established bone marrow donor registries. Bone Marrow Transplant 2000; 25: 475–481.

    Article  CAS  Google Scholar 

  18. Barker JN, Davies SM, DeFor T et al. 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 

Download references

Acknowledgements

JH Dalle is a fellow of La Fondation Charles-Bruneau. We thank Sonia Bizier for her technical assistance. The HSCT team recognizes the contribution of the patients and their families, and of the numerous members of the staff of the hospital involved in the care of these patients.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M A Champagne.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dalle, J., Duval, M., Moghrabi, A. 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 33, 605–611 (2004). https://doi.org/10.1038/sj.bmt.1704433

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1704433

Keywords

This article is cited by

Search

Quick links