Researchers from Duke University have reported that unrelated umbilical cord blood transplants for myelodysplastic syndrome in children result in a three-year event-free survival of 61%. The details of this study appeared in the August 2009 issue of Biology of Blood and Marrow Transplantation.[1]
Allogeneic stem cell transplants are an important therapy for selected children with hematologic diseases. The source of stems cells is usually from HLA-matched related or unrelated donors. For children without a suitable donor, stem cells from unrelated umbilical cord blood appear to be an acceptable alternative.
The current study reports the outcomes of 23 children who received umbilical cord blood transplants for advanced MDS. All patients were treated with myeloablative regimens, which involved total body irradiation in 78%. The incidence of transplant-related deaths in one year was 27%. Causes of death included graft failure, relapse, and infection. Event-free survival was 70% at one year and 61% at three years. Better outcomes were associated with ages under 11 years and weight less than 38 kg.
Comments: These data are comparable to those achieved with matched sibling transplants. Umbilical cord blood transplants should be used as early as possible in the disease course of MDS when no related or unrelated donor is available.
Reference:
[1] Parikh SH, Mendizabal A, Martin A, et al. Unrelated donor umbilical cord blood transplantation in pediatric myelodysplastic syndrome: a single center experience. Biology of Blood and Marrow Transplantation. 2009;15:948-955.
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