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Unrelated cord blood transplantation in children with sickle cell disease: review of four-center experience
Authors:Adamkiewicz Tom V  Szabolcs Paul  Haight Ann  Baker K Scott  Staba Susan  Kedar Amos  Chiang K Y  Krishnamurti Lakshmanan  Boyer Michael W  Kurtzberg Joan  Wagner John E  Wingard John R  Yeager Andrew M
Affiliation:Department of Family Medicine, Morehouse School of Medicine, Atlanta, East Point, GA 30344, USA. tadamkiewicz@msm.edu
Abstract:UCBT was performed in seven children with SCD and stroke (HLA match 4/6 n=5; 5/6 n=2). Four received myeloablative regimens (BU, CY, ATG plus FLU in one patient). One had primary graft failure, three had sustained engraftment, two with grade III-IV GVHD (one died, one developed chronic GVHD), one with stable mixed chimerism. Three patients treated with reduced-intensity regimens (FLU, BU or CY, ATG, TLI) failed to engraft; one engrafted after second UCBT (HU, TT, RXA, ALZ, TBI). Four patients (57%) developed viral infections. Engraftment, GVHD, and infection remain challenges.
Keywords:sickle cell disease    umbilical cord transplant    unrelated donor transplant    reduced intensity conditioning
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