Combined umbilical cord blood and bone marrow from HLA-identical sibling donors for hematopoietic stem cell transplantation in children with hemoglobinopathies.

Abstract

BACKGROUND:

It is well established that umbilical cord blood and bone marrow are biologically different stem cell sources.

PATIENTS AND METHODS:

We analyzed the feasibility and outcome of hematopoietic stem cell transplantation (HSCT) in 13 children (median age 5.9 years) with hemoglobinopathies after the co- infusion of cord blood (CB) and bone marrow (BM) from the same human leucocyte antigen (HLA) identical sibling donor. We also compared outcomes of children with co-transplantation to outcomes in children with hemoglobinopathies who had received a BM (n = 21) or CB (n = 22) transplant alone.

RESULTS:

Compared to CB transplant (CBT) recipients, the co-transplant group had more rapid neutrophil (17 vs. 25 days, P = 0.013) and platelet (29 vs. 48 days, P = 0.009) recovery and less transplant related mortality. Patients who received a co-transplant had a lower incidence of ≥ grade II acute (0% vs. 26.3%) and chronic (0% vs. 21%) graft versus host disease (GVHD) compared to BM transplant (BMT) recipients (P = 0.055 and 0.045, respectively). With a median follow-up of >60 months in each treatment group, the 5-year probability of event free survival (EFS) was 100% in the co-transplant group, 90% after BMT and 86% after CBT (P = 0.42).

CONCLUSION:

Co-transplantation of CB and BM from HLA-identical sibling donors appears to be a feasible and effective strategy to further optimize outcomes of HSCT for hemoglobinopathies.

• Authors: Sandeep Soni, Farid Boulad, Morton J Cowan, Andromachi Scaradavou, Jueeli Dahake, Sandie Edwards, Mark C Walters
• Journal: Pediatric blood & cancer (Pediatr Blood Cancer) Vol. 61 Issue 9 Pg. 1690-4 (Sep 2014) ISSN: 1545-5017 [Electronic] United States
• PMID: 24803091 (Publication Type: Journal Article)
• Copyright: © 2014 Wiley Periodicals, Inc.

Chemical References

• HLA Antigens

Topics

• Adolescent
• Bone Marrow Transplantation
• Child
• Child, Preschool
• Cord Blood Stem Cell Transplantation
• Feasibility Studies
• Female
• Follow-Up Studies
• Graft Survival
• HLA Antigens (immunology)
• Hematopoietic Stem Cell Transplantation
• Hemoglobinopathies (mortality, therapy)
• Histocompatibility Testing
• Humans
• Infant
• Male
• Prognosis
• Survival Rate