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

Title
Current status of pediatric umbilical cord blood transplantation in Korea: A multicenter retrospective analysis of 236 cases
Author(s)
하정옥구홍회[구홍회]유건희[유건희]성기웅[성기웅]이수현[이수현]정낙균[정낙균]조빈[조빈]김학기[김학기]강형진[강형진]신희영[신희영]안효섭[안효섭]
Keywords
STEM-CELL TRANSPLANTATION; BONE-MARROW; ACUTE-LEUKEMIA; CYTOMEGALOVIRUS-INFECTION; NONMALIGNANT DISEASES; PERIPHERAL-BLOOD; UNRELATED DONORS; ADULT PATIENTS; ENGRAFTMENT; CHILDREN
Issue Date
201101
Publisher
WILEY-BLACKWELL
Citation
AMERICAN JOURNAL OF HEMATOLOGY, v.86, no.1, pp.12 - 17
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 CD341 cells were 4.84 x 10(7)/kg and 2.00 x 10(5)/kg, respectively. The median times to neutrophil (>0.5 x 10(9)/L) and platelet recovery (>20 x 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%. Am. J. Hematol. 86: 12-17, 2011. (C) 2010 Wiley-Liss, Inc.
URI
http://hdl.handle.net/YU.REPOSITORY/25752http://dx.doi.org/10.1002/ajh.21886
ISSN
0361-8609
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의과대학 > 소아청소년과학교실 > Articles
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