Background

Cord blood transplantation (CBT) is accepted therapeutic method in transplantology since 1988. The first isolated CBT was performed on 12 October 2000 in Poznań.

Objective

Analysis of results of CBT in Polish pediatric centers.

Patients and methods

A total numer of 19 patients (5 female, 14 male), aged 0.1–10 years (median 4.3yrs) transplanted with cord blood between 2000–2011 in Polish pediatric centers. The initial diagnosis was: acute lymphoblastic leukemia (n=6), acute myeloid leukemia (n=1), myelodysplstic syndrome (n=2), Wiskott-Aldrich syndrome (n=3), Fanconi anemia (n=2), adrenoleukodystrophy (n=1), Langerhans cell histiocytosis (n=1), chronic granulomatous disease (n=1), Kostmann syndrome (n=1), Sandhoff syndrome (n=1). Pre-transplant conditioning was myeloablative in 9 patients and reduced-intensity in 10 patients. The source of cord blood was family donor in 8 cases or unrelated donor in 11 cases. Histocompatibility 6/6 HLA between donor-recipient was present in 10 cases.

Results

10/19 (52.6%) children stay alive, median survival 3.1 years (95%CI=1.4–4.7), probability of 2-year survival was 0.409±0.133. The cause of death was primary graft failure (n=2), infectious complications (n=3) or relapse (n=4). Two children with primary graft failure had subsequent haploidentical transplantation. In multivariate analysis, generalized documented infection was the only predictive adverse factor of overall survival.

Conclusion

CBT is an important therapeutic option for patients lacking matched donor, offering positive outcome for a half of patients.