Abstract OBJECTIVE: To study the influence of cord blood total nucleated cell (TNC) dose on the efficacy of cord blood transplantation in children. METHODS: Thirty-four children with hematological disease received cord blood transplantation. They were assigned to 3 groups according to the infused TNC dose: TNC>10×107/kg (n=7), 10×107/kg>TNC≥7×107/kg (n=9) and TNC10×107/kg got a long-term stable engraftment. The median time of absolute neutrophil count >0.5×109/L was 14.8 days (range 12-20 days) and platelets >50×109/L was 52.3 days (range 26-86 days). They survived in a disease-free state. Of the 9 children in the group infused with TNC between 10×107/kg and 7×107/kg, 7 got engraftment. The median time of absolute neutrophil count >0.5×109/L was 16.4 days (range 11-30 days) and platelets >50×109/L was 63.7 days (range 34-140 days). Four children got a long-term stable engraftment and survived in a disease-free state. Two children with beta-thalassemia major had secondary rejection after engraftment and autologous hematopoitic recovery. One child died after engraftment and one child died in the early period after transplantation. Of the 18 children in the group infused with TNC 0.5×109/L was 19.5 days (range 10-29 days) and platelets >50×109/L was 70.1 days (range 41-116 days). Eight children had a long-term stable engraftment and survived in a disease-free state. Two children with beta-thalassemia major had secondary rejection after engraftment and autologous hematopoitic recovery. Six children died after engraftment. Two children had graft failure. CONCLUSIONS: TNC dose is an important influencing factor for hematopoietic stem cell engraftment in cord blood transplantation. An increased TNC dose may improve the success of cord blood transplantation.［Chin J Contemp Pediatr, 2010, 12 (7):551-556］
LIU Sha,HAO Wen-Ge,HUANG Yong-Lan et al. Influence of total nucleated cell dose on the efficacy of cord blood transplantation[J]. 中国当代儿科杂志, 2010, 12(07): 551-556.
LIU Sha,HAO Wen-Ge,HUANG Yong-Lan et al. Influence of total nucleated cell dose on the efficacy of cord blood transplantation[J]. CJCP, 2010, 12(07): 551-556.
［2］Lucarelli G, Andreani M, Angelucci E. The cure of thalassemia with bone marrow transplantation［J］. Bone Marrow Transplant, 2001, 28:S11-S13.
［3］Rocha V, Cornish J, Sievers EL, Filipovich A, Locatelli F, Peters C, et al. Comparison of outcomes of unrelated bone marrow and unbilical cord blood transplants in children with acute leukemia［J］. Blood, 2001, 97(10):2962-2971.
［5］Gluckman E, Rocha V, Boyer-Chammard A, Locatelli F, Arcese W, Pasquini R, et al.Outcome of cord-blood transplantation from related and unrelated donors: Eurocord Transplant Group and the European Blood and Marrow Transplantation Group［J］. N Engl J Med, 1997, 337(6):373-381.
［6］Kurtzberg J, Prasad VK, Carter SL, Wagner JE, Baxter-Lowe LA, Wall D, et al. Results of the Cord Blood Transplantation Study (COBLT): clinical outcomes of unrelated donor umbilical cord blood transplantation in pediatric patients with hematologic malignancies［J］. Blood, 2008, 112(10):4318-4327.
［7］Gluckman E. Hematopoietic stem-cell transplants using umbilical-cord blood［J］. N Engl J Med, 2001, 344(24):1860-1861.
［8］Wagner JE, Barker JN, DeFor TE, Baker KS, Blazar BR, Eide C, et al. Transplantation of unrelated donor umbilical cord blood in 102 patients with malignant and nonmalignant diseases: influence of CD34 cell dose and HLA disparity on treatment-related mortality and survival［J］. Blood, 2002, 100(5): 1611-1618.
［9］Styczynski J, Cheung YK, Garvin J, Savage DG, Billote GB, Harrison L, et al. Outcomes of unrelated cord blood transplantation in pediatric recipients ［J］. Bone Marrow Transplant, 2004, 34(2), 129-136.
［10］Shpall EJ, Quinones R, Giller R, Zeng C, Baron AE, Jones RB, et al. Transplantation of ex vivo expanded cord blood［J］. Biol Blood Marrow Transplant, 2002,8(7):368-376.
［12］Goussetis E, Peristeri J, Kitra V, Kattamis A, Petropoulos D, Papassotiriou I, et al. Combined umbilical cord blood and bone marrow transplantation in the treatment of beta-thalassemia major［J］. Pediatr Hematol Oncol, 2000, 17(4):307-314.
［13］Magro E, Regidor C, Cabrera R, Sanjuán I, Forés R, García-Marco J, et al. Early hematopoietic recovery after single unit unrelated cord blood transplantation in adults supported by co-infusion of mobilized stem cells from a third party donor［J］. Haematologica, 2006, 91(5):640-648.
［14］Rocha V, Gluckman E. Improving outcomes of cord blood transplantation: HLA matching, cell dose and other graft-and transplantationrelated factors［J］. Br J Haematol, 2009, 147(2):262-274.
