Outcome following unrelated cord blood transplant in 136 patients with malignant and non-malignant diseases: a report from the Australian and New Zealand children's haematology and oncology group
| Autor: | Melissa Gabriel, Marcus R. Vowels, Tracey A. O'Brien, Heather Tapp, D. Baker, Cecilia Oswald, Lochie Teague, T.E. Petterson, R. Bolton-Jones, Peter J. Shaw, Karin Tiedemann |
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| Rok vydání: | 2008 |
| Předmět: |
medicine.medical_specialty
Cord Platelet Engraftment Neutrophils Graft vs Host Disease Antigens CD34 Cord Blood Stem Cell Transplantation Umbilical cord Gastroenterology Internal medicine Humans Medicine Child Survival rate Retrospective Studies Transplantation Neutrophil Engraftment business.industry Hematology Fetal Blood medicine.disease Hematologic Diseases Hematopoiesis Surgery Survival Rate Treatment Outcome medicine.anatomical_structure Graft-versus-host disease Child Preschool Cord blood Regression Analysis business |
| Zdroj: | Bone Marrow Transplantation. 43:207-215 |
| ISSN: | 1476-5365 0268-3369 |
| DOI: | 10.1038/bmt.2008.314 |
| Popis: | Unrelated umbilical cord blood (UCB) is an alternative stem cell source for paediatric patients lacking a matched related or unrelated marrow donor. We report the results of all paediatric unrelated UCB transplants performed in Australia and New Zealand over a 10-year period. A total of 135 patients were transplanted, 100 for malignant disease (74%) and 35 for non-malignant disorders. The majority (88%) of patients received an HLA-mismatched graft. The median infused total nucleated cell dose was 4.7 x 10(7)/kg and CD34+ count 1.9 x 10(5)/kg. Neutrophil engraftment occurred in 83% of patients by day 42 (median 23 days) and platelet engraftment in 55% by day 60 (median 56 days). Grades II-IV and III-IV acute GVHD occurred in 41 and 18% of patients, respectively. TRM and overall survival 1-year post transplant were 32 and 61%, respectively. A higher probability of neutrophil recovery (P=0.004) and faster time to recovery (median 18 days vs 26 days, P=0.008) were observed in recipients of a cord unit with a CD34 cell dose >or=1.7 x 10(5)/kg. Our results support selection of cord units with CD34 cell doses >or=1.7 x 10(5)/kg to promote faster engraftment, improve survival and lower TRM. |
| Databáze: | OpenAIRE |
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