Pediatric Relateddonor Ucbt

The clinical data reported on pediatric related-donor UCBT are largely based on the experiences of the ICBTR46'47 and the EuroCord Registry48-50 (Table 97.3). The ICBTR reported on 74 children with a median age of 4.9 years. Both malignant and nonmalignant diseases were treated. The conditioning regimen was total body irradiation (TBI) based in half of the patients. GVHD prophylaxis consisted of cyclosporine and either prednisone or methotrexate. HLA type was identical or disparate at one locus in 75% of the patients. The EuroCord Registry reported on 138 patients with a median age of 5 years, 63% of whom had a malignant disease. The conditioning regimen varied according to disease and age, but again was TBI based in approximately half of the patients. GVHD prophylaxis consisted mainly of cyclosporine. The majority of the grafts were HLA identical.

The ICBTR reported a 91% engraftment rate at day 60 with median neutrophil recovery at 22 days in closely HLA-matched patients. Platelet recovery occurred at a median of 51 days. There was no statistical correlation between engraftment and cell dose. The EuroCord Registry noted an 83% probability of engraftment with neutrophil recovery occurring at a median of 26 days. This was associated with a cell dose of >3.7 X 107/kg.

The ICBTR recorded a 3% rate of acute GVHD in patients with 0-1 HLA mismatch, followed by three cases of chronic GVHD. The EuroCord Registry reported acute grade II-IV GVHD in 20% of patients and chronic GVHD in 6%. Fifty percent of patients

Pediatric related donor UCBT
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