International Journal of Hematology

DOI: 10.1007/s12185-009-0266-9 Pages: 374-382

Survival after cord blood transplantation from unrelated donor as a second hematopoietic stem cell transplantation for recurrent pediatric acute myeloid leukemia

1. Okayama University Graduate School of Medicine and Dentistry, Department of Pediatrics

2. Showa University Fujigaoka Hospital, Department of Pediatrics

3. Hirosaki University School of Medicine, Department of Pediatrics

4. Osaka Medical Center and Research Institute for Maternal and Child Health, Department of Hematology/Oncology

5. Ibaraki Children’s Hospital, Department of Pediatrics

6. Kanagawa Children’s Medical Center, Division of Hemato-oncology/Regulation Medicine

7. Children’s Medical Center, Japanese Red Cross Nagoya First Hospital, Division of Hematology/Oncology

8. Tokai University School of Medicine, Department of Cell Transplantation

Correspondence to:
K. Isoyama
Email: isoyama@showa-university-fujigaoka.gr.jp

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Abstract

The Japan Cord Blood Bank Network (JCBBN) reports the treatment of 22 children with acute myeloid leukemia (AML) who received umbilical cord blood transplantation from unrelated donors (CBT) as their second hematopoietic stem cell transplantation (HSCT). Provided by the JCBBN, between February 1997 and September 2006, 22 patients had CBT as a second HSCT. In the initial HSCT, eight received autologous, seven received CBT, and the remaining had allogenic BMT. At the time of CBT as a second HSCT, seven were in the second complete remission (CR2), two in the third CR (CR3), the remaining were not in remission. Reduced intensity conditioning (RIC) conducted for 10 cases and myeloablative conditioning (MAC) for 12 cases. The overall survival rate was 31.3%, 5 years after CBT. Second complete remission at second transplantation was favorable prognosis (58.3 ± 18.6%, compared with 17.1 ± 10.8% for the non-CR group. Mortality after CBT as a second HSCT accounted for 15 cases, 8 from treatment-related mortality. In conclusion, CBT combined with RIC as second HSCT may be useful against a recurrence of AML in children after the initial HSCT.

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