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Current status of pediatric umbilical cord blood transplantation in Korea: a multicenter retrospective analysis of 236 cases.

Authors
Yoo, KH; Lee, SH; Sung, KW; Koo, HH; Chung, NG; Cho, B; Kim, HK; Kang, HJ; Shin, HY; Ahn, HS; Baek, HJ; Han, DK; Kook, H; Hwang, TJ; Kim, SY; Lee, YH; Hah, JO; Im, HJ; Seo, JJ; Park, SK; Jung, HJ; Park, JE; Lim, YJ; Park, SS; Lim, YT; Yoo, ES; Ryu, KH; Park, HJ; Park, BK
Citation
American journal of hematology, 86(1):12-17, 2011
Journal Title
American journal of hematology
ISSN
0361-86091096-8652
Abstract
We report the outcome of 236 pediatric umbilical cord blood transplantations (UCBT) performed in Korea. Given that the sources of the grafts were mostly unrelated donors (n = 226; 95.8%), only the results of unrelated UCBT were included for all statistics. The most frequent primary disease was acute leukemia (n = 167). In total, 91.7% of recipients were seropositive for cytomegalovirus (CMV). The median doses of nucleated cells and CD34+ cells were 4.84 × 10(7)/kg and 2.00 × 10(5)/kg, respectively. The median times to neutrophil (>0.5 × 10(9)/L) and platelet recovery (>20 × 10(9)/L) were 18 and 45 days, respectively. Grade 2-4 acute graft-versus-host-disease (GVHD) and chronic GVHD developed in 41.1 and 36.1% of cases, respectively. Forty-five patients developed CMV disease. The 5-year overall and event-free survival were 47.5 and 36.9%, respectively. Multivariate analysis revealed that adverse factors for survival of the whole cohort were total body irradiation-based conditioning (P = 0.007), salvage transplant (P = 0.001), failure to achieve early complete chimerism (P < 0.0005), and CMV disease (P = 0.001). The outcomes of the single- and double-unit UCBT (n = 64) were similar, while double-unit recipients were heavier (P < 0.0005) and older (P < 0.0005). We conclude that double-unit UCBT is a reasonable option for older or heavier children and that the thorough surveillance of CMV infection and the development of an effective CMV therapeutic strategy may be especially important for Korean children, whose CMV seroprevalence exceeds 90%.
MeSH terms
Acute DiseaseAdolescentChildChild, Preschool*Cord Blood Stem Cell TransplantationCytomegalovirus Infections/etiologyDisease-Free SurvivalFemaleFetal Blood/*transplantationGraft vs Host Disease/immunologyHLA Antigens/immunology*Hematopoietic Stem Cell TransplantationHumansInfantInfant, NewbornLeukemia/surgeryMaleMultivariate AnalysisRepublic of KoreaRetrospective StudiesTreatment Outcome
DOI
10.1002/ajh.21886
PMID
21064135
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Pediatrics & Adolescent Medicine
AJOU Authors
정, 현주박, 준은
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