Indications and results of cord blood transplant in children with leukemia.

Umbilical cord blood transplant (UCBT) is now used more frequently for transplanting children with high-risk malignancies. The advantages are the rapid availability of donor cells, the possibility of using HLA-mismatched transplants and the decreased risk of acute and chronic GvHD. The Eurocord registry has collected and analyzed data on unrelated CBTs performed in European Blood and Marrow Transplant Group (EBMT) and non-EBMT centers. The literature shows that after UCBT relapse rate (RR), disease-free survival and overall survival of children with acute leukemia are similar to other hematopoietic stem cell sources (matched unrelated BM). Disease status at the time of transplantation is found in several studies to be a very important determinant of long-term outcome. In conclusion, UCB is a valuable alternative source of hematopoietic stem cell transplantation in children with acute leukemia who need an allogeneic transplant, but lack a suitable sibling donor.