Kw. Chan et al., Fludarabine-based preparative protocol for unrelated donor cord blood transplantation in children: successful engraftment with minimal toxicity, BONE MAR TR, 23(8), 1999, pp. 849-851
Citations number
11
Categorie Soggetti
Hematology,"Medical Research Diagnosis & Treatment
Unrelated umbilical cord blood (UCB) is a new source of hematopoietic stem
cell (HSC) for allogeneic transplantation. The optimal conditioning for UCB
transplant has not been defined. Intensive immunosuppression is frequently
employed because of the higher risk of graft failure. Fludarabine monophos
phate is shown to be an effective agent for facilitating allogeneic HSC eng
raftment. We have recently encountered three children who were not ideal ca
ndidates for 'conventional' conditioning protocols. TBI followed by fludara
bine and melphalan were used for transplant preparation. The UCB units were
one HLA-antigen (n = 1) and two HLA-antigen mismatched with the recipients
. All three patients engrafted successfully. There was mild extramedullary
toxicity. Two patients are alive with complete chimerism 8 and 20 months af
ter transplant. A fludarabine-based protocol may be considered for selected
cases of UCB transplants.