First Successful Cord Blood Transplantation from the National Marrow Donor Program for Acute Myeloid Leukemia in Japan

Cord blood is an alternative graft source for patients lacking sibling or unrelated marrow donors, however since there has been no affiliation with cord blood banks overseas, foreign cord blood unit (CBU) is not available in Japan. Here we report the first successful case of cord blood transplantation coordinated through the National Marrow Donor Program (NMDP) for a 34-year-old Filipina of mixed race with AML, weighning 78.5kg. She underwent a conventional preparative regimen and was infused with a 4/6 serologically HLA-matched Asian female CBU with sufficient total nucleated cells and CD34+ cell count. Neutrophil recovery was delayed as late as on 42 days post transplantation. This was caused by a low viability of only 31.5% measured in our facility before infusion, whereas the viability before cryopreservation at the cord blood bank was reportedly 91.0%. The patient developed no fatal complications including graft-versus-host disease. The duration of the coordination process is expected to become shorter with the full collaboration between the cord blood banks in Japan and NMDP. Relatively high nucleated cell number of CBU in NMDP also serves to overcome the difficult task of finding a donor for patients with heavy weight. The great cost is also a major problem.