Double-chimaerism after transplantation of two human leucocyte antigen mismatched, unrelated cord blood units.
The small number of progenitor cells is the major limitation to the use of umbilical cord blood (UCB) for the transplantation of adults. We tested the hypothesis that two units transplanted simultaneously could each contribute to haematopoietic reconstitution. A patient with advanced acute lymphocytic leukaemia received a mismatched, unrelated UCB transplant using units from two donors after conditioning. The recipient achieved a complete remission without graft-versus-host disease. Double chimaerism was documented in several leucocyte subpopulations; both units contributed to haematopoiesis until relapse. Triple chimaerism was present from relapse until death due to leukaemia. This approach may potentially improve UCB transplantation outcome for adults lacking a histocompatible donor.
De Lima
Marcos
M
Department of Blood and Marrow Transplantation, Pathology, and Leukaemia, M. D. Anderson Cancer Center, Houston, TX 77030, USA. mdelima@mdanderson.org
St  John
Lisa S
LS
Wieder
Eric D
ED
Lee
Ming S
MS
McMannis
John
J
Karandish
Safa
S
Giralt
Sergio
S
Beran
Miroslav
M
Couriel
Daniel
D
Korbling
Martin
M
Bibawi
Samer
S
Champlin
Richard
R
Komanduri
Krishna V
KV
D000328:Adult; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D007962:Leukocytes / Q000276:immunology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D018183:Transplantation Chimera; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous
D006680:HLA Antigens