[Combined transplantation of umbilical cord blood and bone marrow from same sibling donor in children with beta-thalassemia major].

The objective of this study was to investigate the curative effect of combined sibling umbilical cord blood and bone marrow transplantation in treatment of beta-thalassemia major. Combined umbilical cord blood and bone marrow transplantation from an HLA-identical sibling were performed for 3 patients with beta-thalassemia major. The nucleated cells infused into 3 recipients were 19.5 x 10(7)/kg, 20.8 x 10(7)/kg and 23.3 x 10(7)/kg respectively. They accepted the conditioning regimen consisting of busulfan, cyclophosphamide, antithymocyteglobulin. The results showed that three patients gained protracted and stable engraftment. The time to achieve more than 0.5 x 10(9)/L neutrophils in three patients was 16, 18, and 17 days respectively; the time to achieve more than 50 x 10(9)/L platelet in three patients was 48, 50, and 49 days respectively. The speed of hematopoietic recovery was faster than that of umbilical cord blood transplantation (UCBT) only. Three patients all suffered from acute graft-versus-host disease (aGVHD) of I grade. They had lived with free-thalassemia for 1.5, 2.0 and 2.1 years respectively. Their Hb had been maintained at normal level without transfusion. It is concluded that combined UCBT and BMT may be an effective and safe way to treat pediatric beta-thalassemia major.