title: Cord blood transplantation from unrelated donors: a preliminary report from the Japanese Cord Blood Bank Network.
abstract: As a source for hematopoietic stem cell transplantation (HSCT), cord blood transplantation from unrelated donors (UCBT) is now considered as an acceptable alternative to patients who need unrelated HSCT. To confirm the findings that mismatched UCBT is feasible, we discussed here the results for 477 patients with hematologic malignancies and non-malignancies who were subjected to UCBT coordinated by the Japanese Cord Blood Bank Network (JCBBN). From February 1997 to October 2001, 411 patients with malignancies and 66 with non-malignancies had UCBT through the cord blood bank in the JCBBN; 311 patients had HLA 0-1 mismatched UCBT; 165, had a 2-4 HLA mismatch. The Kaplan-Meier estimates for 3-year disease-free survival rate (DFS) were 35.2 +/- 2.8% in malignant diseases, and 33.6 +/- 7.2% in patients with non-malignant diseases. The HLA disparity had no effect on DFS, incidence of acute graft-versus-host disease, or engraftment. As reported previously, we also noted the importance of graft cell dose in determining survival in UCBT. Major advantages of UCBT include its rapid availability compared with unrelated donor bone marrow, and tolerance of an HLA mismatch at 2 loci, which will enable extension of the donor pool. This review outlines the latest UCBT progress, with emphasis on practical considerations in HLA-mismatched umbilical cord blood selection.
authors.affiliation: Department of Pediatrics, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama 277-8501, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Isoyama
authors.forename: Kei
authors.initials: K
authors.lastname: Ohnuma
authors.forename: Koji
authors.initials: K
authors.lastname: Kato
authors.forename: Tsuneo A
authors.initials: TA
authors.lastname: Takahashi
authors.forename: Shunro
authors.initials: S
authors.lastname: Kai
authors.forename: Shun-Ichi
authors.initials: S
authors.lastname: Kato
authors.forename: Minoko
authors.initials: M
authors.lastname: Takanashi
authors.forename: Norihiro
authors.initials: N
authors.lastname: Sato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sato
authors.forename: Kohichi
authors.initials: K
authors.lastname: Kitajima
authors.forename: Tomoki
authors.initials: T
authors.lastname: Naoe
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Saito
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Nishihira
mesh_terms: D000293:Adolescent; D000328:Adult; D001771:Blood Banks / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data*; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D005544:Forecasting; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000209:etiology; D006402:Hematologic Diseases / Q000401:mortality / Q000628:therapy; D006648:Histocompatibility; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality / Q000628:therapy; D016019:Survival Analysis; D016896:Treatment Outcome