Gluckman E, Rocha V, Chastang C
Hôpital St Louis, Paris, France.
Bone Marrow Transplant. 1998 Jul;22 Suppl 1:S68-74.
Cord blood banks have increased the use of cord blood transplants (CBT) for patients with hematological disorders. EUROCORD has established a registry for providing information on the outcome of CBT. Questionnaires were sent to all EUROCORD members to collect information on patients transplanted from 1988 to 1996. One hundred and forty-three CBT, performed in 45 centers, were analyzed for survival, engraftment and graft-versus-host disease (GVHD). Results in recipients of related and unrelated transplants were analyzed separately. In 78 patients who received CB from a related donor, 1-year survival was 63 +/- 6%. Age, weight, HLA identity and negative cytomegalovirus (CMV) serology in the recipient were significant favorable prognostic factors. Among these 78 patients, the incidence of grade > or = II GVHD was 9% in HLA matched CBT and 50% in mismatched CBT. Neutrophil engraftment was associated with age < 6 years (P = 0.02), weight < 20 kg (P = 0.02). It was 73% in patients receiving < 3.7 x 10(7) nucleated cells (NC) infused/kg and 85% in patients receiving more (P = 0.06). Among 65 patients, who received CB from an unrelated donor, 1-year survival was 29 +/- 7%. Negative recipient CMV serology was associated with improved survival (P = 0.01). Acute GVHD > or = II was observed in 40% of these patients. Negative recipient CMV serology was the most important factor for predicting GVHD (P = 0.04). Neutrophil recovery was 76% in patients receiving < 3.7 x 10(7) NC/kg and 94% in patients receiving more (P = 0.008). Cord blood is a feasible alternative source of hematopoietic stem cells for treating patients with various hematological disorders.
脐血库增加了脐血移植（CBT）在血液系统疾病患者中的应用。欧洲脐血库（EUROCORD）建立了一个登记处，以提供有关脐血移植结果的信息。向所有EUROCORD成员发送了调查问卷，以收集1988年至1996年接受移植患者的信息。对在45个中心进行的143例脐血移植进行了生存、植入和移植物抗宿主病（GVHD）分析。对相关和非相关移植受者的结果分别进行了分析。在78例接受来自相关供体脐血的患者中，1年生存率为63±6%。受者的年龄、体重、HLA匹配度和巨细胞病毒（CMV）血清学阴性是显著的有利预后因素。在这78例患者中，HLA匹配的脐血移植中≥II级GVHD的发生率为9%，不匹配的脐血移植中为50%。中性粒细胞植入与年龄<6岁（P = 0.02）、体重<20 kg（P = 0.02）有关。接受输注核细胞（NC）<3.7×10⁷/kg的患者中为73%，接受更多的患者中为85%（P = 0.06）。在65例接受来自非相关供体脐血的患者中，1年生存率为29±7%。受者CMV血清学阴性与生存率提高相关（P = 0.01）。这些患者中有40%观察到急性GVHD≥II级。受者CMV血清学阴性是预测GVHD的最重要因素（P = 0.04）。接受NC<3.7×10⁷/kg的患者中性粒细胞恢复率为76%，接受更多的患者中为94%（P = 0.008）。脐血是治疗各种血液系统疾病患者的可行造血干细胞替代来源。
