RAPID COMMUNICATION Successful Transplantation of HLA-Matched and HLA-Mismatched Umbilical Cord Blood From Unrelated Donors: Analysis of Engraftment and Acute Graft-Versus-Host Disease

To reduce the morbidity and mortality associated with unrelated donor bone marrow (BM) transplantation and potentially extend the pool of suitable donors, cryopreserved unrelated donor umbilical cord blood was considered as an alternate source of hematopoietic stem cells for transplantation. Patients with leukemia, BM failure syndrome, or inborn error of metabolism were eligible for a phase I clinical trial designed t o estimate the risk of graft failure and severe acute graft-versus-host disease after transplantation of umbilical cord blood from unrelated donors. As of December 21, 1995, unrelated donor umbilical cord blood was used t o reconstitute hematopoiesis in eighteen patients aged 0.1 t o 21.3 years weighing 3.3 t o 78.8 kg with acquired or congenital lympho-hematopoietic disorders or metabolic disease. Patients received either HLA-matched (n = 7) or HLA-1 to 3 antigen disparate (n = 11) grafts collected and evaluated by