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Prepublished online as a Blood First Edition Paper on June 7, 2002; DOI 10.1182/blood-2002-01-0294. This Article Full Text Full Text (PDF) All Versions of this Article: 2002-01-0294v1 100/5/1611    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Wagner, J. E. Articles by Davies, S. M. Search for Related Content PubMed PubMed Citation Articles by Wagner, J. E. Articles by Davies, S. M. Related Collections Transplantation Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 1 September 2002, Vol. 100, No. 5, pp. 1611-1618 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS 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 John E. Wagner, Juliet N. Barker, Todd E. DeFor, K. Scott Baker, Bruce R. Blazar, Cindy Eide, Anne Goldman, John Kersey, William Krivit, Margaret L. MacMillan, Paul J. Orchard, Charles Peters, Daniel J. Weisdorf, Norma K. C. Ramsay, and Stella M. Davies From the Blood and Marrow Transplant Program of the Departments of Pediatrics and Medicine and the Biostatistical Support Group, University of Minnesota Cancer Center and School of Medicine, Minneapolis. The potential benefits of unrelated donor marrow transplantation are offset by the immunologic complications of graft-versus-host disease (GVHD) and infection. Therefore, we used cryopreserved umbilical cord blood (UCB) as a strategy to reduce the risks of GVHD and treatment-related mortality (TRM) and improve survival. Data on 102 patients (median age 7.4 years) who received transplants between 1994 and 2001 for the treatment of malignant (n = 65; 68% were high-risk patients) and nonmalignant (n = 37) diseases were evaluated. Log-rank tests and Cox regression analyses were used to determine the effects of various demographic, graft-related, and treatment factors on engraftment, GVHD, TRM, relapse, and survival. As of October 15, 2001, the median follow-up was 2.7 years (range, 0.3-7.2). Incidences of neutrophil and platelet engraftment were 0.88 (CI, 0.81-0.95) and 0.65 (CI, 0.53-0.77), respectively. Notably, incidences of severe acute and chronic GVHD were 0.11 (CI, 0.05-0.17) and 0.10 (CI, 0.04-0.16), respectively. At 1 year after transplantation, proportions of TRM and survival were 0.30 (CI, 0.21-0.39) and 0.58 (CI, 0.48-0.68), respectively. In Cox regression analyses, CD34 cell dose was the one factor consistently identified as significantly associated with rate of engraftment, TRM, and survival. Despite the low incidence of GVHD, the proportion of patients with leukemia relapse at 2 years was 0.17 (CI, 0.00-0.38) and 0.45 (CI, 0.28-0.61) for patients with standard and high-risk disease, respectively. There is a high probability of survival in recipients of UCB grafts that are disparate in no more than 2 human leukocyte antigens (HLAs) when the grafts contain at least 1.7 × 105 CD34+ cells per kilogram of recipient's body weight. Therefore, graft selection should be based principally on CD34 cell dose when multiple UCB units exist with an HLA disparity of 2 or less. © 2002 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: C. G. Brunstein, J. N. Barker, D. J. Weisdorf, T. E. DeFor, J. S. Miller, B. R. Blazar, P. B. McGlave, and J. E. Wagner Umbilical cord blood transplantation after nonmyeloablative conditioning: impact on transplantation outcomes in 110 adults with hematologic disease Blood, October 15, 2007; 110(8): 3064 - 3070. [Abstract] [Full Text] [PDF] A. P. Iori, W. Arcese, F. Milano, E. Calabrese, G. F. Torelli, W. Barberi, M. G. Mascolo, L. De Felice, M. Screnci, B. Lucarelli, et al. Unrelated cord blood transplant in children with high-risk acute lymphoblastic leukemia: a long-term follow-up Haematologica, August 1, 2007; 92(8): 1051 - 1058. [Abstract] [Full Text] [PDF] J. 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