The Lindsley F. Kimball Research Institute of the New York Blood Center, 310 East 67th Street, New York, New York 10021, USA
The transplantation of placental/umbilical cord blood (P/CB)
has been used successfully to reconstitute bone marrow function
in both related and unrelated recipients. We report here the
experience of the New York Blood Center P/CB Program. Since
its inception in 1992, over 400 unrelated transplants were supported
between July 1993 and September 1997. Overall, event-free survival
for all diagnoses and ages approached 0.45. Success and rapidity
of engraftment correlated most strongly with the degree of human
leukocyte antigen (HLA) disparity and cell dose/kg body weight
recipient. Acute graft-versus-host disease (GVHD) was common
in all patients but, surprisingly, did not differ between those
patients who received grafts having one or more antigen mismatches.
Chronic GVHD was uncommon and only rarely contributed to death.
These results demonstrate the feasibility of large-scale P/CB
banking for the provision of cryopreserved stem cell preparations
for unrelated transplants. The degree of the program's success
argues strongly for additional P/CB banks in order to increase
the likelihood of finding a suitable stem cell preparation for
patients for whom related matched donors do not exist.
