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Analysis of 120 pediatric patients with nonmalignant disorders transplanted using unrelated plasma-depleted or -reduced cord blood

Authors

  • Lawrence Petz,

    1. From the StemCyte International Cord Blood Center, Covina, California; Chang Gung University & Chang Gung Memorial Hospital, Taiwan; the City of Hope Medical Center, Duarte, California; the University of Malaya Medical Center, Kuala Lumpur, Malaysia; the University of Arizona Medical Center, Tucson, Arizona; the Subang Jaya Medical Center, Kuala Lumpur, Malaysia; the Mount Elizabeth Hospital, Singapore; B.C.W. Statistical Consultants, Los Angeles, California; StemCyte Taiwan National Cord Blood Center, Linkou, Taiwan; and StemCyte India Therapeutics Private Limited, Ahmedabad, India.
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  • Tang-Her Jaing,

    1. From the StemCyte International Cord Blood Center, Covina, California; Chang Gung University & Chang Gung Memorial Hospital, Taiwan; the City of Hope Medical Center, Duarte, California; the University of Malaya Medical Center, Kuala Lumpur, Malaysia; the University of Arizona Medical Center, Tucson, Arizona; the Subang Jaya Medical Center, Kuala Lumpur, Malaysia; the Mount Elizabeth Hospital, Singapore; B.C.W. Statistical Consultants, Los Angeles, California; StemCyte Taiwan National Cord Blood Center, Linkou, Taiwan; and StemCyte India Therapeutics Private Limited, Ahmedabad, India.
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  • Joseph Rosenthal,

    1. From the StemCyte International Cord Blood Center, Covina, California; Chang Gung University & Chang Gung Memorial Hospital, Taiwan; the City of Hope Medical Center, Duarte, California; the University of Malaya Medical Center, Kuala Lumpur, Malaysia; the University of Arizona Medical Center, Tucson, Arizona; the Subang Jaya Medical Center, Kuala Lumpur, Malaysia; the Mount Elizabeth Hospital, Singapore; B.C.W. Statistical Consultants, Los Angeles, California; StemCyte Taiwan National Cord Blood Center, Linkou, Taiwan; and StemCyte India Therapeutics Private Limited, Ahmedabad, India.
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  • Chatchada Karanes,

    1. From the StemCyte International Cord Blood Center, Covina, California; Chang Gung University & Chang Gung Memorial Hospital, Taiwan; the City of Hope Medical Center, Duarte, California; the University of Malaya Medical Center, Kuala Lumpur, Malaysia; the University of Arizona Medical Center, Tucson, Arizona; the Subang Jaya Medical Center, Kuala Lumpur, Malaysia; the Mount Elizabeth Hospital, Singapore; B.C.W. Statistical Consultants, Los Angeles, California; StemCyte Taiwan National Cord Blood Center, Linkou, Taiwan; and StemCyte India Therapeutics Private Limited, Ahmedabad, India.
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  • Auayporn Nademanee,

    1. From the StemCyte International Cord Blood Center, Covina, California; Chang Gung University & Chang Gung Memorial Hospital, Taiwan; the City of Hope Medical Center, Duarte, California; the University of Malaya Medical Center, Kuala Lumpur, Malaysia; the University of Arizona Medical Center, Tucson, Arizona; the Subang Jaya Medical Center, Kuala Lumpur, Malaysia; the Mount Elizabeth Hospital, Singapore; B.C.W. Statistical Consultants, Los Angeles, California; StemCyte Taiwan National Cord Blood Center, Linkou, Taiwan; and StemCyte India Therapeutics Private Limited, Ahmedabad, India.
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  • Lee Lee Chan,

    1. From the StemCyte International Cord Blood Center, Covina, California; Chang Gung University & Chang Gung Memorial Hospital, Taiwan; the City of Hope Medical Center, Duarte, California; the University of Malaya Medical Center, Kuala Lumpur, Malaysia; the University of Arizona Medical Center, Tucson, Arizona; the Subang Jaya Medical Center, Kuala Lumpur, Malaysia; the Mount Elizabeth Hospital, Singapore; B.C.W. Statistical Consultants, Los Angeles, California; StemCyte Taiwan National Cord Blood Center, Linkou, Taiwan; and StemCyte India Therapeutics Private Limited, Ahmedabad, India.
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  • Michael L. Graham,

