2004 Volume 18 Issue 3 Pages 127-139
Unrelated cord blood transplantation (UR-CBT) has been established as an alternative for hematopoietic stem cell transplantation. Japan Cord Blood Bank Network offer over 17, 000 cord blood units and more than 1, 500 transplants were done by the beginning of 2004. The advantages of UR-CBT include transplantability between HLA mismatched pairs and immediate availability for urgent transplantation, but delayed hematological recovery and low incidence of engraftment are recognized as major disadvantages. Outcome of UR-CBT for children with acute leukemia revealed no correlation between HLA disparity and acute GVHD, and high relapse rate in patients with advanced disease or who received HLA matched graft. By multivariate analysis, the only prognostic factor for disease-free survival was disease status at transplantation. From now on, effort should be made to improve the outcome of transplant by overcoming disadvantages of CBT concomitant with decreasing the risks of late toxicities.
