title: Cord blood transplantation in Western Australia.
abstract: OBJECTIVE
  Thirty-one umbilical cord blood transplants performed in Western Australia were retrospectively examined in order to document local experience and relevant prognostic factors. Three cord units were from human leucocyte antigen-matched siblings and the remainder were unrelated single (n= 22) or double (n= 6) cord blood transplants.
  
  
  METHODS
  Twenty patients were transplanted for malignant conditions and 11 for non-malignant conditions. Cord units contained a median of 5.6 × 107 total nucleated cells/kg and 1.4 × 105 CD34+ cells/kg. Cumulative incidence of neutrophil engraftment was 76% at day 60.
  
  
  RESULTS
  Of those who did not engraft, two patients remain alive following subsequent allogeneic bone marrow transplant. There were no deaths caused by graft-versus-host disease. Overall survival at median follow up of 28 months was 62%. Two year overall survival was influenced by type of disease (non-malignant = 91 ± 9% vs malignant = 41 ± 13%, P= 0.005), total nucleated cell dose (>3.5 × 107/kg = 87 ± 9% vs <3.5 × 107/kg = 34 ± 15%, P= 0.01) and CD34 dose (>1.7 × 105/kg = 92% vs <1.7 × 105/kg = 46%, P= 0.04). Age and human leucocyte antigen match did not influence survival. Four relapses occurred, all of which were fatal.
  
  
  CONCLUSIONS
  Cord blood transplantation for malignant and non-malignant disease is practised in Western Australia and outcomes are satisfactory. Trends and techniques in cord blood transplantation in this state are comparable with those observed nationally and overseas. Although numbers are small, cell dose appears to be predictive of overall survival
authors: D
authors: D
authors: Purtill
authors: J
authors: J
authors: Cooney
authors: P
authors: P
authors: Cannell
authors: R
authors: R
authors: Herrmann
authors: F
authors: F
authors: Trimboli
authors: T
authors: T
authors: Carter
authors: D
authors: D
authors: Baker
authors: C
authors: C
authors: Cole
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D064591:Allografts; D016026:Bone Marrow Transplantation / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000401:mortality / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D030342:Genetic Diseases, Inborn / Q000601:surgery; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000453:epidemiology; D019337:Hematologic Neoplasms / Q000601:surgery; D006650:Histocompatibility Testing; D006801:Humans; D007165:Immunosuppression Therapy; D007223:Infant; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D014904:Western Australia; D055815:Young Adult