Unrelated cord blood transplantation for second hemopoietic stem cell transplantation.
BACKGROUND
The Kanagawa Cord Blood Bank (KCBB) reports the treatment of 12 patients who received umbilical cord blood transplantation (CBT) from unrelated donors as their second hemopoietic stem cell transplantation (HSCT).


METHODS
Provided by the KCBB, between February 1997 and September 2000, 12 patients had unrelated CBT as a second HSCT. Six patients were male and six female; nine patients were in malignant, and three were in non-malignant conditions. The median age of the patients was 7.9 years (range, 2.2-28.0), and the median bodyweight was 22.5 kg (12.0-55.0). The HLA-A and -B serological and DR genotypical disparities between the patients and CBT donors were as follows: one patient was a 0-mismatch, six were 1-mismatches, and five were 2-mismatches.


RESULTS
The median time between first and second HSCT was 14.0 months (1.0-47.0). The overall survival rate was 25.0%, three years after CBT (Kaplan-Meier estimate). Mortality after CBT as a second HSCT accounted for nine cases, six from infection and three from treatment-related mortality other than infection.


CONCLUSIONS
Cord blood transplantation offers the advantage of rapid availability, absence of donor risk, and possibly less HLA restriction. In these contexts, unrelated CBT should be considered as a source of HSCT for a second transplant.
Isoyama
Keiichi
K
Department of Pediatrics, Showa University Fujigaoka Hospital, Japan.
Ohnuma
Kei
K
Ikuta
Koichiro
K
Toyoda
Yasunori
Y
Nakajima
Fumiaki
F
Yamada
Kouichiro
K
Nishihira
Hirokazu
H
D000326:Adrenoleukodystrophy / Q000628:therapy; D000328:Adult; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D006801:Humans; D007938:Leukemia / Q000628:therapy; D008297:Male; D016532:Mucopolysaccharidosis II / Q000628:therapy; D011683:Purine-Nucleoside Phosphorylase / Q000172:deficiency; D012008:Recurrence; D019233:Retreatment
D011683:Purine-Nucleoside Phosphorylase