Current status of pediatric umbilical cord blood transplantation in Korea: A multicenter retrospective analysis of 236 cases

Keon Hee Yoo, Soo Hyun Lee, Ki Woong Sung, Hong Hoe Koo, Nak Gyun Chung, Bin Cho, Hack Ki Kim, Hyoung Jin Kang, Hee Young Shin, Hyo Seop Ahn, Hee Jo Baek, Dong Kyun Han, Hoon Kook, Tai Ju Hwang, Sun Young Kim, Young-Ho Lee, Jeong Ok Hah, Ho Joon Im, Jong Jin Seo, Sang Kyu ParkHyun Joo Jung, Jun Eun Park, Yeon Jung Lim, Seong Shik Park, Young Tak Lim, Eun Sun Yoo, Kyung Ha Ryu, Hyeon Jin Park, Byung Kiu Park

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Abstract

We report the outcome of 236 pediatric umbilical cord blood transplantations (UCBT) performed in Korea. Given that the sources of the grafts were mostly unrelated donors (n = 226; 95.8%), only the results of unrelated UCBT were included for all statistics. The most frequent primary disease was acute leukemia (n = 167). In total, 91.7% of recipients were seropositive for cytomegalovirus (CMV). The median doses of nucleated cells and CD34+ cells were 4.84 × 107/kg and 2.00 × 105/kg, respectively. The median times to neutrophil (>0.5 × 109/L) and platelet recovery (>20 × 109/L) were 18 and 45 days, respectively. Grade 2-4 acute graft-versus-host-disease (GVHD) and chronic GVHD developed in 41.1 and 36.1% of cases, respectively. Forty-five patients developed CMV disease. The 5-year overall and event-free survival were 47.5 and 36.9%, respectively. Multivariate analysis revealed that adverse factors for survival of the whole cohort were total body irradiation-based conditioning (P = 0.007), salvage transplant (P = 0.001), failure to achieve early complete chimerism (P < 0.0005), and CMV disease (P = 0.001). The outcomes of the single- and double-unit UCBT (n = 64) were similar, while double-unit recipients were heavier (P < 0.0005) and older (P < 0.0005). We conclude that double-unit UCBT is a reasonable option for older or heavier children and that the thorough surveillance of CMV infection and the development of an effective CMV therapeutic strategy may be especially important for Korean children, whose CMV seroprevalence exceeds 90%.

Original languageEnglish
Pages (from-to)12-17
Number of pages6
JournalAmerican Journal of Hematology
Volume86
Issue number1
DOIs
StatePublished - 2011 Jan 1

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Korea
Cytomegalovirus
Fetal Blood
Transplantation
Pediatrics
Graft vs Host Disease
Transplants
Unrelated Donors
Chimerism
Whole-Body Irradiation
Seroepidemiologic Studies
Cytomegalovirus Infections
Acute Disease
Disease-Free Survival
Leukemia
Neutrophils
Blood Platelets
Multivariate Analysis
Survival
Therapeutics

