Pediatric Unrelateddonor Ucbt For Malignant Diseases

The EuroCord Registry reported unrelated-donor UCBT data from 95 children (median age 4.8 years) with AML.58 Eight percent were HLA identical, 46% were disparate at one locus, and 43% were mismatched at >2 loci. The median cell dose was 4.4 X 107/kg. The median time to neutrophil recovery was 26 days. By multivariate analysis, neutrophil recovery correlated with the status of disease at transplantation and the use of hematopoietic growth factor immediately post-UCBT. Acute GVHD was seen in 35% of patients and was not predicted by HLA disparity. Chronic GVHD was noted in 5 of 53 patients. The 100-day TRM was 20%. Relapse occurred in 26% of the patients and was associated with weight >21 kg and active disease at the time of transplantation. The 2-year EFS was 42% with an OS of 49%. Disease status and major ABO incompatibility predicted EFS and OS.

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