title: Unrelated cord blood transplantation for severe aplastic anemia.
abstract: In the present study we evaluated the feasibility of unrelated cord blood transplantation (UCBT) in patients with severe aplastic anemia (SAA). The outcome of 31 SAA patients (median age 28; range: 0.9-72.3 years old) who received UCBT was analyzed. The cumulative incidences of the neutrophil and platelet recovery after UCBT were 54.8 and 72.2%, respectively (95% confidence interval [CI] = 36.0%-70.3% and 51.3%-85.3%, respectively). The cumulative incidences of grade > or =II acute and chronic graft-versus-host disease (aGVHD, cGVHD) were 17.1% (95% CI = 6.2%-32.8%) and 19.7% (95% CI = 6.2%-38.8%), respectively. Currently, 13 patients are alive, having survived for 33.7 months (median; range: 6-77 months) after UCBT. The probability of overall survival (OS) at 2 years was 41.1% (95% CI = 23.8%-57.7%). A conditioning regimen that included low-dose total body irradiation (TBI) (2-5 Gy), fludarabine, and cyclophosphamide resulted in a favorable OS (80%; 95% CI = 20.4%-96.9%). This result suggests that UCBT using the optimal conditioning regimen can be a salvage treatment for patients without a suitable bone marrow donor and warrants evaluation in further prospective studies.
authors: Department of HSCT Data Management, Nagoya University, School of Medicine, Nagoya, Japan.
authors: Ayami
authors: A
authors: Yoshimi
authors: Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan. Electronic address: kojimas@med.nagoya-u.ac.jp.
authors: Seiji
authors: S
authors: Kojima
authors: Department of Hematology, Toranomon Hospital, Tokyo, Japan.
authors: Shuichi
authors: S
authors: Taniguchi
authors: Hematology/Oncology Department of Pediatrics, Osaka General Medical Center, Osaka, Japan.
authors: Junichi
authors: J
authors: Hara
authors: Hematology/Oncology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
authors: Toshimitsu
authors: T
authors: Matsui
authors: Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Yoshiyuki
authors: Y
authors: Takahashi
authors: Hokkaido Cord Blood Bank, Sapporo, Japan.
authors: Hiroshi
authors: H
authors: Azuma
authors: Tokai Cord Blood Bank, Nagoya, Japan.
authors: Koji
authors: K
authors: Kato
authors: Tokyo Cord Blood Bank, Tokyo, Japan.
authors: Tokiko
authors: T
authors: Nagamura-Inoue
authors: Hyogo Cord Blood Bank, Nishinomiya, Japan.
authors: Shunro
authors: S
authors: Kai
authors: Tokai University Cord Blood Bank, Isehara, Japan.
authors: Shunichi
authors: S
authors: Kato
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000741:Anemia, Aplastic / Q000401:mortality / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D036101:Cord Blood Stem Cell Transplantation; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000401:mortality / Q000628:therapy; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate; D019172:Transplantation Conditioning / Q000379:methods / Q000401:mortality; D014184:Transplantation, Homologous