Cite this

Yoo, Keon Hee ; Lee, Soo Hyun ; Sung, Ki Woong ; Koo, Hong Hoe ; Chung, Nak Gyun ; Cho, Bin ; Kim, Hack Ki ; Kang, Hyoung Jin ; Shin, Hee Young ; Ahn, Hyo Seop ; Baek, Hee Jo ; Han, Dong Kyun ; Kook, Hoon ; Hwang, Tai Ju ; Kim, Sun Young ; Lee, Young-Ho ; Hah, Jeong Ok ; Im, Ho Joon ; Seo, Jong Jin ; Park, Sang Kyu ; Jung, Hyun Joo ; Park, Jun Eun ; Lim, Yeon Jung ; Park, Seong Shik ; Lim, Young Tak ; Yoo, Eun Sun ; Ryu, Kyung Ha ; Park, Hyeon Jin ; Park, Byung Kiu. / Current status of pediatric umbilical cord blood transplantation in Korea : A multicenter retrospective analysis of 236 cases. In: American Journal of Hematology. 2011 ; Vol. 86, No. 1. pp. 12-17.
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title = "Current status of pediatric umbilical cord blood transplantation in Korea: A multicenter retrospective analysis of 236 cases",
abstract = "We report the outcome of 236 pediatric umbilical cord blood transplantations (UCBT) performed in Korea. Given that the sources of the grafts were mostly unrelated donors (n = 226; 95.8{\%}), only the results of unrelated UCBT were included for all statistics. The most frequent primary disease was acute leukemia (n = 167). In total, 91.7{\%} of recipients were seropositive for cytomegalovirus (CMV). The median doses of nucleated cells and CD34+ cells were 4.84 × 107/kg and 2.00 × 105/kg, respectively. The median times to neutrophil (>0.5 × 109/L) and platelet recovery (>20 × 109/L) were 18 and 45 days, respectively. Grade 2-4 acute graft-versus-host-disease (GVHD) and chronic GVHD developed in 41.1 and 36.1{\%} of cases, respectively. Forty-five patients developed CMV disease. The 5-year overall and event-free survival were 47.5 and 36.9{\%}, respectively. Multivariate analysis revealed that adverse factors for survival of the whole cohort were total body irradiation-based conditioning (P = 0.007), salvage transplant (P = 0.001), failure to achieve early complete chimerism (P < 0.0005), and CMV disease (P = 0.001). The outcomes of the single- and double-unit UCBT (n = 64) were similar, while double-unit recipients were heavier (P < 0.0005) and older (P < 0.0005). We conclude that double-unit UCBT is a reasonable option for older or heavier children and that the thorough surveillance of CMV infection and the development of an effective CMV therapeutic strategy may be especially important for Korean children, whose CMV seroprevalence exceeds 90{\%}.",
author = "Yoo, {Keon Hee} and Lee, {Soo Hyun} and Sung, {Ki Woong} and Koo, {Hong Hoe} and Chung, {Nak Gyun} and Bin Cho and Kim, {Hack Ki} and Kang, {Hyoung Jin} and Shin, {Hee Young} and Ahn, {Hyo Seop} and Baek, {Hee Jo} and Han, {Dong Kyun} and Hoon Kook and Hwang, {Tai Ju} and Kim, {Sun Young} and Young-Ho Lee and Hah, {Jeong Ok} and Im, {Ho Joon} and Seo, {Jong Jin} and Park, {Sang Kyu} and Jung, {Hyun Joo} and Park, {Jun Eun} and Lim, {Yeon Jung} and Park, {Seong Shik} and Lim, {Young Tak} and Yoo, {Eun Sun} and Ryu, {Kyung Ha} and Park, {Hyeon Jin} and Park, {Byung Kiu}",
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Yoo, KH, Lee, SH, Sung, KW, Koo, HH, Chung, NG, Cho, B, Kim, HK, Kang, HJ, Shin, HY, Ahn, HS, Baek, HJ, Han, DK, Kook, H, Hwang, TJ, Kim, SY, Lee, Y-H, Hah, JO, Im, HJ, Seo, JJ, Park, SK, Jung, HJ, Park, JE, Lim, YJ, Park, SS, Lim, YT, Yoo, ES, Ryu, KH, Park, HJ & Park, BK 2011, 'Current status of pediatric umbilical cord blood transplantation in Korea: A multicenter retrospective analysis of 236 cases', American Journal of Hematology, vol. 86, no. 1, pp. 12-17. https://doi.org/10.1002/ajh.21886

Current status of pediatric umbilical cord blood transplantation in Korea : A multicenter retrospective analysis of 236 cases. / Yoo, Keon Hee; Lee, Soo Hyun; Sung, Ki Woong; Koo, Hong Hoe; Chung, Nak Gyun; Cho, Bin; Kim, Hack Ki; Kang, Hyoung Jin; Shin, Hee Young; Ahn, Hyo Seop; Baek, Hee Jo; Han, Dong Kyun; Kook, Hoon; Hwang, Tai Ju; Kim, Sun Young; Lee, Young-Ho; Hah, Jeong Ok; Im, Ho Joon; Seo, Jong Jin; Park, Sang Kyu; Jung, Hyun Joo; Park, Jun Eun; Lim, Yeon Jung; Park, Seong Shik; Lim, Young Tak; Yoo, Eun Sun; Ryu, Kyung Ha; Park, Hyeon Jin; Park, Byung Kiu.

