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Outcomes of transplantation of unrelated cord blood in children with malignant and non-malignant diseases: an Utrecht–Prague collaborative study

Bone Marrow Transplantation volume 43, pages 655–657 (2009)Cite this article

In paediatrics, SCTs are performed for various malignant and non-malignant diseases: leukaemia; inborn errors of metabolism; SCID; and BM failure syndromes. Unrelated cord blood (UCB) is suggested as a good alternative cell source.1, 2, 3 In the United States, various centres are using UCB as the first alternative when a matched sibling donor is lacking. In Europe, almost all patients are in national or international cohort studies in which cord blood is usually a last alternative (except for inborn errors of metabolisms since 2005). UCB is not widely used within Europe, therefore most published data are from registry studies (Eurocord/EBMT). The paediatric transplant centres in Prague and Utrecht have used cord blood regularly within the same international transplant protocols and use similar supportive care guidelines. In this study, we analysed several parameters for all children who had received UCB transplantation (UCBT) from 2001 to 2007 in these centres related to clinical outcomes.

This retrospective analysis is based on data reported to the local databases (Utrecht and Prague). The main end points were (i) EFS, defined as the time from transplant to autologous reconstitution, graft failure, second transplant or death; (ii) overall survival defined as the time from transplant until date of death. Other end points were (i) neutrophil recovery and (ii) acute or chronic GVHD. Neutrophil recovery was defined as the first day of achieving a neutrophil count of ⩾0.5 × 109/l for three consecutive days. Statistical analysis was performed using uni- and multivariate Cox-proportional hazard regression analyses. The duration of follow-up was the time to the last assessment for survivors. To analyse risk factors for outcomes, we considered variables associated with the recipient (median age at transplant, gender, CMV serology status), the disease (malignant or non-malignant), the cord blood donor (HLA disparity, and median collected total nucleated cell and CD34+ cell doses) and the transplant (conditioning: chemo-based or TBI-based). Probabilities of EFS and overall survival were calculated using the Kaplan–Meier estimate; the two-sided log-rank test was used for univariate comparisons.

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Authors and Affiliations

  1. Department of Immunology/Hematology and BMT, University Medical Center Utrecht, Utrecht, The Netherlands

    J J Boelens & M Bierings

  2. Transplantation Immunology, Tissue Typing Laboratory, University Hospital Maastricht, Maastricht, The Netherlands

    M Tilanus

  3. Europdonor, Leiden, The Netherlands

    J Lie

  4. Department of Paediatric Hematology and Oncology, University Hospital Motol, Prague, Czech Republic

    P Sedlacek

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  1. J J Boelens
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  2. M Bierings
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Correspondence to J J Boelens.

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Boelens, J., Bierings, M., Tilanus, M. et al. Outcomes of transplantation of unrelated cord blood in children with malignant and non-malignant diseases: an Utrecht–Prague collaborative study. Bone Marrow Transplant 43, 655–657 (2009). https://doi.org/10.1038/bmt.2008.367

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