Second allogeneic transplantation using unrelated cord blood for relapsed hematological malignancies after allogeneic transplantation

Abstract

The efficacy of second allogeneic stem cell transplantation (SCT2) using cord blood (CB) for patients with relapsed hematological malignancies after initial allogeneic stem cell transplantation (SCT1) is unknown. We analyzed the results of SCT2 using single-unit unrelated CB in 34 adult patients with relapsed hematological malignancies after SCT1 in our institution. The patients had acute myeloid leukemia (n = 23), acute lymphoblastic leukemia (n = 7), chronic myelogenous leukemia (n = 2), and myelodysplastic syndrome (n = 2). The cumulative incidence of neutrophil and platelet engraftment was 81.6% at 30 days and 68.5% at 100 days, respectively. With a median follow-up of 40 months, the probability of overall survival at 3 years was 29.0%. The cumulative incidence of relapse and transplant-related mortality at 3 years were 60.7% and 27.2%, respectively. The use of CB could offer the opportunity to receive SCT2 for patients who experienced disease relapse after SCT1 without HLA-identical related or unrelated donors.

Keywords::

• Acute lymphoblastic leukemia
• acute myeloid leukemia
• chronic myelogenous leukemia
• cord blood transplantation
• myelodysplastic syndrome
• second allogeneic stem cell transplantation

Acknowledgements

The authors would like to thank all of the physicians and staff at the hospital and the cord blood banks in Japan for their help in this study. This work was supported in part by The Kobayashi Foundation.

Potential conflict of interest

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Supplementary material available online

Supplementary Table 1 to be found at online http://informahealthcare.com/doi/abs/10.3109/10428194.2015.1045900.