    1. From the StemCyte International Cord Blood Center, Covina, California; Chang Gung University & Chang Gung Memorial Hospital, Taiwan; the City of Hope Medical Center, Duarte, California; the University of Malaya Medical Center, Kuala Lumpur, Malaysia; the University of Arizona Medical Center, Tucson, Arizona; the Subang Jaya Medical Center, Kuala Lumpur, Malaysia; the Mount Elizabeth Hospital, Singapore; B.C.W. Statistical Consultants, Los Angeles, California; StemCyte Taiwan National Cord Blood Center, Linkou, Taiwan; and StemCyte India Therapeutics Private Limited, Ahmedabad, India.
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  • Hai Peng Lin,

    1. From the StemCyte International Cord Blood Center, Covina, California; Chang Gung University & Chang Gung Memorial Hospital, Taiwan; the City of Hope Medical Center, Duarte, California; the University of Malaya Medical Center, Kuala Lumpur, Malaysia; the University of Arizona Medical Center, Tucson, Arizona; the Subang Jaya Medical Center, Kuala Lumpur, Malaysia; the Mount Elizabeth Hospital, Singapore; B.C.W. Statistical Consultants, Los Angeles, California; StemCyte Taiwan National Cord Blood Center, Linkou, Taiwan; and StemCyte India Therapeutics Private Limited, Ahmedabad, India.
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  • Patrick Tan,

    1. From the StemCyte International Cord Blood Center, Covina, California; Chang Gung University & Chang Gung Memorial Hospital, Taiwan; the City of Hope Medical Center, Duarte, California; the University of Malaya Medical Center, Kuala Lumpur, Malaysia; the University of Arizona Medical Center, Tucson, Arizona; the Subang Jaya Medical Center, Kuala Lumpur, Malaysia; the Mount Elizabeth Hospital, Singapore; B.C.W. Statistical Consultants, Los Angeles, California; StemCyte Taiwan National Cord Blood Center, Linkou, Taiwan; and StemCyte India Therapeutics Private Limited, Ahmedabad, India.
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  • B.C. Wang,

    1. From the StemCyte International Cord Blood Center, Covina, California; Chang Gung University & Chang Gung Memorial Hospital, Taiwan; the City of Hope Medical Center, Duarte, California; the University of Malaya Medical Center, Kuala Lumpur, Malaysia; the University of Arizona Medical Center, Tucson, Arizona; the Subang Jaya Medical Center, Kuala Lumpur, Malaysia; the Mount Elizabeth Hospital, Singapore; B.C.W. Statistical Consultants, Los Angeles, California; StemCyte Taiwan National Cord Blood Center, Linkou, Taiwan; and StemCyte India Therapeutics Private Limited, Ahmedabad, India.
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  • Chen Fu,

    1. From the StemCyte International Cord Blood Center, Covina, California; Chang Gung University & Chang Gung Memorial Hospital, Taiwan; the City of Hope Medical Center, Duarte, California; the University of Malaya Medical Center, Kuala Lumpur, Malaysia; the University of Arizona Medical Center, Tucson, Arizona; the Subang Jaya Medical Center, Kuala Lumpur, Malaysia; the Mount Elizabeth Hospital, Singapore; B.C.W. Statistical Consultants, Los Angeles, California; StemCyte Taiwan National Cord Blood Center, Linkou, Taiwan; and StemCyte India Therapeutics Private Limited, Ahmedabad, India.
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  • Michelle Chow,

