Cord blood banking and transplant in Europe. Eurocord.
Cord blood banks have increased the use of cord blood transplants (CBT) for patients with hematological disorders. EUROCORD has established a registry for providing information on the outcome of CBT. Questionnaires were sent to all EUROCORD members to collect information on patients transplanted from 1988 to 1996. One hundred and forty-three CBT, performed in 45 centers, were analyzed for survival, engraftment and graft-versus-host disease (GVHD). Results in recipients of related and unrelated transplants were analyzed separately. In 78 patients who received CB from a related donor, 1-year survival was 63 +/- 6%. Age, weight, HLA identity and negative cytomegalovirus (CMV) serology in the recipient were significant favorable prognostic factors. Among these 78 patients, the incidence of grade > or = II GVHD was 9% in HLA matched CBT and 50% in mismatched CBT. Neutrophil engraftment was associated with age < 6 years (P = 0.02), weight < 20 kg (P = 0.02). It was 73% in patients receiving < 3.7 x 10(7) nucleated cells (NC) infused/kg and 85% in patients receiving more (P = 0.06). Among 65 patients, who received CB from an unrelated donor, 1-year survival was 29 +/- 7%. Negative recipient CMV serology was associated with improved survival (P = 0.01). Acute GVHD > or = II was observed in 40% of these patients. Negative recipient CMV serology was the most important factor for predicting GVHD (P = 0.04). Neutrophil recovery was 76% in patients receiving < 3.7 x 10(7) NC/kg and 94% in patients receiving more (P = 0.008). Cord blood is a feasible alternative source of hematopoietic stem cells for treating patients with various hematological disorders.
Hôpital St Louis, Paris, France.
E
E
Gluckman
V
V
Rocha
C
C
Chastang
D000293:Adolescent; D000328:Adult; D001771:Blood Banks / Q000592:standards; D001800:Blood Specimen Collection / Q000592:standards; D002648:Child; D015925:Cryopreservation; D005060:Europe; D005260:Female; D005312:Fetal Blood / Q000166:cytology / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000592:standards; D006412:Hematopoietic Stem Cells / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D014019:Tissue Donors; D016896:Treatment Outcome