Results of Adult Umbilical Cord Blood Transplants Study
Related News: Cord Blood Stem CellsUmbilical cord blood transplants are looking to become more and more an accepted treatment option for traditional bone marrow transplant candidates.
The Eurocord-Netcord Transplant Group indicates that the results of studies shows that umbilical cord blood transplants in adults is an acceptable source of stem cells where patients lack a related or unrelated bone marrow stem cell donor. The analysis was presented at the 31st annual meeting of the European Group for Blood and Marrow Transplantation in Prague this past March....
There has been data over the last 10 years that suggests that umbilical cord blood may be a suitable source of stem cells. The immaturity of the stem cells leads to less rejection and less graft-versus host disease (GVHD). However, previous studies were limited to children because of the relatively low numbers of nucleated and stem cells (CD34+ cells) present in a typical cord blood collection. New studies, however, have included adults with some success and even more recently, even showing that two cord blood infusions are better than one in adults.
This latest study reviewed the outcomes of 171 adult patients, primarily with leukemia, who received an allogeneic stem cell transplant using unrelated mismatched single cord blood as a source of stem cells. These patients did not have a suitable related or unrelated stem cell donor and were all transplanted after 1997. The table below summarizes the major findings of this analysis.
Table 1: Outcomes of Allogeneic Stem Cell Transplants with Unrelated Mismatched Donors
| Number of Patients | 171 |
| Median Age (range) | 29 years (15-55) |
| Median Follow-up (range) | 18 months (1-71) |
| Acute or Chronic Leukemia | 142 |
| Advanced Disease | 53% |
| Failed Autologous Transplant | 19% |
| 1-2 HLA Mismatches | 87% |
| Nucleated Cells x102e7/kg | 2.1 |
| CD34+ Cells x10e5/kg | 1.0 |
| Median Neutrophil Recovery | 28 days (11-57) |
| Neutrophil Recovery by day 60 | 72% |
| Grade II-IV acute GVHD | 32% |
| 2-year Incidence of Chronic GVHD | 36% |
| 2-year Transplant-related Mortality | 51% |
| 2-year Relapse Rate | 22% |
| 2-year DFS Early Disease | 41% |
| 2-year DFS Intermediate Disease | 34% |
| 2-year DFS Advanced Disease | 18% |
Outcomes of these studies were adversely affected by advanced disease status and lower stem cell doses.
Posted on April 23, 2005 09:13 PM