Meta-analysis of cord blood transplantations for indication of leukemia from private umbilical cord blood banks from 1993-2009.

Abstract

6596 Background: Experimental cord blood (CB) transplantation was initially described in 1972 but became clinically relevant in 1988 after the first CB transplantation in Fanconi anemia. Soon afterwards private blood banks were established to store umbilical cord blood and stem cells individually. Until 11/2009 n = 400 CB transplantations from private cord blood banks including clinical trials are confirmed to be performed worldwide. Leukemia is among several indications CB is used for. For in-depth analysis an evaluation was done for this subgroup. Methods: For the first time a comprehensive meta-analysis with a database was performed covering all known cord blood transplantations n = 400 worldwide from private storage between 1993 and 2009. A variety of parameters were analyzed e.g. disease, age, sex, type of use, HLA status, storage time, CB volume, count of TNC/MNC and country of cord blood transplantation. Results: From 12/1993-11/2009 n = 92/400 indications for all CB transplantations were for leukemia (23.0%). The group was divided in ALL (n = 50), AML (n = 36), CML (n = 3), CLL (n = 1) and not known (n = 2). The age at transplantation was Ø 84 months (n = 90; range 0-600), n = 20 were male, n = 23 were female, the rest n.k. All were allogenic transfers beside one autologue for ALL. HLA status was Ø 5.8 (n = 22; range 3-6), storage time was Ø 18 months (n = 85; range 1-69), CB volume Ø 99 ml (n = 70; range 24-257), TNC/MNC count Ø 9.15 × 108 (n = 57; range 2.44-25.14). Country of CB transplantation was primarily the USA (n = 81; 88.0%), Canada and Germany (n = 2 each; 2.2%), Poland, Malaysia and Singapore (n = 1 each; 1.1%) or n.k. (n = 4; 4.3%). Conclusions: Umbilical cord blood transplantation is a common indication for leukemia usually served by public cord blood banks. This analysis shows that cord blood from private blood banks serves as additional source of stem cells for such indications. Due to limited data published the long-term outcome is not documented. A CB transplant registry for private cord blood banks is suggested to document follow ups and long-term results to confirm identical results to public stem cell sources. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Vita34 Vita34 Vita34, Germany