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Abstract
The outcome after unrelated cord blood transplantation (CBT) is similar to that of matched unrelated bone marrow transplantation in children, and the results of CBT in adult patients has recently shown improvement. In addition, the use of reduced-intensity conditioning regimens for CBT has shown stable engraftment and reduced treatment-related mortality (TRM). From May 2005 to Jan 2006, four adult patients with acute myelogenous leukemia were treated with CBT after reduced-intensity conditioning at our hospital. The mean age of patients was 53.8 yrs, and all patients received 2 HLA antigen mismatched single unit cord blood. The infused mean cell dose was 2.85×107/kg for total nucleated cells and 0.72×105/kg for CD34+ cells. All patients had engraftment. The mean number of days to WBC and platelet engraftment was D+20.3 and D+60.3, respectively. There was no TRM within 100 days after transplantation. At the last follow up, three of the four patients were alive. One patient transplanted in first complete remisson is alive in remission at day 413, but the other patients transplanted in advanced disease all relapsed. Reduced-intensity CBT is a feasible approach in selected adult patients with acute myeloid leukemia.
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Fig. 1
Clinical courses of 4 patients with AML who received cord blood stem cell transplantation. Abbreviations: CSA, cyclosporine; CHF, congestive heart failure; CMV Ag+, CMV antigenemia; CR, complete remission; IP, interstitial pneumonitis.
Fig. 2
Changing profiles of absolute neutrophil count (ANC) and platelet count in patient (case 2) with AML who received cord blood stem cell transplantation.
Table 1.
Characteristics of patients with acute myelogenous leukemia
| Case | Age/Sex | Body weight (kg) | Cytogenetic abnormality | Disease status at transplantation |
|---|---|---|---|---|
| 1 | 56/F | 60 | － | 1st CR |
| 2 | 49/F | 56 | t (15:17) | 3rd CR |
| 3 | 44/F | 51 | 7p (del) | 1st relapse |
| 4 | 66/M | 61 | Complex | 2nd relapse |
Table 2.
Characteristics of infused cord bloods and transplantation outcomes
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