    1. From the StemCyte International Cord Blood Center, Covina, California; Chang Gung University & Chang Gung Memorial Hospital, Taiwan; the City of Hope Medical Center, Duarte, California; the University of Malaya Medical Center, Kuala Lumpur, Malaysia; the University of Arizona Medical Center, Tucson, Arizona; the Subang Jaya Medical Center, Kuala Lumpur, Malaysia; the Mount Elizabeth Hospital, Singapore; B.C.W. Statistical Consultants, Los Angeles, California; StemCyte Taiwan National Cord Blood Center, Linkou, Taiwan; and StemCyte India Therapeutics Private Limited, Ahmedabad, India.
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  • Stephen Forman,

    1. From the StemCyte International Cord Blood Center, Covina, California; Chang Gung University & Chang Gung Memorial Hospital, Taiwan; the City of Hope Medical Center, Duarte, California; the University of Malaya Medical Center, Kuala Lumpur, Malaysia; the University of Arizona Medical Center, Tucson, Arizona; the Subang Jaya Medical Center, Kuala Lumpur, Malaysia; the Mount Elizabeth Hospital, Singapore; B.C.W. Statistical Consultants, Los Angeles, California; StemCyte Taiwan National Cord Blood Center, Linkou, Taiwan; and StemCyte India Therapeutics Private Limited, Ahmedabad, India.
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  • Robert Chow

    Corresponding author
    1. From the StemCyte International Cord Blood Center, Covina, California; Chang Gung University & Chang Gung Memorial Hospital, Taiwan; the City of Hope Medical Center, Duarte, California; the University of Malaya Medical Center, Kuala Lumpur, Malaysia; the University of Arizona Medical Center, Tucson, Arizona; the Subang Jaya Medical Center, Kuala Lumpur, Malaysia; the Mount Elizabeth Hospital, Singapore; B.C.W. Statistical Consultants, Los Angeles, California; StemCyte Taiwan National Cord Blood Center, Linkou, Taiwan; and StemCyte India Therapeutics Private Limited, Ahmedabad, India.
      Robert Chow, MD, AM, StemCyte International Cord Blood Center, 1589 W. Industrial Park Street, Covina, CA 91722; e-mail: rchow888888@yahoo.com.
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Robert Chow, MD, AM, StemCyte International Cord Blood Center, 1589 W. Industrial Park Street, Covina, CA 91722; e-mail: rchow888888@yahoo.com.

Abstract

BACKGROUND: Unrelated cord blood (CB) is an important stem cell source for unrelated hematopoietic cell transplantation (HCT) of patients with nonmalignant disorders. Processing methods to prepare red blood cell–reduced CB units incur significant nucleated cell loss. In contrast, plasma depletion or reduction (PDR) processing of CB units entails the removal of only a portion of the plasma with minimal nucleated cell loss. However, there are relatively limited data regarding outcomes of CB transplants using units processed by PDR.

STUDY DESIGN AND METHODS: A Center for International Blood and Marrow Transplant Research (CIBMTR)-audited analysis was performed on 120 pediatric patients with nonmalignant disorders transplanted between November 2001 and January 2008 at 29 US and 17 international centers using PDR CB units from two CB banks.

RESULTS: Transplant characteristics were as follows: median age, 3.5 years (range, 0.1-14 years); median patient weight, 15 kg (range, 4-61 kg); 58% male; HLA matches (intermediate-resolution HLA-A and HLA-B and high-resolution HLA-DRB1) of the units used in these patients six of six in 26, five of six in 48, four of six in 47, and three of six or two of six in 6; median prefreeze total nucleated cell dose, 10.5 × 107/kg; median prefreeze CD34+ dose, 3.7 × 105/kg; and nonmyeloablative regimen in 24%. The median times to myeloid and platelet engraftment were 21 and 49 days, respectively. The cumulative incidence of reported Grade II to IV acute graft-versus-host disease (aGVHD) was 38 ± 5%, and 19 ± 4% had Grade III to IV aGVHD. The Kaplan-Meier estimates of 3-year transplant-related mortality, overall survival, and disease-free survival were 20 ± 4, 79 ± 4, and 70 ± 6%, respectively.

CONCLUSION: These data demonstrate the effectiveness of PDR CB units for HCT.

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