Retrospective analysis of cord blood transplantation on 62 adult patients with advanced hematological malignancies

The Japan Cord Blood Network was established in 1999 and 8 institutions from the Kyushu Hematology Organization Study Group had performed cord blood transplantation (CBT) 67 times on 62 patients with advanced hematological malignancies from 1999 to 2004, which included acute and chronic leukemias in 34 patients, non-Hodgkin's lymphoma in 14, adult T-cell leukemia in 11 and others in 3 patients. The median age was 44 and disease status was no remission on 50 patients prior to CBT. Myeloablative conditioning regimens were used in 27 patients while 35 patients received non-myeloablatives. Engraftment could not be determined in 25 patients and the median survival time was 70 days. Thirteen patients were alive from 288 to 1277 days and 49 had been expired. The causes of death were the underlying disease in 19 patients, severe infection in 14 and graft-versus-host disease in 3 and miscellaneous in the remaining patients. This retrospective study shows that some patients with far-advanced hematological malignances could be successfully treated with CBT at the expense of many early deaths due to early relapse and severe infection. It is of importance that the appropriate indication for CBT should be discussed between transplant experts and patients and their families in each case.