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Updated: Jul 4, 2026
Pan-myeloid Differentiation of Human Cord Blood Derived CD34+ Hematopoietic Stem and Progenitor Cells
Published on: August 9, 2019
Unrelated cord blood transplantation in CML: Japan Cord Blood Bank Network analysis
T Nagamura-Inoue1, S Kai, H Azuma
1Department of Cell Processing and Transfusion, Research Hospital, The Institute of Medical Science, University of Tokyo, Tokyo, Japan. tokikoni@ims.u-tokyo.ac.jp
Insights
Unrelated cord blood transplantation (UCBT) is a viable treatment for chronic myeloid leukemia (CML). Higher nucleated cell doses improve recovery, while advanced disease and older age increase mortality risks.
Area of Science:
- Hematology
- Transplantation Medicine
- Oncology
Background:
- Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm.
- Unrelated cord blood transplantation (UCBT) is an established treatment modality for hematologic malignancies.
- Patient selection and conditioning regimens are critical for successful UCBT outcomes.
Purpose of the Study:
- To evaluate the efficacy and safety of UCBT in patients with CML.
- To identify factors influencing neutrophil and platelet recovery post-UCBT.
- To assess the impact of disease phase and patient age on survival outcomes.
Main Methods:
- Retrospective analysis of 86 CML patients undergoing UCBT.
- Data collected from the Japan Cord Blood Bank Network registry.
- Multivariate analysis to identify predictors of outcomes.
Main Results:
- Nucleated cell dose >3.0 x 10^7/kg was associated with higher neutrophil (91%) and platelet (86%) recovery rates.
- Older age (>50 years) correlated with increased transplant-related mortality.
- Advanced disease stage and lower cell doses were linked to reduced leukemia-free and event-free survival.
Conclusions:
- UCBT is a feasible treatment option for CML patients.
- Optimizing cell dose and considering patient age are crucial for UCBT success.
- The European Group for Blood and Marrow Transplantation score effectively predicts UCBT outcomes in CML.
Abstract:
We analysed 86 patients with CML who received unrelated cord blood transplantation (UCBT), identified through a registry of the Japan Cord Blood Bank Network. At transplantation, the median patient age was 39 years (range, 1-67 years); 38 patients were in chronic phase (CP), 13 in the accelerated phase (AP) and 35 in blast crisis (BC). Median duration from diagnosis to UCBT was 1.5 years (range, 0.2-14.6 years). A nucleated cell (NC) dose of more than 3.0 x 10(7) per kg was sufficient to achieve neutrophil (91%) and platelet recovery (86%), whereas the lower dose of NC achieved only 60 and 61%, respectively. The duration and type of pre-transplant treatment did not affect neutrophil or platelet recovery. Results of multivariate analysis indicated that older patients (>50 years) had a higher incidence of transplant-related mortality. Advanced-disease stage and lower doses of NCs were significantly associated with lower leukaemia-free and event-free survival. At 2-year survival for patients in CP, AP and BC was 71, 59 and 32%, respectively (P=0.0004). A pre-transplant European Group for Blood and Marrow Transplantation scoring system was effective in predicting the outcome of UCBT. We conclude that UCBT is a reasonable alternative therapy for patients with CML.
