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Early identification and management of graft failure after unrelated cord blood transplantation
- Source :
- Bone Marrow Transplantation. 42:35-41
- Publication Year :
- 2008
- Publisher :
- Springer Science and Business Media LLC, 2008.
-
Abstract
- Delayed hematologic recovery is common after unrelated donor umbilical cord blood transplants (UCBT). Clinically it is important to quickly differentiate slow engraftment from graft failure (GF). We report the engraftment data on 110 pediatric UCBT recipients. By day 28, 71 patients achieved an ANC >0.5 × 109 per liter, and 6 others died early without recovery. Of the remaining 33 patients who were still neutropenic, 20 eventually attained donor myeloid recovery, 3 died of transplant-related complications or recurrent leukemia and 10 survived without donor-derived hematopoiesis. These patients received a second UCBT 33–95 days after the first transplant, after additional immunosuppression. One patient died early, the remaining nine patients were engrafted; eight demonstrated complete, and one mixed, donor chimerism (with subsequent graft loss). Acute GVHD developed in three, and chronic GVHD in six of the eight engrafted patients. Two patients developed EBV-lymphoproliferative disorder. Infections, especially viral, were common and protracted. Six of 10 patients are alive, 165–1375 (median 1147) days after second UCBT. Chimerism studies correlated with subsequent engraftment course. Any result showing
- Subjects :
- Male
medicine.medical_specialty
Transplantation Conditioning
Myeloid
Adolescent
medicine.medical_treatment
Umbilical cord
Cohort Studies
Internal medicine
medicine
Humans
Transplantation, Homologous
Treatment Failure
Child
Retrospective Studies
Salvage Therapy
Transplantation Chimera
Transplantation
Hematology
business.industry
Graft Survival
Hematopoietic Stem Cell Transplantation
Infant
Immunosuppression
medicine.disease
Surgery
Haematopoiesis
Leukemia
surgical procedures, operative
medicine.anatomical_structure
Child, Preschool
Female
Cord Blood Stem Cell Transplantation
Viral disease
Stem cell
business
Subjects
Details
- ISSN :
- 14765365 and 02683369
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- Bone Marrow Transplantation
- Accession number :
- edsair.doi.dedup.....9c9dd5529241200a9ff5a96e9dd6c7d0