For over 20 years, umbilical-cord blood has been used in approximately 30,000 hematopoietic stem cell transplants for patients with severe hematologic diseases.
Umbilical-cord blood transplants, however, are primarily performed on children and smaller adults since the number of available progenitor cells is limited. Previously, smaller studies suggested that double-unit cord-blood transplants may be advantageous for patients. In a randomized prospective trial, researchers followed 224 patients 1 to 21 years old with hematologic cancers who were randomly assigned to receive either double-unit (n=111) or single-unit (n=113) cord-blood transplants. Baseline characteristics including degree of donor-recipient HLA-matching and disease type of both trial arms were matched. Double-unit transplant recipients had a one-year overall survival rate of 65% compared to 73% for single-unit recipients (P=0.17). No significant differences were observed for neutrophil recovery, death, relapse, or infections. Single-unit recipients, however, had improved platelet recovery and a lower risk of graft-versus-host disease.
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