02310nas a2200289   4500008003900000245008400039210006900123300000700192490000700199520155700206100001501763700001401778700001301792700001501805700001201820700001401832700001301846700001501859700001301874700001401887700001001901700001401911700001601925700001601941700001401957856004901971       2010                          d00aDonor-derived second hematologic malignancies after cord blood transplantation.0 aDonorderived second hematologic malignancies after cord blood tr  a250 v163 aDouble umbilical cord blood transplantation (UCBT) with a reduced-intensity conditioning regimen is an effective strategy for adult patients without a matched donor. The risk of second malignancies in these patients has not yet been established, however. In the present study, 98 adults with a hematologic malignancy underwent double UCBT. Seventy patients received a reduced-intensity conditioning regimen of fludarabine 30 mg/m(2)/day for 6 days, melphalan 100 mg/m(2)/day for 1 day, and rabbit antithymocyte globulin 1.5 mg/kg/day for 4 days, and 28 patients received a myeloablative total body radiation-containing conditioning regimen. Sixty-three patients received sirolimus-based graft-versus-host disease (GVHD) prophylaxis, and 35 patients received non-sirolimus-based GVHD prophylaxis. The median patient age was 48 years (range, 19-67 years). Eighteen patients developed a second malignancy at a median of 134 days after transplantation. Sixteen patients had lymphoma, and 2 patients had myelodysplasic syndrome/myeloproliferative disorder (MDS/MPD). Sixteen of these second malignancies (both cases of MDS/MPD and 14 of the lymphomas) were donor-derived; the origins of the others were not determined. GVHD prophylaxis, HLA matching, primary disease, age, total nucleated cell dose, and CD34(+) cell dose were not associated with a higher rate of second malignancy. Second myelogenous malignancies of donor origin occur after double UCBT, suggesting that a search for donor origin should be performed in all patients with suspected relapse.1 aBallen, KK1 aCutler, C1 aYeap, BY1 aMcAfee, SL1 aDey, BR1 aAttar, EC1 aChen, YB1 aHaspel, RL1 aLiney, D1 aKoreth, J1 aHo, V1 aAlyea, EP1 aSoiffer, RJ1 aSpitzer, TR1 aAntin, JH  uhttps://www.notifylibrary.org/reference/5117