Results of the Cord Blood Transplantation Study (COBLT): clinical outcomes of unrelated donor umbilical cord blood transplantation in pediatric patients with hematologic malignancies

Blood. 2008 Nov 15;112(10):4318-27. doi: 10.1182/blood-2007-06-098020. Epub 2008 Aug 21.

Abstract

Outcomes of unrelated donor cord blood transplantation in 191 hematologic malignancy children (median age, 7.7 years; median weight, 25.9 kg) enrolled between 1999 and 2003 were studied (median follow-up, 27.4 months) in a prospective phase 2 multicenter trial. Human leukocyte antigen (HLA) matching at enrollment was 6/6 (n = 17), 5/6 (n = 58), 4/6 (n = 111), or 3/6 (n = 5) by low-resolution HLA-A, -B, and high-resolution (HR) DRB1. Retrospectively, 179 pairs were HLA typed by HR. The median precryopreservation total nucleated cell (TNC) dose was 5.1 x 10(7) TNC/kg (range, 1.5-23.7) with 3.9 x 10(7) TNC/kg (range, 0.8-22.8) infused. The median time to engraftment (absolute neutrophil count > 500/mm(3) and platelets 50 000/muL) was 27 and 174 days. The cumulative incidence of neutrophil engraftment by day 42 was 79.9% (95% confidence interval [CI], 75.1%-85.2%); acute grades III/IV GVHD by day 100 was 19.5% (95% CI, 13.9%-25.5%); and chronic GVHD at 2 years was 20.8% (95% CI, 14.8%-27.7%). HR matching decreased the probability of severe acute GVHD. The cumulative incidence of relapse at 2 years was 19.9% (95% CI, 14.8%-25.7%). The probabilities of 6-month and 2-year survivals were 67.4% and 49.5%. Unrelated donor cord blood transplantation from partially HLA-mismatched units can cure many children with leukemias. The study was registered at www.clinicaltrials.gov as #NCT00000603.

Publication types

  • Clinical Trial, Phase II
  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Acute Disease
  • Adolescent
  • Child
  • Child, Preschool
  • Cord Blood Stem Cell Transplantation*
  • Disease-Free Survival
  • Female
  • Graft Survival*
  • Graft vs Host Disease / blood
  • Graft vs Host Disease / mortality*
  • HLA Antigens / blood
  • Hematologic Neoplasms / blood
  • Hematologic Neoplasms / mortality*
  • Hematologic Neoplasms / therapy*
  • Histocompatibility Testing / methods
  • Humans
  • Infant
  • Leukocyte Count / methods
  • Male
  • Platelet Count / methods
  • Prospective Studies
  • Retrospective Studies
  • Survival Rate
  • Time Factors
  • Transplantation, Homologous

Substances

  • HLA Antigens

Associated data

  • ClinicalTrials.gov/NCT00000603