UNRELATED UMBILICAL CORD-BLOOD STEM-CELL TRANSPLANTATION - A REPORT FROM KANAGAWA-CORD-BLOOD-BANK, JAPAN

Umbilical cord-blood (CB) has been used as a source of hematopoietic s tem cells in pediatric patients with sibling donors. As a result of th e success with CB transplantation from sibling donors, pilot programs for the banking of unrelated donor CB were initiated in the organizati on of Kanagawa Cord Blood Bank, Japan in 1995. As of December 1997, un related donor CB was used to reconstitute hematopoiesis in seven patie nts aged 0.7-12.8 years, weighing 7-36 kg with high-risk leukemia (n = 5), myelodysplastic syndrome (n = 1), and immunodeficiency syndrome ( n = 1). Engraftment of CB was achieved in six patients. The absolute n eutrophil count reached 500/mu l in a median of 27 days; a platelet co unt of 20000/mu l was reached by a median of 64 days in three patients who could be evaluated. Five patients are currently surviving. Grade I GVHD developed in three patients and grade III in one patient; no GV HD developed in three patients. Although only a small number of patien ts have been studied and the period of observation is too short to det ermine long-term survival, HLA-matched or HLA-mismatched CB from unrel ated donors can provide an alternative source of hematopoietic reconst itution for clinical transplantation. (C) 1998 Published by Elsevier S cience Ireland Ltd. All rights reserved.