Abstract
Recently, reduced-intensity cord blood transplantation (Mini-CBT) has been focused at many transplantation centers and it has been performed mainly for elderly patients. Although we find some reports that discuss transplantation results, there are still few papers that research transfusion medicine in CBT.
We have performed cord blood transplants to 11 patients with hematologically malignant disease. Five patients were conditioned by 12Gy of TBI (Total body irradiation) and high-dose chemotherapy (Full-CBT) and 6 patients were transplanted as Mini-CBT (2Gy of TBI, Fuludarabin and Busulfan). Post-transplant immunosuppressive regimen consists of cyclosporin+short term Methotrexate for Full-CBT and cyclosporin+mycophenolate mofetil for Mini-CBT. As post-transplant courses were uneventful in most cases and engrafted in all cases exhibiting less than mild GVHD, we could not observe significant differences in the transplantation results of both CBT groups. Regarding RBC transfusion in Full-CBT group, the frequency, total units, and final day of transfusion were 13.0, 26.0 and 43.0 respectively, and those in Mini-CBT group were 7.5, 15.0 and 36.5 respectively, resulting in no significant difference between the two groups. Regarding platelet transfusion, the frequency, total unit and final day of transfusion in Full-CBT group were 22.5, 217.5 and 43.5 respectively and those in Mini-CBT group were 23.0, 230.0 and 42.0 respectively, showing no significant differences. For trial, we used 5 unit-platelet concentrates in 2 cases, resulting in the large decrease of the amount of transfused platelets, but the frequency of transfusion showed no differences. No bleeding was observed in these cases.
As a conclusion Mini-CBT does not increase the quantity of consumed blood transfusions. However the number of case studies is still so small, further investigation is needed to reach final conclusions.
