Annals of Hematology

, Volume 89, Issue 10, pp 1035–1044

Double umbilical cord blood transplantation for children and adolescents

Authors

  • Hyoung Jin Kang
    • Division of Hematology/Oncology, Department of Pediatrics, Cancer Research InstituteSeoul National University College of Medicine
  • Keon Hee Yoo
    • Department of PediatricsSungkyunkwan University School of Medicine, Samsung Medical Center
  • Ji Won Lee
    • Division of Hematology/Oncology, Department of Pediatrics, Cancer Research InstituteSeoul National University College of Medicine
  • Hyery Kim
    • Division of Hematology/Oncology, Department of Pediatrics, Cancer Research InstituteSeoul National University College of Medicine
  • Soo Hyun Lee
    • Department of PediatricsSungkyunkwan University School of Medicine, Samsung Medical Center
  • Ki Woong Sung
    • Department of PediatricsSungkyunkwan University School of Medicine, Samsung Medical Center
  • Kyung Duk Park
    • Division of Hematology/Oncology, Department of Pediatrics, Cancer Research InstituteSeoul National University College of Medicine
  • Hong Hoe Koo
    • Department of PediatricsSungkyunkwan University School of Medicine, Samsung Medical Center
  • Hee Young Shin
    • Division of Hematology/Oncology, Department of Pediatrics, Cancer Research InstituteSeoul National University College of Medicine
    • Division of Hematology/Oncology, Department of Pediatrics, Cancer Research InstituteSeoul National University College of Medicine
Original Article

DOI: 10.1007/s00277-010-0985-2

Cite this article as:
Kang, H.J., Yoo, K.H., Lee, J.W. et al. Ann Hematol (2010) 89: 1035. doi:10.1007/s00277-010-0985-2

Abstract

Umbilical cord blood transplantation (UCBT) with two units has been conducted with promising results in adults to overcome the limitation of low cell numbers. In an attempt to improve the outcomes, double UCBT was performed in children and adolescents. Sixty-one patients, including 44 acute leukemia, and 17 other hematologic diseases, received double UCBT. Donor-type engraftment achieved in 82% of patients. Except one patient with persistent mixed chimerism of two units, other 49 patients showed dominancy of one unit and only the CFU-GM was significant factor influencing dominancy. The event-free survival (EFS) of leukemia and other hematologic disease were 59% and 53%, respectively, and the EFS of acute leukemia patients who received transplant in first or second CR (68.6%) was significantly better than in those with advanced disease (22.2%) (P = 0.007). Among the factors influencing outcomes, low cell dose difference between two units (TNC difference/TNC of large unit <15%) were associated with higher TRM, relapse, and lower EFS. Double UCBT was a promising modality of transplant in children and adolescence. However, engraftment and other results were not so satisfactory yet. To improve the outcomes, development of new selection guideline, probably including cell dose difference between two units and technology to enhance engraftment and reduce transplantation-related mortality are warranted.

Keywords

Cord blood transplantation Double units Cell dose Children and adolescents

Copyright information

© Springer-Verlag 2010