Unrelated, HLA-mismatched multiple human umbilical cord blood transfusion in four cases with advanced solid tumors: initial studies.

Four patients with advanced solid tumors were treated by means of high-dose chemotherapy and HLA-mismatched and unrelated multi-cord blood transfusion. Of these patients, three achieved complete remission and one achieved a partial remission. Little or no graft vs. host disease (GVHD) was observed. Partial donor cell engraftment was suggested by 101 to 320 days for two patients by cytogenetic analysis and hemoglobin F levels in the peripheral blood. Recurrent disease was confirmed clinically on day 210 (4-year-old girl with liposarcoma) and on day 90 (11-year-old boy with non-Hodgkin's lymphoma). These results suggest the possibility that HLA-mismatched and unrelated multi-cord blood transfusion may engraft with little or no GVHD and hasten recovery from marrow suppression that is due to chemotherapy. It remains to be determined, however, whether these results document true stem/progenitor cell engraftment or alternatively transient engraftment of more mature cells along with repopulation by autologous cells.