Umbilical cord blood transplantation (UCBT) for adult chronic myeloid leukemia (CML) patients - a single institution experience

M. Wetzler, M. R. Baer, James L Slack, L. Ford, P. L. McCarthy, B. J. Bambach

Research output: Contribution to journalArticle

Abstract

Allogeneic stem cell transplantation has been the treatment of choice for CML, as it offers the potential for cure of an otherwise fatal disease. Umbilical-cord blood is an alternative source of stem cells for patients who do not have suitable related or unrelated allogeneic donors. We have treated 6 adult CML patients with UCBT. The median age at time of UCBT was 38 (22-53 years). Three were male and three female. All patients were in chronic phase CML with t(9,22). Two patients received interferon-a pre-transplant. Interferon-α was discontinued at least 3 months pre-transplant in these patients. Median time from diagnosis to UCBT was 11.9 (3.0-23.2 months). The preparative regimen consisted of cyclophosphamide (120 mg/kg), anti-thymocyte globulin (90 mg/kg) and total body irradiation (1200 cGy). Graft-versus host disease (GVHD) prophylaxis included cyclosporine and steroids. HLA matching was 5/6 in 2 and 4/6 in 4 patients. Median cell dose was 2.4 × 107 nucleated cells/kg (range 1.9-2.7). Cells were thawed but not washed prior to infusion. One patient died on day 14 from regimen related toxicity. In the other 5 evaluable patients, day of engraftment post-UCBT was as follows: absolute neutrophil count > 500/mm3 - day 26 (16-43) and platelet > 50K/mm3 - day 75 (49-112). All 5 patients are alive in complete cytogenetic and molecular remission with a median follow-up of 17.6 (9.7-21.9 months). One patient had grade III, one had grade II, and two had grade I acute GVHD. Three patients required treatment for chronic GVHD, 2 were mild and one - severe. One patient developed severe neurologic complications of unknown etiology. This patient has almost completely recovered at this point. These data suggest that UCBT is a feasible approach to therapy with curative intent for adult CML patients who do not have suitable related or unrelated adult donors.

Original languageEnglish (US)
JournalBlood
Volume96
Issue number11 PART II
StatePublished - 2000
Externally publishedYes

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Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Fetal Blood
Blood
Transplantation
Grafts
Transplants
Stem cells
Interferons
Patient treatment
Graft vs Host Disease
Antilymphocyte Serum
Unrelated Donors
Platelets
Cyclophosphamide
Cyclosporine
Toxicity
Steroids
Irradiation
Leukemia, Myeloid, Chronic Phase
Whole-Body Irradiation

ASJC Scopus subject areas

  • Hematology

Cite this

Wetzler, M., Baer, M. R., Slack, J. L., Ford, L., McCarthy, P. L., & Bambach, B. J. (2000). Umbilical cord blood transplantation (UCBT) for adult chronic myeloid leukemia (CML) patients - a single institution experience. Blood, 96(11 PART II).

Umbilical cord blood transplantation (UCBT) for adult chronic myeloid leukemia (CML) patients - a single institution experience. / Wetzler, M.; Baer, M. R.; Slack, James L; Ford, L.; McCarthy, P. L.; Bambach, B. J.

In: Blood, Vol. 96, No. 11 PART II, 2000.

Research output: Contribution to journalArticle

Wetzler, M. ; Baer, M. R. ; Slack, James L ; Ford, L. ; McCarthy, P. L. ; Bambach, B. J. / Umbilical cord blood transplantation (UCBT) for adult chronic myeloid leukemia (CML) patients - a single institution experience. In: Blood. 2000 ; Vol. 96, No. 11 PART II.
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