Multiple unit HLA-unmatched sex-mismatched umbilical cord blood transplantation for advanced XXXX .

@entity1 @entity981 @entity2132 @entity1583 @entity2280
We investigated the effect of multiple-unit umbilical cord blood (UCB) transplantation on engraftment in the setting of severe human leukocyte antigen (HLA) mismatch. Ten poor-risk adult @entity1 with @entity1583 received multiple unit, HLA-unmatched, sex-mismatched, unrelated UCB transplantation after a reduced intensity-conditioning regimen (RICR) with engraftment as the primary endpoint. The median age of the @entity1 was 55 years with a range of 28-67. @entity1 received one unit of UCB per 10 kg of recipient body weight (5-7 units). The median number of nucleated cells and @entity2280 (+) cells per kilogram of recipient body weight infused was 6.3 x 10(7) (range 3.8-10.0) (NC/kg) and 5.7 x 10(5) (range 1.1-11.9) ( @entity2280 /kg), respectively. Three @entity1 expired before day 28 and were not evaluable for engraftment. Five of the remaining 7 @entity1 showed increasing neutrophil counts. Fluorescent in situ hybridization (FISH) for the Y chromosome or HLA-typing showed only donor cells in the peripheral blood. After engraftment, HLA typing was done on 3 @entity1 and their infused UCB units. All revealed the presence of a single HLA type concordant with one of the infused units. Moreover, the order of infusion did not influence which UCB unit engrafted. The engrafting UCB units were infused first or second in one case and fourth in the other two. One @entity1 transplanted for refractory @entity981 ( @entity981 ) survives in continuous complete remission 4 years after transplant. He engrafted with one UCB unit, is fully hematologically reconstituted, has no evidence of @entity2132 ( @entity2132 ), and takes no immunosuppressive medication. HLA typing reveals that the recipient and the engrafted cord blood match at only one HLA-B locus using conventional 6 antigen typing (A, B, and DR). Although engraftment was not accelerated, it did occur in the majority of evaluable @entity1 . Long-term disease-free survivorship without debilitating @entity2132 is possible in @entity1 with refractory @entity1583 who receive unmatched multiple unit UCB.
