Umbilical cord blood transplant from unrelated HLA-mismatched donors in children with high risk leukemia

W. Arcese, C. Guglielmi, A. P. Iori, M. Screnci, D. Carmini, A. M. Testi, M. L. Moleti, A. Mengarelli, I. Del Giudice, G. Cimino, L. Elia, M. C. Rapanotti, P. Perrone, L. Laurenti, G. Gentile, F. Boecklin, A. Romano, L. De Felice, F. Mandelli

Research output: Contribution to journalArticle

Abstract

In the last 3 years, 14 children with high-risk leukemia (11 ALL, 2 AML and 1 CML) underwent cord blood transplantation from unrelated HLA-mismatched donors at a median of 99 days from the start of search. Eight patients were transplanted in second CR, one in accelerated phase, three at relapse and two patients in first CR. Conditioning regimen (fractionated TBI, etoposide, CY and anti-lymphocyte serum) and prophylaxis of GVHD (CsA and 6-methylprednisolone) were identical for all patients. Neutrophils > 0.5 x 109/l were reached at a median of 33 days from transplant, but in four cases we observed an autologous hematopoietic reconstitution (three spontaneous, one after autologous BM rescue). Acute and chronic GVHD were observed in 10/14 and 3/8 evaluable cases, respectively. Three patients died of transplant-related toxicity and three patients relapsed. The probabilities of event-free, disease-free and overall survival were 50, 53 and 64%, respectively. Cord blood transplant from HLA-mismatched unrelated donor is a valid option for the treatment of children with high-risk leukemia. With our eligibility criteria, conditioning regimen and prophylaxis of graft-versus-host disease, the main obstacles to successful transplant were represented by graft failure and fatal acute GVHD.

Original languageEnglish
Pages (from-to)549-554
Number of pages6
JournalBone Marrow Transplantation
Volume23
Issue number6
Publication statusPublished - 1999

Fingerprint

Fetal Blood
Leukemia
Tissue Donors
Transplants
Unrelated Donors
Methylprednisolone
Graft vs Host Disease
Etoposide
Disease-Free Survival
Neutrophils
Transplantation
Lymphocytes
Recurrence
Serum
Therapeutics

Keywords

  • Children
  • Cord blood
  • Leukemia
  • Transplantation

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Arcese, W., Guglielmi, C., Iori, A. P., Screnci, M., Carmini, D., Testi, A. M., ... Mandelli, F. (1999). Umbilical cord blood transplant from unrelated HLA-mismatched donors in children with high risk leukemia. Bone Marrow Transplantation, 23(6), 549-554.

Umbilical cord blood transplant from unrelated HLA-mismatched donors in children with high risk leukemia. / Arcese, W.; Guglielmi, C.; Iori, A. P.; Screnci, M.; Carmini, D.; Testi, A. M.; Moleti, M. L.; Mengarelli, A.; Del Giudice, I.; Cimino, G.; Elia, L.; Rapanotti, M. C.; Perrone, P.; Laurenti, L.; Gentile, G.; Boecklin, F.; Romano, A.; De Felice, L.; Mandelli, F.

In: Bone Marrow Transplantation, Vol. 23, No. 6, 1999, p. 549-554.

Research output: Contribution to journalArticle

Arcese, W, Guglielmi, C, Iori, AP, Screnci, M, Carmini, D, Testi, AM, Moleti, ML, Mengarelli, A, Del Giudice, I, Cimino, G, Elia, L, Rapanotti, MC, Perrone, P, Laurenti, L, Gentile, G, Boecklin, F, Romano, A, De Felice, L & Mandelli, F 1999, 'Umbilical cord blood transplant from unrelated HLA-mismatched donors in children with high risk leukemia', Bone Marrow Transplantation, vol. 23, no. 6, pp. 549-554.
Arcese W, Guglielmi C, Iori AP, Screnci M, Carmini D, Testi AM et al. Umbilical cord blood transplant from unrelated HLA-mismatched donors in children with high risk leukemia. Bone Marrow Transplantation. 1999;23(6):549-554.
Arcese, W. ; Guglielmi, C. ; Iori, A. P. ; Screnci, M. ; Carmini, D. ; Testi, A. M. ; Moleti, M. L. ; Mengarelli, A. ; Del Giudice, I. ; Cimino, G. ; Elia, L. ; Rapanotti, M. C. ; Perrone, P. ; Laurenti, L. ; Gentile, G. ; Boecklin, F. ; Romano, A. ; De Felice, L. ; Mandelli, F. / Umbilical cord blood transplant from unrelated HLA-mismatched donors in children with high risk leukemia. In: Bone Marrow Transplantation. 1999 ; Vol. 23, No. 6. pp. 549-554.
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