CORD-BLOOD TRANSPLANTATION FROM SIBLING DONORS IN JAPAN - REPORT OF THE NATIONAL SURVEY

A joint national survey on cord blood transplantation (CBT) was conduc ted in Japan and 18 sibling CBTs were reported. Diseases of the patien ts were leukemia (ten), neuroblastoma (one), bone marrow failure (four ) and inborn errors of metabolism (three). A volume of 50-141 mi of co rd blood containing 27-197 x 10(7) nucleated cells was collected from sibling infants soon after delivery. HLA antigens were identical in 14 and one to three antigens mismatched in four. Engraftment of donor co rd blood was achieved in 17 cases. Autologous hematopoiesis was recove red in one case. Days of engraftment were 13-29 days (median 19 days) for neutrophils (500/mu l), 18-67 days (median 30 days) for reticulocy tes (2%) and 21-96 days (median 46 days) for platelets (50 x 10(3)/mu l). Acute GVHD was grade 0 in seven cases, grade I in five cases and g rade II in one case in HLA-identical pairs, but became grade II in two cases and grade III in two cases in HLA-mismatched pairs. Chronic GVH D of limited type developed in two out of 17 evaluable cases, however both responded to immunosuppressive therapy. Altogether, 14 out of 18 patients are currently surviving 4-27 months following transplantation . Probabilities of overall survival and disease free survival were est imated to be 77.0 and 71.8% using Kaplan-Meier tests. These findings s uggest the feasibility of cord blood transplantation from sibling dono rs and the possibility of unrelated cord blood transplantation. A cord blood banking system is necessary for the universal use of cord blood stem cells from unrelated donors. (C) 1998 Publsihed by Elsevier Scie nce Ireland Ltd. All rights reserved.