HAPLOIDENTICAL RELATED UMBILICAL-CORD BLOOD STEM-CELL TRANSPLANT IN ACHILD WITH ACUTE NONLYMPHOCYTIC LEUKEMIA

Umbilical cord blood stem cells (UCBSC) were used to reconstitute hema topoiesis following myeloablative therapy in a 13-month-old infant wit h acute nonlymphocytic leukemia (ANLL):FAB-M5 who had failed to sustai n a chemotherapeutic remission, The patient's mother was 18 weeks preg nant with her second child at the time of diagnosis, Amniocentesis rev ealed that the fetus was HLA-haploidentical with the patient at the pa ternally inherited allele, The umbilical cord blood was harvested and processed by Ficoll centrifugation with 100% recovery of 5 x 10(7) mon onuclear cells/kg and then cryopreserved, Two weeks after collection t he cells were thawed and then infused into the patient following condi tioning with total body irradiation, cyclophosphamide, and etoposide, Graft-versus-host-disease (GVHD) prophylaxis consisted of cyclosporine and methotrexate, The patient experienced clinical grade I GVHD consi sting of skin involvement only that resolved within 2 weeks following the addition of corticosteroids. Engraftment was achieved with an abso lute neutrophil count (ANC) above 0.5 x 10(9)/1 on day 16, a platelet count above 50 x 10(9)/1 II on day 56, platelet transfusion independen ce on day 32 and red blood cell transfusion independence after day 44. Three months following transplantation restriction fragment length po lymorphisms (RFLP) revealed no discernible difference between the dono r and the recipient, The patient remains in remission without evidence of GVHD 23 months post-transplant.