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Unrelated umbilical cord blood transplantation
in children: experience of the Hong Kong Red Cross Blood Transfusion
Service
CK Li, MMK Shing, KW Chik,
KS Tsang, NLS Tang, PKS Chan, NK Chan, V Lee, MHL Ng, CK Lin, PMP
Yuen
Department of Paediatrics, The Chinese University of Hong Kong,
Prince of Wales Hospital, Shatin, Hong Kong
OBJECTIVE. To review the outcome of unrelated umbilical
cord blood transplantation in children using cord blood from the
Hong Kong Red Cross Blood Transfusion Service.
DESIGN. Retrospective study.
PATIENTS. Records of eight patients who received
unrelated umbilical cord blood transplants between 1999 and 2003
were reviewed.
MAIN OUTCOME MEASURES. Engraftment of haematopoietic
cells and graft-versus-host disease after transplantation.
RESULTS. The median age of the patients was 4.9
years (range, 1.0-9.4 years). Five patients had acute leukaemia,
one had non-Hodgkin's lymphoma, one had X-linked adrenoleukodystrophy,
and one had mucolipidosis. The infused umbilical cord blood units
contained a median of 6.7 x 10 7 /kg nucleated cells
and 4.0 x 10 /kg CD34-positive cells. Neutrophil engraftment was
achieved at a median of 13 days (range, 11-19 days) and, for seven
patients, platelet engraftment was achieved at a median of 39 days
(range, 24-98 days). Acute graft-versus-host disease occurred in
all patients (grades I to III). One of the patients died because
of encephalitis; of the other seven, five developed chronic graft-versus-host
disease of the skin. At a median follow-up of 2 years, the four
patients with leukaemia and the one with non-Hodgkin's lymphoma
remained in continuous complete remission; the patient with adrenoleukodystrophy
showed stabilisation of neurological condition.
CONCLUSION. The Hong Kong Red Cross Blood Transfusion
Service Cord Blood Bank stored cord blood units of good quality
for transplantation, the outcome of which was comparable to that
of bone marrow transplantation.
Hong Kong Med J 2004;10:89-95
Key words: Child; Cord blood stem cell transplantation;
Graft vs host disease; Leukemia
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