Double Umbilical Cord Blood Transplantation for Patients With Malignant and Non-Malignant Disorders
Inclusion Criteria:
- Patients will be eligible for double cord blood stem cell transplant (TNC ≥ 4x107/kg
of two combined units) if available single cord blood has TNC ≤4.0 x 107/kg and they
lack a matched (5-6/6) family donor, a 10/10 unrelated adult donor, and/or if their
disease status required emergent stem cell transplant and they could not wait 2-3
months for searching for a matched unrelated adult donor.
- Adequate renal function defined as:Serum creatinine <1.5 x normal, or Creatinine
clearance or radioisotope GFR >60 ml/min/m2 or >60 ml/min/1.73 m2 or an equivalent
GFR as determined by the institutional normal range.
- Adequate liver function defined as:Total bilirubin <1.5 x normal, or SGOT (AST) or
SGPT (ALT) <3.0 x normal
- Adequate cardiac function defined as:Shortening fraction >27% by echocardiogram, or
Ejection fraction >47% by radionucleotide angiogram or echocardiogram.
- Adequate pulmonary function defined as:Uncorrected DLCO 50% by pulmonary function
test.For children who are uncooperative, no evidence of dyspnea at rest, no exercise
intolerance, and a pulse oximetry >94% on room air.
Eligibility for Moderate Intensity, Reduced Intensity Regimen and Fanconi's Anemia
(Regimens C, D and E)
- Adequate renal function defined as: Serum creatinine <2.0 x normal, or Creatinine
clearance or radioisotope GFR 40 ml/min/m2 or >40 ml/min/1.73 m2 or an equivalent GFR
as determined by the institutional normal range.
- Adequate liver function defined as:Total bilirubin <2.5 x normal, or SGOT (AST) or
SGPT (ALT) <5.0 x normal
- Adequate cardiac function defined as:Shortening fraction of >25% by echocardiogram,
or Ejection fraction >40% by radionucleotide angiogram or echocardiogram.
- Adequate pulmonary function defined as:Uncorrected DLCO >35% by pulmonary function
test. For children who are uncooperative, no evidence of dyspnea at rest, no exercise
intolerance, and a pulse oximetry >94% on room air.
Exclusion Criteria:
- Females who are pregnant or breast-feeding
- Patients with documented uncontrolled infection at the time of study entry