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