Unrelated cord blood transplantation in CML: Japan Cord Blood Bank Network analysis

• Published in: Bone marrow transplantation (Basingstoke) Vol. 42; no. 4; pp. 241 - 251
• Main Authors: Nagamura-Inoue, T, Kai, S, Azuma, H, Takanashi, M, Isoyama, K, Kato, K, Takahashi, S, Taniguchi, S, Miyamura, K, Aoki, K, Hidaka, M, Nagamura, F, Tojo, A, Fang, X M, Kato, S
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.08.2008; Nature Publishing Group
• Subjects: Adolescent; Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blast crisis; Blood; Blood banks; Bone marrow; Bone marrow, stem cells transplantation. Graft versus host reaction; Care and treatment; Cell Biology; Child; Child, Preschool; Chronic myeloid leukemia; Cord blood; Cord Blood Stem Cell Transplantation - mortality; Diagnosis; Disease-Free Survival; Dosage; Female; Fetal blood; Hematologic and hematopoietic diseases; Hematology; Humans; Infant; Internal Medicine; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - therapy; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Leukocytes (neutrophilic); Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Multivariate analysis; Network analysis; Neutrophils; original-article; Patients; Platelets; Public Health; Recovery; Recurrence; Risk Factors; Stem cell transplantation; Stem Cells; Survival; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation; Transplants & implants; Asia; Japan; CML; unrelated cord blood transplantation; cord blood cells; Hematology; Unrelated donor; Stem cell; Hematopoietic cell; Homograft; Chronic myelogenous leukemia; Malignant hemopathy; Blood; Myeloproliferative syndrome; Blood cell; Network; Graft; Blood bank; Umbilical cord; Cancer
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/bmt.2008.164

We analysed 86 patients with CML who received unrelated cord blood transplantation (UCBT), identified through a registry of the Japan Cord Blood Bank Network. At transplantation, the median patient age was 39 years (range, 1–67 years); 38 patients were in chronic phase (CP), 13 in the accelerated phase (AP) and 35 in blast crisis (BC). Median duration from diagnosis to UCBT was 1.5 years (range, 0.2–14.6 years). A nucleated cell (NC) dose of more than 3.0 × 10 7 per kg was sufficient to achieve neutrophil (91%) and platelet recovery (86%), whereas the lower dose of NC achieved only 60 and 61%, respectively. The duration and type of pre-transplant treatment did not affect neutrophil or platelet recovery. Results of multivariate analysis indicated that older patients (>50 years) had a higher incidence of transplant-related mortality. Advanced-disease stage and lower doses of NCs were significantly associated with lower leukaemia-free and event-free survival. At 2-year survival for patients in CP, AP and BC was 71, 59 and 32%, respectively ( P =0.0004). A pre-transplant European Group for Blood and Marrow Transplantation scoring system was effective in predicting the outcome of UCBT. We conclude that UCBT is a reasonable alternative therapy for patients with CML.