Unrelated cord blood transplantation in children with sickle cell disease: review of four-center experience.
UCBT was performed in seven children with SCD and stroke (HLA match 4/6 n=5; 5/6 n=2). Four received myeloablative regimens (BU, CY, ATG plus FLU in one patient). One had primary graft failure, three had sustained engraftment, two with grade III-IV GVHD (one died, one developed chronic GVHD), one with stable mixed chimerism. Three patients treated with reduced-intensity regimens (FLU, BU or CY, ATG, TLI) failed to engraft; one engrafted after second UCBT (HU, TT, RXA, ALZ, TBI). Four patients (57%) developed viral infections. Engraftment, GVHD, and infection remain challenges.
Department of Family Medicine, Morehouse School of Medicine, Atlanta, East Point, GA 30344, USA. tadamkiewicz@msm.edu
Tom V
TV
Adamkiewicz
Paul
P
Szabolcs
Ann
A
Haight
K Scott
KS
Baker
Susan
S
Staba
Amos
A
Kedar
K Y
KY
Chiang
Lakshmanan
L
Krishnamurti
Michael W
MW
Boyer
Joan
J
Kurtzberg
John E
JE
Wagner
John R
JR
Wingard
Andrew M
AM
Yeager
D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005312:Fetal Blood / Q000637:transplantation*; D006801:Humans; D008297:Male