Umbilical Cord Blood Transplantation As Treatment Of Adult Patients With Hematologic Disorders

Inclusion criteria

Patients must have a histologically confirmed diagnosis at The Vancouver General Hospital or the BCCA-Vancouver.

Eligible patients will have one of the following underlying diseases:

• High risk acute lymphoblastic leukemia (ALL) in first complete remission, with high risk being defined by the presence of t(4;11), t(9;22) or t(1;19) or patients presenting with extreme hyperleukocytosis (WBC >100x109/L) or failure to achieve a complete remission after standard induction therapy.
• Acute myeloid leukemia (AML) in first complete remission with high risk cytogenetics or failure to achieve complete remission after standard induction therapy. ALL or AML in second or subsequent remission
• Myelofibrosis with myeloid metaplasia.
• Chronic myeloid leukemia in chronic (failed interferon and/or Gleevec) or accelerated phase.
• Myelodysplastic syndrome with IPSS risk category >Int-1
• Aplastic anemia
• Non-Hodgkin's lymphoma, chronic lymphocytic leukemia or Hodgkin's disease in relapse or second or subsequent remission.
• Multiple Myeloma
• No active central nervous system (CNS) disease.
• No 9/10 or better HLA antigen matched related donor or VUD available.
• The patient's condition precludes waiting to search and find a VUD in the Unrelated Donor Registries
• Acceptance of standard blood product support
• Adequate organ function as defined by current Leukemia/BMT Program of BC standards (Appendix 10.1)
• Karnofsky performance status ≥ 80 (Appendix 10.2)

Exclusion criteria

• Active infection
• Pregnancy
• Significant psychiatric disorder
• Progressive disease