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Outcomes among 562 recipients of placental-blood transplants from unrelated donors.

Publication ,  Journal Article
Rubinstein, P; Carrier, C; Scaradavou, A; Kurtzberg, J; Adamson, J; Migliaccio, AR; Berkowitz, RL; Cabbad, M; Dobrila, NL; Taylor, PE ...
Published in: N Engl J Med
November 26, 1998

BACKGROUND: A program for banking, characterizing, and distributing placental blood, also called umbilical-cord blood, for transplantation provided grafts for 562 patients between August 24, 1992, and January 30, 1998. We evaluated this experience. METHODS: Placental blood was stored under liquid nitrogen and selected for specific patients on the basis of HLA type and leukocyte content. Patients were prepared for the transplantation of allogeneic hematopoietic cells in the placental blood and received prophylaxis against graft-versus-host disease (GVHD) according to routine procedures at each center. RESULTS: Outcomes at 100 days after transplantation were known for all 562 patients, and outcomes at 1 year for 94 percent of eligible recipients. The cumulative rates of engraftment among the recipients, according to actuarial analysis, were 81 percent by day 42 for neutrophils (median time to engraftment, 28 days) and 85 percent by day 180 for platelets (median, day 90). The speed of myeloid engraftment was associated primarily with the leukocyte content of the graft, whereas transplantation-related events were associated with the patient's underlying disease and age, the number of leukocytes in the graft, the degree of HLA disparity, and the transplantation center. After engraftment, age, HLA disparity, and center were the primary predictors of outcome. Severe acute GVHD (grade III or IV) occurred in 23 percent of patients, and chronic GVHD occurred in 25 percent. The rate of relapse among recipients with leukemia was 9 percent within the first 100 days, 17 percent within 6 months, and 26 percent by 1 year. These rates were associated with the severity of GVHD, type of leukemia, and stage of the disease. CONCLUSIONS: Placental blood is a useful source of allogeneic hematopoietic stem cells for bone marrow reconstitution.

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Published In

N Engl J Med

DOI

ISSN

0028-4793

Publication Date

November 26, 1998

Volume

339

Issue

22

Start / End Page

1565 / 1577

Location

United States

Related Subject Headings

  • Risk
  • Recurrence
  • Placenta
  • Outcome Assessment, Health Care
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Lymphoma
  • Leukocyte Count
  • Leukemia
 

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Rubinstein, P., Carrier, C., Scaradavou, A., Kurtzberg, J., Adamson, J., Migliaccio, A. R., … Stevens, C. E. (1998). Outcomes among 562 recipients of placental-blood transplants from unrelated donors. N Engl J Med, 339(22), 1565–1577. https://doi.org/10.1056/NEJM199811263392201
Rubinstein, P., C. Carrier, A. Scaradavou, J. Kurtzberg, J. Adamson, A. R. Migliaccio, R. L. Berkowitz, et al. “Outcomes among 562 recipients of placental-blood transplants from unrelated donors.N Engl J Med 339, no. 22 (November 26, 1998): 1565–77. https://doi.org/10.1056/NEJM199811263392201.
Rubinstein P, Carrier C, Scaradavou A, Kurtzberg J, Adamson J, Migliaccio AR, et al. Outcomes among 562 recipients of placental-blood transplants from unrelated donors. N Engl J Med. 1998 Nov 26;339(22):1565–77.
Rubinstein, P., et al. “Outcomes among 562 recipients of placental-blood transplants from unrelated donors.N Engl J Med, vol. 339, no. 22, Nov. 1998, pp. 1565–77. Pubmed, doi:10.1056/NEJM199811263392201.
Rubinstein P, Carrier C, Scaradavou A, Kurtzberg J, Adamson J, Migliaccio AR, Berkowitz RL, Cabbad M, Dobrila NL, Taylor PE, Rosenfield RE, Stevens CE. Outcomes among 562 recipients of placental-blood transplants from unrelated donors. N Engl J Med. 1998 Nov 26;339(22):1565–1577.
Journal cover image

Published In

N Engl J Med

DOI

ISSN

0028-4793

Publication Date

November 26, 1998

Volume

339

Issue

22

Start / End Page

1565 / 1577

Location

United States

Related Subject Headings

  • Risk
  • Recurrence
  • Placenta
  • Outcome Assessment, Health Care
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Lymphoma
  • Leukocyte Count
  • Leukemia