Cord blood transplant in childhood ALL.
BACKGROUND
Optimal therapy for high risk and relapsed acute lymphoblastic leukemia (ALL) remains uncertain. Wider availability of cord blood from related and unrelated donors has prompted studies of its use for hematopoietic stem cell transplant (HSCT).


METHODS
We evaluated 26 consecutive cord blood transplants (CBT) for ALL performed at our center from 1996 to 2002 on studies using consistent conditioning therapy and graft-versus-host disease (GVHD) prophylaxis. Median patient age was 8.5 years (range, 0.5-24 year). Cord blood (CB) was from unrelated donors in 25/26 cases. Median CB nucleated cell dose was 3.26e7/kg (range, 0.8-12.9).


RESULTS
With median follow-up of 548 days, 16/26 patients (62%) are event-free survivors. Acute GVHD developed in 14/24 evaluable patients, reaching grade III-IV in 7 patients. Chronic GVHD occurred in 10/22 evaluable patients. Multivariate analysis showed higher total nucleated cell dose per kilogram to be the strongest predictor of event-free survival.


CONCLUSIONS
We conclude that CBT can effectively treat ALL in children with high risk features and following relapse.
Sawczyn
Kelly K
KK
The Children's Hospital, Denver, Colorado, USA.
Quinones
Ralph
R
Malcolm
Janet
J
Foreman
Nicholas
N
Garrington
Tim
T
Gore
Lia
L
Gao
Dexiang
D
Giller
Roger
R
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000517:prevention & control; D006650:Histocompatibility Testing; D006801:Humans; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000401:mortality / Q000628:therapy*; D012008:Recurrence; D012189:Retrospective Studies; D014019:Tissue Donors; D014184:Transplantation, Homologous; D016896:Treatment Outcome