title: Double-chimaerism after transplantation of two human leucocyte antigen mismatched, unrelated cord blood units.
abstract: 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.
authors.affiliation: Department of Blood and Marrow Transplantation, Pathology, and Leukaemia, M. D. Anderson Cancer Center, Houston, TX 77030, USA. mdelima@mdanderson.org
authors.forename: Marcos
authors.initials: M
authors.lastname: De Lima
authors.forename: Lisa S
authors.initials: LS
authors.lastname: St  John
authors.forename: Eric D
authors.initials: ED
authors.lastname: Wieder
authors.forename: Ming S
authors.initials: MS
authors.lastname: Lee
authors.forename: John
authors.initials: J
authors.lastname: McMannis
authors.forename: Safa
authors.initials: S
authors.lastname: Karandish
authors.forename: Sergio
authors.initials: S
authors.lastname: Giralt
authors.forename: Miroslav
authors.initials: M
authors.lastname: Beran
authors.forename: Daniel
authors.initials: D
authors.lastname: Couriel
authors.forename: Martin
authors.initials: M
authors.lastname: Korbling
authors.forename: Samer
authors.initials: S
authors.lastname: Bibawi
authors.forename: Richard
authors.initials: R
authors.lastname: Champlin
authors.forename: Krishna V
authors.initials: KV
authors.lastname: Komanduri
mesh_terms: 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
chemical_list: D006680:HLA Antigens