Treatments for patients with hematologic malignancies not in remission are limited,
but a few clinical studies have investigated the effects of salvaged unrelated cord
blood transplantation (CBT). We retrospectively studied 19 patients with acute
leukemia, 5 with myelodysplastic syndrome (MDS with refractory anemia with excess
blasts [RAEB]), and 2 with non-Hodgkin's lymphoma who received 1 CBT unit ≤2 loci
human leukocyte antigen (HLA)-mismatched after undergoing myeloablative conditioning
regimens between July 2005 and July 2014. All of them were in non-remission before
transplantation. The infused total nucleated cell (TNC) dose was 4.07 (range
2.76-6.02)×107/kg and that of CD34+ stem cells was 2.08
(range 0.99-8.65)×105/kg. All patients were engrafted with neutrophils
that exceeded 0.5×109/L on median day +17 (range 14-37 days) and had
platelet counts of >20×109/L on median day +35 (range 17-70 days).
Sixteen patients (61.5%) experienced pre-engraftment syndrome (PES), and six (23.1%)
patients progressed to acute graft-versus-host disease (GVHD). The cumulative
incidence rates of II-IV acute GVHD and chronic GVHD were 50% and 26.9%,
respectively. After a median follow-up of 27 months (range 5-74), 14 patients
survived and 3 relapsed. The estimated 2-year overall survival (OS), disease-free
survival (DFS), and non-relapse mortality (NRM) rates were 50.5%, 40.3%, and 35.2%,
respectively. Salvaged CBT might be a promising modality for treating hematologic
malignancies, even in patients with a high leukemia burden.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.