Os

62%d

63%e

UCBT, umbilical cord blood transplantation; ICBTR, International Cord Blood Transplant Registry; TNC, total nucleated cells; GVHD, graft-versus-host disease; TRM, transplant-related mortality; EFS, event-free survival; OS, overall survival; NA, not available. aObserved at 60 days.

bObserved in patients with malignant diseases. cObserved in patients with nonmalignant diseases. dObserved at 1.6 years. eObserved at 1 year.

UCBT, umbilical cord blood transplantation; ICBTR, International Cord Blood Transplant Registry; TNC, total nucleated cells; GVHD, graft-versus-host disease; TRM, transplant-related mortality; EFS, event-free survival; OS, overall survival; NA, not available. aObserved at 60 days.

bObserved in patients with malignant diseases. cObserved in patients with nonmalignant diseases. dObserved at 1.6 years. eObserved at 1 year.

with any HLA disparity developed grade II-IV GVHD, while only 9% did so in HLA-identical transplants.

Initial reports from the ICBTR and EuroCord Registry noted relapse in 49 and 22% of patients with malignancies. The ICBTR reported a 46% event-free survival (EFS) for patients with a malignant disease compared to 78% for patients with a nonmalignant condition. The overall survival (OS) for all patients was 62%, with a median follow-up of 1.6 years. Those who were HLA matched or disparate at one loci had a higher OS of 72%. The EuroCord Registry reported an OS of 63% at 1 year. The 2-year OS varied with disease—46% in patients with malignancies, 76% with aplastic anemia, 79% with inborn errors of metabolism, and 100% with hemoglobinopathies.

OS correlated with infusion of >3.7 ( 107 TNC/kg, HLA identity (73% if HLA-identical and 33% with any HLA-disparity), age <6, weight <20 kg, and negative cytomegalovirus (CMV) serology.

In a multivariate analysis of data from the EuroCord Registry after related-donor HLA-matched UCBTs and SCTs, it was found that neutrophil and platelet recovery following UCBT were delayed as compared to that in SCT. Rates of acute and chronic GVHD were reduced following UCBT (RR 0.40 and 0.35, respectively). Survival was similar.51

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