Researchers from Northwestern University have shown that children with high-risk acute lymphocytic leukemia (ALL) receiving umbilical cord blood transplants have similar outcomes to patients receiving related allogeneic stem cell transplants. The details of this comparative study were presented at the Third Annual International Umbilical Cord Blood Transplantation Symposium in Los Angeles, Calif., June 3-4, 2005.

Allogeneic stem cell transplants are an important therapy for selected children with ALL. High risk ALL patients are defined as those who relapse within 24-36 months of diagnosis; have unfavorable cytogenetics, have infant ALL or have a poor response to induction therapy. Allogeneic stem cell transplants from related and unrelated donors have been used to successfully treat such high-risk children.

For children without a related or unrelated donor, umbilical cord blood transplants are becoming a common treatment for children with high-risk ALL. Several reports have suggested that the results of umbilical cord blood transplants are as effective as transplants from unrelated donors. Now, researchers have demonstrated that umbilical cord blood transplants are as effective as related donor transplants for the treatment of high-risk ALL.

The current study compared the outcomes of children with high-risk ALL receiving HLA matched related transplants with those receiving umbilical cord blood transplants. Table 1 summarizes the main findings of this comparative study.

Table 1: Umbilical Cord Blood Transplants vs. Allogeneic Related Transplants in High-Risk ALL Patients

	Umbilical Cord Blood	Allogeneic Related
Number of Patients	26	23
Treatment-Related Mortality	19%	13%
Relapses	15%	25%
Survival at 3 Years	65%	64%
Event-Free Survival at 3 Years	61%	60%

The major difference between the two groups was the slow engraftment of umbilical cord blood.

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Reference:

Jacobsohn DA, Hewlett B, Seshardri R, et al. Outcomes of unrelated cord blood transplants and allogeneic related hematopoietic stem cell transplants in children with high-risk acute lymphocytic leukemia. Proceedings of the Third Annual International Umbilical Cord Blood Transplantation Symposium; Los Angeles, Calif. June 3-4, 2005.

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