title: Long-term results of placental blood allografting using reduced-intensity conditioning: multicenter experience in a developing country.
abstract: BACKGROUND
  Placental blood (PLB) hematopoietic stem cell transplantation has recently been explored in an increasing number of patients; the best conditioning regimen has not been established.
  
  
  METHODS
  In an eight-year period, 66 consecutive patients, both children and adults (40 males and 26 females), were grafted with allogeneic placental blood cells using a reduced-intensity conditioning regimen: 23 patients were grafted because of a non-malignant condition and 43 patients for a malignant disease. The median age was 7 years (range 5 months to 72 years).
  
  
  RESULTS
  Median time to recover >0.5×10(9)/l granulocytes was 19 days, whereas median time to recover >20×10(9)/l platelets was 23 days. Thirty-eight individuals failed to engraft and they either recovered endogenous hematopoiesis or died. Patients have been followed for periods ranging from 0.5 to 66 months, median 9 months. The median overall post-transplant survival (OS) was 22 months and the 36-month OS was 32%; it was significantly better for individuals grafted with 6/6 matched cords (45%). The cumulative incidences of grade II-IV acute graft-versus-host disease (GVHD) and grade III-IV acute GVHD for the patients who engrafted were 33 and 10%, respectively.
  
  
  CONCLUSIONS
  The low engraftment rate should be improved by selecting better cord blood units; additional studies are needed to define if non-myeloablative conditioning is preferable over conventional conditioning.
authors.affiliation: Centro de Hematologia y Medicina Interna de Puebla, Puebla, Mexico.
authors.forename: Guillermo J
authors.initials: GJ
authors.lastname: Ruiz-Delgado
authors.forename: Consuelo
authors.initials: C
authors.lastname: Mancias-Guerra
authors.forename: Julio
authors.initials: J
authors.lastname: Macias-Gallardo
authors.forename: Oscar
authors.initials: O
authors.lastname: Gonzalez-Llano
authors.forename: Ana
authors.initials: A
authors.lastname: Hernandez-Arizpe
authors.forename: Laura Nelly
authors.initials: LN
authors.lastname: Rodriguez-Romo
authors.forename: Sylvia Aide
authors.initials: SA
authors.lastname: Martinez-Cabriales
authors.forename: David
authors.initials: D
authors.lastname: Gómez-Almaguer
authors.forename: Guillermo J
authors.initials: GJ
authors.lastname: Ruiz-Argüelles
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002066:Busulfan / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D002066:Busulfan