Umbilical cord transplantation

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13 Scopus citations

Abstract

The clinical efficacy of allogeneic bone marrow transplantation has been limited by difficulties in locating HLA-matched donors, and the occurrence of graft failure, severe graft-versus-host disease (GVHD), and opportunistic infections. Placental or umbilical cord blood may overcome some of these problems. Phase I-II trials of umbilical cord blood transplants (UCBT) show an overall engraftment rate of approximately 90%, with a median time to neutrophil recovery of 26 days. Nucleated cell, dose, and CFU-GM acid CD34+ content were inversely correlated with the time to neutrophil recovery (P < .01 for each). The overall probability of grade II-IV GVHD was approximately 40%, despite high degrees of HLA disparity between donor and recipient. In analysis of data at two institutions, the only factors predictive of survival were age and cell dose within the context of HLA 0-2 antigen disparities. There was no significant effect of HLA on the likelihood or speed of engraftment, the risk of grade II-IV acute GVHD, or survival. UCBT offers several potential advantages over bone marrow transplants for reconstitution of hematopoiesis, including the shorter interval to transplant, the absence of donor attrition, the absence of harvest complications, and the extremely low risk of cytomegalovirus transmission.

Original languageEnglish (US)
Pages (from-to)S30-S32
JournalLeukemia
Volume12
Issue numberSUPPL. 1
StatePublished - Jan 1 1998

Keywords

  • Colony-forming unit-granulocyte-macrophage (CFU-GM)
  • Graft-versus-host disease (GVHD)
  • Umbilical cord blood transplantation (UCBT)

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