title: Umbilical Cord Blood Transplantation Is a Feasible Rescue Therapeutic Option for Patients Suffering from Graft Failure after Previous Hematopoietic Stem Cell Transplantation.
abstract: OBJECTIVE
  Umbilical cord blood (UCB) is an important graft source for hematopoietic stem cell transplantation (SCT). Due to less stringent human leukocyte antigen (HLA) matching criteria compared to bone marrow or peripheral blood stem cells, UCB enables patients lacking an HLA-matched donor to receive potentially curative SCT.
  
  
  METHODS
  We retrospectively analyzed the efficacy and safety of UCB transplantation (UCBT) at our center.
  
  
  RESULTS
  Between June 2009 and June 2015, 27 UCBT were performed in 25 patients. Reasons for the use of UCB were lack of adequate related or unrelated stem cell donor (n = 20) and graft failure after previous SCT (n = 7). Median time to neutrophil engraftment was 22 days. Four patients experienced primary graft failure. Thirteen patients developed acute graft-versus-host disease (GVHD), whereupon 6 subsequently also developed chronic GVHD. After a median follow-up time of 19 months, 9 patients relapsed and 12 patients died. Cause of death was relapse in 8 and transplant-related events in 4 patients. Median overall survival and progression-free survival have not been reached yet.
  
  
  CONCLUSIONS
  In our experience, UCBT is an alternative graft source for patients lacking a suitable related or unrelated donor and a feasible treatment option for patients experiencing graft failure after previous SCT.
authors.affiliation: Department of Medicine III, Clinical Division of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria.
authors.forename: Marija
authors.initials: M
authors.lastname: Bojic
authors.forename: Nina
authors.initials: N
authors.lastname: Worel
authors.forename: Wolfgang R
authors.initials: WR
authors.lastname: Sperr
authors.forename: Peter
authors.initials: P
authors.lastname: Schellongowski
authors.forename: Philipp
authors.initials: P
authors.lastname: Wohlfarth
authors.forename: Ilse
authors.initials: I
authors.lastname: Schwarzinger
authors.forename: Gerlinde
authors.initials: G
authors.lastname: Mitterbauer-Hohendanner
authors.forename: Gottfried
authors.initials: G
authors.lastname: Fischer
authors.forename: Karin Ute
authors.initials: KU
authors.lastname: Dieckmann
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Lamm
authors.forename: Michael
authors.initials: M
authors.lastname: Leiner
authors.forename: Axel
authors.initials: A
authors.lastname: Schulenburg
authors.forename: Margit
authors.initials: M
authors.lastname: Mitterbauer
authors.forename: Hildegard T
authors.initials: HT
authors.lastname: Greinix
authors.forename: Peter
authors.initials: P
authors.lastname: Kalhs
authors.forename: Werner
authors.initials: W
authors.lastname: Rabitsch
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005240:Feasibility Studies; D005260:Female; D005312:Fetal Blood / Q000637:transplantation*; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology* / Q000601:surgery*; D019337:Hematologic Neoplasms / Q000601:surgery*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome