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Cairo MS, Wagner EL, Fraser J, Cohen G, van de Ven C, Carter SL, Kernan NA, Kurtzberg J. Characterization of banked umbilical cord blood hematopoietic progenitor cells and lymphocyte subsets and correlation with ethnicity, birth weight, sex, and type of delivery: a Cord Blood Transplantation (COBLT) Study report. Transfusion 2005; 45:856-66. [PMID: 15934982 DOI: 10.1111/j.1537-2995.2005.04429.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Cord Blood Transplantation (COBLT) Study banking program was initiated in 1996. The study goals were to develop standard operating procedures for cord blood (CB) donor recruitment and banking and to build an ethnically diverse unrelated CB bank to support a transplantation protocol. STUDY DESIGN AND METHODS The hematopoietic progenitor cell (HPC) and lymphocyte subset (LS) content of approximately 8000 CB units were characterized, and these results were correlated with donor ethnicity, birth weight, gestational age, sex, and type of delivery. RESULTS There was a significant correlation of CD34+ cell count with colony-forming unit (CFU)-granulocyte-macrophage (r=0.68, p<0.001), CFU-granulocyte-erythroid-macrophage-megakaryocyte (r=0.52, p<0.001), burst-forming unit-erythroid (BFU-E; r=0.61, p<0.001), and total CFUs (r=0.67, p<0.001). Nucleated red blood cell count was significantly correlated with total CD34+ (r=0.56, p<0.001), total CFU (r=0.50, p<0.001), BFU-E (r=0.48, p<0.001), and counts of CD34+ subsets (p<0.001). Caucasian ethnicity was significantly correlated with higher CD3+/CD4+, CD19+, and CD16+/CD56+ LSs. Furthermore, CD34+/CD38- and CD34+/CD61+ CB units (HPC-C) were significantly lower in African American and Asian persons compared to Caucasian and Hispanic persons. Male sex was associated with significantly fewer CD3+/CD4+, CD19+, and CD16+/CD56+ but increased CD3+/CD8+ LSs (p<0.001). Finally, cesarean section was associated with significantly higher total CFU and CD16+/CD56+ but lower CD3+/CD4+, CD3+/CD8+, and CD19+ LSs. CONCLUSION These results provide a standard and range for uniformly processed HPC-C progenitor cells and LSs. CB progenitor cells and/or LSs may in the future predict for rapidity of engraftment, incidence of graft-versus-host disease, speed and quality of immunore- constitution, graft-versus-tumor effects, and/or success of gene transfection after CB transplantation.
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Kurtzberg J, Cairo MS, Fraser JK, Baxter-Lowe L, Cohen G, Carter SL, Kernan NA. Results of the cord blood transplantation (COBLT) study unrelated donor banking program. Transfusion 2005; 45:842-55. [PMID: 15934981 DOI: 10.1111/j.1537-2995.2005.04428.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The goals of the Cord Blood Transplantation (COBLT) Study banking program initiated in 1996 were to develop standard operating procedures (SOPs) for cord blood (CB) donor recruitment and banking and to build an ethnically diverse unrelated CB bank to support a transplantation protocol. STUDY DESIGN AND METHODS The program included collection centers, three banks, a steering committee, and a medical coordinating center (MCC) that developed and validated SOPs and a Web-based data collection system. External oversight was performed by the National Heart, Lung, and Blood Institute and the MCC. RESULTS A total of 34,799 potential donors were screened and 20,710 consented. A total of 17,207 ethnically diverse units were collected between 1998 and 2001. A total of 11,077 (64%) units were cryopreserved and quarantined. Of these, 79 percent met eligibility criteria and were HLA-typed and entered into the search registry. Higher CB volumes and cell counts were obtained from cesarean sections compared to vaginal deliveries. Units from African American persons contained lower cell counts per volume compared to other ethnicities. Birth weight correlated with volume and cell content. External oversight was accomplished through custom reports generated by the data collection system and periodic site visits. During maintenance, a breach in the SOPs was detected during a site visit at one of the banks. These units were designated for future use in nonclinical research. CONCLUSION The COBLT Study demonstrated that SOPs and data collection can be implemented in multiple banks coordinated by one MCC. Relationships between donor demographics and CB content may be useful in the development of other CB banking programs.
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Affiliation(s)
- Joanne Kurtzberg
- Division of Pediatric Blood and Marrow Transplantation, Duke University Medical Center, Durham, North Carolina 27710, USA.
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53
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Bradley MB, Cairo MS. Cord blood immunology and stem cell transplantation. Hum Immunol 2005; 66:431-46. [PMID: 15935881 DOI: 10.1016/j.humimm.2005.01.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2004] [Accepted: 01/14/2005] [Indexed: 10/25/2022]
Abstract
Allogeneic stem cell transplantation can be curative in a variety of malignant and nonmalignant disorders. Unfortunately, more than 75% of potential recipients lack a matched family donor. Although 50% of these recipients may find a matched unrelated adult stem cell donor from one of the worldwide registries, the other 50% have had no other viable donor alternatives. Cord blood cellular immunity is immature at birth and allows for a greater human leukocyte antigen disparity between a cord blood donor and recipient after an unrelated cord blood transplant. More than 25 cord blood banks have been developed worldwide to support the growing clinical needs of unrelated cord blood transplantation. Standard operating procedures have been developed for maternal donor screening and consent, cord blood collection, processing, cryopreservation, characterization, shipping, and thawing. Cord blood transplantation after myeloablative and reduced-intensity conditioning has been successfully demonstrated, resulting in long-term full donor chimerism, decreased Grade 3/4 acute graft-versus-host disease and improvements in overall survival. Several areas of ongoing research include ex vivo expansion of cord blood hematopoietic progenitor cells to enhance the rapidity of engraftment and isolation and activation of select immune cell populations for prevention or treatment of acute graft-versus-host disease, infectious complications, and tumor reoccurrence.
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Affiliation(s)
- M Brigid Bradley
- Department of Pediatrics, Columbia University, New York, NY 10032, USA
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Archivée: Mise en banque du sang de cordon ombilical : Implications pour les fournisseurs de soins périnatals. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2005. [DOI: 10.1016/s1701-2163(16)30521-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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55
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Styczynski J, Cheung YK, Garvin J, Savage DG, Billote GB, Harrison L, Skerrett D, Wolownik K, Wischhover C, Hawks R, Bradley MB, Del Toro G, George D, Yamashiro D, van de Ven C, Cairo MS. Outcomes of unrelated cord blood transplantation in pediatric recipients. Bone Marrow Transplant 2005; 34:129-36. [PMID: 15107815 DOI: 10.1038/sj.bmt.1704537] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We report results of unrelated cord blood transplants (UCBT) in 29 pediatric recipients in one center and the risk factors associated with survival. Median age: 9 years (0.5-20); diagnosis: ALL (9), AML (4), CML (1), HD (3), HLH (1), NHL (3), NBL (2); B-thal (1), FA (1), FEL (1), Krabbe (1), WAS (1), SAA (1); median follow-up: 11 months; conditioning: total body irradiation (TBI)-ablative (14), chemotherapy-ablative (6) and reduced intensity chemotherapy (9); GVHD prophylaxis: MMF/FK506 (18), cyclosporin A (CsA)+steroids+/-MMF (7) or CsA+methotrexate (MTX) (4); median total nucleated cells (TNC): 3.8 x 10(7)/kg (1.1-11); median CD34+: 2.3 x 10(5)/kg (0.2-9.9); and HLA match: 2 (6/6), 5 (5/6), 22 (4/6). Neutrophil engraftment by cumulative incidence curves 63% (median 28 (95% confidence interval (CI) 18-32)). Probability of >/=grade II acute graft-versus-host disease (aGVHD) by day +60 27%, >/=grade III aGVHD 20% and chronic graft-versus-host disease 3%. Estimated 1-year overall survival (OS) 46% (95% CI 30-71) and standard risk 60% (95% CI 29-100%). Variables associated with improved survival by multivariate analysis include non-TBI-ablative conditioning (P=0.024), CD34+/kg (P=0.038) and gender (P=0.048). These results suggest that CD34/kg cell dose and non-TBI-ablative conditioning may be important variables influencing OS following UCBT in pediatric recipients. Given the small number of patients, these results should be viewed cautiously.
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Affiliation(s)
- J Styczynski
- Department of Pediatrics, Children's Hospital of New York-Presbyterian, Herbert Irving Comprehensive Cancer Center, NY 10032, USA
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56
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Abstract
Since the first report of a successful umbilical cord blood transplantation in 1988, there has been great interest in the use of cord blood as an alternative stem cell source to treat cancer and genetic diseases. More than 4000 cord blood transplantations have been performed worldwide. In this review, the scientific rationale for this therapy, as well as related preclinical studies, cord blood banking issues, and ethical concerns, will be addressed. Results of studies in both pediatric and adult transplantation will be discussed. Finally, new indications for cord blood use and emerging technologies will be addressed.
