Unrelated cord blood transplantation after myeloablative conditioning for adult patients with refractory anemia

• Published in: International journal of hematology Vol. 81; no. 5; pp. 424 - 427
• Main Authors: OOI, Jun, ISEKI, Tohru, NAGAMURA, Fumitaka, UCHIMARU, Kaoru, TOJO, Arinobu, ASANO, Shigetaka, TAKAHASHI, Satoshi, TOMONARI, Akira, TAKASUGI, Kashiya, UCHIYAMA, Michihiro, KONUMA, Takaaki, FUKUNO, Kenji, SODA, Yasushi, OHNO, Nobuhiro
• Format: Journal Article
• Language: English
• Published: Tokyo Springer 01.06.2005; Springer Nature B.V
• Subjects: Adult; Anemia, Refractory - therapy; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Combined Modality Therapy; Cord Blood Stem Cell Transplantation - methods; Disease-Free Survival; Graft Survival; Hematologic and hematopoietic diseases; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical sciences; Middle Aged; Salvage Therapy; Transplantation Conditioning - methods; Whole-Body Irradiation; Human; Refractory anemia; Hematology; Unrelated donor; Stem cell; Cord blood transplantation; Hematopoietic cell; Homograft; Malignant hemopathy; Myelodysplastic syndrome; Blood cell; Graft; Adult; Myelosuppression; Conditioning; Umbilical cord; MDS
• ISSN: 0925-5710; 1865-3774
• DOI: 10.1532/IJH97.05014

We report the results of unrelated cord blood transplantation (CBT) after myeloablative conditioning in 3 patients with myelodysplastic syndrome-refractory anemia (MDS-RA). All patients were treated with total body irradiation, cytosine arabinoside (Ara-C), and cyclophosphamide, followed by unrelated HLA-mismatched CBT. Granulocyte colony-stimulating factor was infused continuously, starting 12 hours before Ara-C therapy and continuing until the end of Ara-C therapy. All patients received standard cyclosporine and methotrexate therapy as graft-versus-host disease prophylaxis. All patients had myeloid reconstitution, and the times to reach an absolute neutrophil count >0.5 x 10(9)/L were 23, 20, and 26 days. All patients showed full donor chimerism at the time of the first bone marrow examination (on day +42, +43, and +62) after CBT. All patients are alive and free of disease at between 17 and 39 months after CBT. These results suggest that adult MDS-RA patients without suitable related or unrelated bone marrow donors should be considered as candidates for CBT.