alexa Results of the Cord Blood Transplantation Study (COBLT): clinical outcomes of unrelated donor umbilical cord blood transplantation in pediatric patients with hematologic malignancies.


Journal of Blood Disorders & Transfusion

Author(s): Kurtzberg J, Prasad VK, Carter SL, Wagner JE, BaxterLowe LA,

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Abstract Outcomes of unrelated donor cord blood transplantation in 191 hematologic malignancy children (median age, 7.7 years; median weight, 25.9 kg) enrolled between 1999 and 2003 were studied (median follow-up, 27.4 months) in a prospective phase 2 multicenter trial. Human leukocyte antigen (HLA) matching at enrollment was 6/6 (n = 17), 5/6 (n = 58), 4/6 (n = 111), or 3/6 (n = 5) by low-resolution HLA-A, -B, and high-resolution (HR) DRB1. Retrospectively, 179 pairs were HLA typed by HR. The median precryopreservation total nucleated cell (TNC) dose was 5.1 x 10(7) TNC/kg (range, 1.5-23.7) with 3.9 x 10(7) TNC/kg (range, 0.8-22.8) infused. The median time to engraftment (absolute neutrophil count > 500/mm(3) and platelets 50 000/muL) was 27 and 174 days. The cumulative incidence of neutrophil engraftment by day 42 was 79.9\% (95\% confidence interval [CI], 75.1\%-85.2\%); acute grades III/IV GVHD by day 100 was 19.5\% (95\% CI, 13.9\%-25.5\%); and chronic GVHD at 2 years was 20.8\% (95\% CI, 14.8\%-27.7\%). HR matching decreased the probability of severe acute GVHD. The cumulative incidence of relapse at 2 years was 19.9\% (95\% CI, 14.8\%-25.7\%). The probabilities of 6-month and 2-year survivals were 67.4\% and 49.5\%. Unrelated donor cord blood transplantation from partially HLA-mismatched units can cure many children with leukemias. The study was registered at as #NCT00000603.
This article was published in Blood and referenced in Journal of Blood Disorders & Transfusion

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