Unrelated donor cord blood transplantation for non-malignant disorders in children and adolescents

Pediatr Transplant. 2014 Mar;18(2):221-9. doi: 10.1111/petr.12213. Epub 2013 Dec 30.

Abstract

This study analyzes the data reported to the Korean Cord Blood Registry between 1994 and 2008, involving children and adolescents with non-malignant diseases. Sixty-five patients were evaluated in this study: SAA (n = 24), iBMFS, (n = 16), and primary immune deficiency/inherited metabolic disorder (n = 25). The CI of neutrophil recovery was 73.3% on day 42. By day 100, the CI of acute grade II-IV graft-versus-host disease was 32.3%. At a median follow-up of 71 months, five-yr OS was 50.7%. The survival rate (37.5%) and CI of neutrophil engraftment (37.5%) were lowest in patients with iBMFS. Deaths were mainly due to infection, pulmonary complications, and hemorrhage. In a multivariate analysis, the presence of >3.91 × 10(5) /kg of infused CD34 + cells was the only factor consistently identified as significantly associated with neutrophil engraftment (p = 0.04) and OS (p = 0.03). UCBT using optimal cell doses appears to be a feasible therapy for non-malignant diseases in children and adolescents for whom there is no appropriate HLA-matched related donor. Strategies to reduce transplant-related toxicities would improve the outcomes of UCBT in non-malignant diseases.

Keywords: adolescents; children; non-malignant disease; unrelated cord blood transplantation.

MeSH terms

  • Adolescent
  • Anemia, Aplastic / therapy
  • Antigens, CD34 / metabolism
  • Bone Marrow Diseases
  • Bone Marrow Failure Disorders
  • Brain Diseases, Metabolic, Inborn / therapy
  • Child
  • Child, Preschool
  • Cord Blood Stem Cell Transplantation / methods*
  • Female
  • Graft vs Host Disease / etiology
  • HLA Antigens / metabolism
  • Hemoglobinuria, Paroxysmal / therapy
  • Humans
  • Immunologic Deficiency Syndromes / therapy
  • Infant
  • Male
  • Multivariate Analysis
  • Registries
  • Republic of Korea
  • Retrospective Studies
  • Treatment Outcome
  • Unrelated Donors

Substances

  • Antigens, CD34
  • HLA Antigens