Abstract
Cord blood stem cell transplantation (CBSCT) was performed on a patient with advanced neuroblastoma. The patient was a girl, 1 year and 6 months old, who had shown partial remission following treatment with intensive chemotherapy according to the new A 1 regimen. However, 3 weeks after surgical removal of the original tumor and metastatic lymph nodes in the abdomen, extensive relapse occurred. The patient was treated with CBSCT from an HLA-matched sibling donor after the administration of carboplatin, etoposide, melphalan and abdominal irradiation. The number of nucleated cells in the cord blood was 2.0×107/kg, and that of granulocyte-macrophage colony-forming units 3.8×104/kg. Methotrexate was given on days 3 and 6 as a prophylaxis against graft-versus-host disease (GVHD). The neutrophil count rose to above 500/μl on day 24.The platelet count exceeded 50, 000/μl on day 67, and the last platelet transfusion was on day 60. Grade I acute GVHD was treated with prednisolone, which was discontinued on day 46 without any symptoms of GVHD. On day 43, the patient showed local relapse in the left tibial bone and the right patella, which were irradiated for treatment. However, on day 120, systemic relapse occurred. On day 170, the patient died of cancer. Hematopoietic cells in her bone marrow were detected in those derived from the donor. This case, with previously reported CBSCT cases, encourages us to perform unrelated CBSCT in selected patients through our regional cord blood bank, or the Kanagawa Cord Blood Bank.
