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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 (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 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 Social Bookmarking                   What's this? Submitted January 31, 2002 Accepted April 22, 2002 Transplantation of unrelated donor umbilical cord blood in 102 patients with malignant and non-malignant 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 S Baker, Bruce R Blazar, Cindy Eide, Anne Goldman, John Kersey, William Krivit, Margaret MacMillan, Paul J Orchard, Charles Peters, Daniel J Weisdorf, Norma K Ramsay, and Stella M Davies Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA Department of Medicine, University of Minnesota, Minneapolis, MN, USA Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA; Biostatistical Support Group, University of Minnesota, Minneapolis, MN, USA Biostatistical Support Group, University of Minnesota, Minneapolis, MN, USA Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA; Department of Medicine, University of Minnesota, Minneapolis, MN, USA * Corresponding author; email: wagne002{at}tc.umn.edu. Rationale. The potential benefits of unrelated donor marrow transplantation are offset by the immunologic complications of graft-versus-host disease (GVHD) and infection. Therefore, cryopreserved umbilical cord blood (UCB) was used as a strategy to reduce the risks of GVHD and treatment-related mortality (TRM) and improve survival. Objectives. Data on 102 patients (median age 7.4 years) transplanted between 1994 and 2001 for the treatment of malignant (n=65; 68% high-risk) and non-malignant diseases (n=37) 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. Findings. As of October 15, 2001, the median follow-up was 2.7 (0.3-7.2) years. Incidences of neutrophil and platelet engraftment were 0.88 (0.81-0.95) and 0.65 (0.53-0.77), respectively. Notably, incidences of severe acute and chronic GVHD were 0.11 (0.05-0.17) and 0.10 (0.04-0.16), respectively. At 1 year after transplantation, proportions of TRM and survival were 0.30 (0.21-0.39) and 0.58 (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 low incidence of GVHD, leukemia relapse was 0.17 (0.00-0.38) and 0.45 (0.28-0.61) at 2 years for patients with standard and high-risk disease, respectively. Conclusions. There is a high probability of survival in recipients of HLA 0-2 antigen disparate UCB grafts containing 1.7 x 105 CD34+ cells/kilogram. Therefore, graft selection should be based principally on CD34 cell dose when multiple UCB units exist with 2 HLA antigen disparity. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: A. Y. H. Leung and Y.-L. 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