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 language||English (US)|
|Issue number||11 PART II|
|State||Published - Dec 1 2000|
ASJC Scopus subject areas
- Cell Biology