In: American Journal of Hematology, Vol. 86, No. 1, 01.01.2011, p. 12-17.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Current status of pediatric umbilical cord blood transplantation in Korea

T2 - A multicenter retrospective analysis of 236 cases

AU - Yoo, Keon Hee

AU - Lee, Soo Hyun

AU - Sung, Ki Woong

AU - Koo, Hong Hoe

AU - Chung, Nak Gyun

AU - Cho, Bin

AU - Kim, Hack Ki

AU - Kang, Hyoung Jin

AU - Shin, Hee Young

AU - Ahn, Hyo Seop

AU - Baek, Hee Jo

AU - Han, Dong Kyun

AU - Kook, Hoon

AU - Hwang, Tai Ju

AU - Kim, Sun Young

AU - Lee, Young-Ho

AU - Hah, Jeong Ok

AU - Im, Ho Joon

AU - Seo, Jong Jin

AU - Park, Sang Kyu

AU - Jung, Hyun Joo

AU - Park, Jun Eun

AU - Lim, Yeon Jung

AU - Park, Seong Shik

AU - Lim, Young Tak

AU - Yoo, Eun Sun

AU - Ryu, Kyung Ha

AU - Park, Hyeon Jin

AU - Park, Byung Kiu

PY - 2011/1/1

Y1 - 2011/1/1

N2 - We report the outcome of 236 pediatric umbilical cord blood transplantations (UCBT) performed in Korea. Given that the sources of the grafts were mostly unrelated donors (n = 226; 95.8%), only the results of unrelated UCBT were included for all statistics. The most frequent primary disease was acute leukemia (n = 167). In total, 91.7% of recipients were seropositive for cytomegalovirus (CMV). The median doses of nucleated cells and CD34+ cells were 4.84 × 107/kg and 2.00 × 105/kg, respectively. The median times to neutrophil (>0.5 × 109/L) and platelet recovery (>20 × 109/L) were 18 and 45 days, respectively. Grade 2-4 acute graft-versus-host-disease (GVHD) and chronic GVHD developed in 41.1 and 36.1% of cases, respectively. Forty-five patients developed CMV disease. The 5-year overall and event-free survival were 47.5 and 36.9%, respectively. Multivariate analysis revealed that adverse factors for survival of the whole cohort were total body irradiation-based conditioning (P = 0.007), salvage transplant (P = 0.001), failure to achieve early complete chimerism (P < 0.0005), and CMV disease (P = 0.001). The outcomes of the single- and double-unit UCBT (n = 64) were similar, while double-unit recipients were heavier (P < 0.0005) and older (P < 0.0005). We conclude that double-unit UCBT is a reasonable option for older or heavier children and that the thorough surveillance of CMV infection and the development of an effective CMV therapeutic strategy may be especially important for Korean children, whose CMV seroprevalence exceeds 90%.

AB - We report the outcome of 236 pediatric umbilical cord blood transplantations (UCBT) performed in Korea. Given that the sources of the grafts were mostly unrelated donors (n = 226; 95.8%), only the results of unrelated UCBT were included for all statistics. The most frequent primary disease was acute leukemia (n = 167). In total, 91.7% of recipients were seropositive for cytomegalovirus (CMV). The median doses of nucleated cells and CD34+ cells were 4.84 × 107/kg and 2.00 × 105/kg, respectively. The median times to neutrophil (>0.5 × 109/L) and platelet recovery (>20 × 109/L) were 18 and 45 days, respectively. Grade 2-4 acute graft-versus-host-disease (GVHD) and chronic GVHD developed in 41.1 and 36.1% of cases, respectively. Forty-five patients developed CMV disease. The 5-year overall and event-free survival were 47.5 and 36.9%, respectively. Multivariate analysis revealed that adverse factors for survival of the whole cohort were total body irradiation-based conditioning (P = 0.007), salvage transplant (P = 0.001), failure to achieve early complete chimerism (P < 0.0005), and CMV disease (P = 0.001). The outcomes of the single- and double-unit UCBT (n = 64) were similar, while double-unit recipients were heavier (P < 0.0005) and older (P < 0.0005). We conclude that double-unit UCBT is a reasonable option for older or heavier children and that the thorough surveillance of CMV infection and the development of an effective CMV therapeutic strategy may be especially important for Korean children, whose CMV seroprevalence exceeds 90%.

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