Adult recipients of umbilical cord blood transplants after nonmyeloablative preparative regimens.
We report the outcome of 13 patients with advanced malignancies who underwent nonmyeloablative conditioning therapy followed by infusion of partially matched unrelated cord blood cells. The median age of these patients was 49 years, and their median weight was 65.7 kg. The median nucleated cell dose infused was 2.07 x 10(7)/kg. Eight of the 13 patients demonstrated donor chimerism between 4 weeks and 6 months, and subsequent conversion to full donor chimerism was achieved in 5 patients. Three patients were alive and free of disease at 158 to 1054 days, with a median survival of 288 days after transplantation. The 100-day event-free survival is 69%, and overall survival is 77%. At 1 year, the event-free and overall survival was 43%. Treatment-related mortality observed within the first 100 days after transplantation was low: 1 previously extensively pretreated patient died of multiorgan failure. This result provides a basis for further exploring this potentially curative approach to selected patients who lack matched related or unrelated hematopoietic stem cell donors.
Division of Cellular Therapy/BMT, Duke University Medical Center, Durham, North Carolina 27710, USA. Chao0002@mc.duke.edu
Nelson J
NJ
Chao
Liang-Piu
LP
Koh
Gwynn D
GD
Long
Cristina
C
Gasparetto
Mitchell
M
Horwitz
Ashley
A
Morris
Martha
M
Lassiter
Keith M
KM
Sullivan
David A
DA
Rizzieri
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001772:Blood Cell Count; D036101:Cord Blood Stem Cell Transplantation; D018572:Disease-Free Survival; D005260:Female; D005312:Fetal Blood / Q000166:cytology; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D006680:HLA Antigens / Q000032:analysis; D019337:Hematologic Neoplasms / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008545:Melanoma / Q000628:therapy; D008875:Middle Aged; D010865:Pilot Projects; D016019:Survival Analysis; D018183:Transplantation Chimera / Q000097:blood; D019172:Transplantation Conditioning; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D006680:HLA Antigens; D007166:Immunosuppressive Agents