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Affiliation(s)
- Karen K Ballen
- Massachusetts General Hospital, 100 Blossom St, Cox 640, Boston, MA 02114, USA.
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57
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Abstract
Early clinical reports outlining outcomes for primarily pediatric patients undergoing UCB transplantation point to delayed time to hematopoietic recovery and favorable incidence and severity of GvHD. Recently, clinical reports in adult patients identified the feasibility of UCB transplantation for those patients lacking an available histocompatible-related or unrelated adult donor Intensive clinical and laboratory research is ongoing focused on strategies to foster UCB allogeneic donor engraftment thereby allowing wider application of this stem cell source for patients requiring allogeneic transplantation.
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Affiliation(s)
- W Tse
- Medicine and Pathology, Case Western Reserve University, University Hospitals Comprehensive Cancer Center, Cleveland, Ohio, USA
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58
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Liu B, Chen JS, Cao M, Gu SL, Liao C, Li DZ, Zhong HZ. Platelet characteristic antigens of CD34+ cells in cryopreserved cord blood: a study of platelet-derived microparticles in transplant processing. Vox Sang 2004; 87:96-104. [PMID: 15355500 DOI: 10.1111/j.1423-0410.2004.00538.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES In previous studies, we found that platelet microparticles (PMPs) bind to cord blood (CB) CD34+ cells and transfer adhesion molecules to them, which enhances their engraftment. Before applying this phenomenon in actual transplants, we investigated the effect of PMPs on cryopreserved CD34+ cells in CB. MATERIALS AND METHODS We cryopreserved 18 CB units, then evaluated the binding of PMPs to CD34+ cells after thawing, by varying the expression of platelet characteristic antigens (CD41a, CD61, CD62P and CXCR4) on these cells. Adherence of the CD34+ cells, coated with freeze/thaw-induced PMPs, to endothelium and fibronectin was also studied, as were the effects of thrombin-induced PMPs from both fresh and preserved CB platelets. RESULTS PMPs induced by freezing and thawing adhered less well to CD34+ cells than did those from fresh CB, and cells coated with these PMPs had poor adherence. However, thrombin-induced PMPs from both fresh and preserved CB platelets bound equally well to cryopreserved CD34+ cells and improved their adhesion properties. CONCLUSIONS PMPs could be a useful tool for enhancing engraftment after CB transplantation.
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Affiliation(s)
- B Liu
- Medical Experimental Centre, Guangzhou 12th People's Hospital, Guangzhou, China.
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59
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Nakagawa R, Watanabe T, Kawano Y, Kanai S, Suzuya H, Kaneko M, Watanabe H, Okamoto Y, Kuroda Y, Nakayama T. Analysis of maternal and neonatal factors that influence the nucleated and CD34+ cell yield for cord blood banking. Transfusion 2004; 44:262-7. [PMID: 14962318 DOI: 10.1111/j.1537-2995.2004.00645.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND It would be beneficial to be able to predict the cord blood (CB) cell yield from volunteer donors before cell processing. STUDY DESIGN AND METHODS The maternal and neonatal factors that influence the total nucleated cell (TNC), CD34+ cell, and CFU-GM yields in CB collected for the Chugoku-Shikoku Cord Blood Bank were evaluated. RESULTS In a univariate analysis, the volume of CB collected was significantly correlated with the TNC, CD34+ cell, and CFU-GM yields (p < 0.001). A longer cord (p < 0.001), larger placenta (p < 0.001), and bigger baby (p < 0.001) were associated with a greater volume of CB. A female baby (p < 0.05) and longer gestational age (p < 0.005) were associated with a higher TNC concentration. A younger maternal age (p < 0.05), larger birth weight (p < 0.001), shorter gestational age (p < 0.001), and shorter time from collection to processing (p < 0.05) were associated with a higher CD34+ cell concentration. A multivariate linear regression analysis was performed to predict the yield and determine first-level selection criteria to start processing when the volume of CB units was on the borderline. However, this formula might not be suitable for actual use. CONCLUSION Maternal and neonatal factors appeared to affect CB cell yields. These findings might be useful for efficiently collecting more qualified CB units.
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Affiliation(s)
- Ryuji Nakagawa
- Department of Pediatrics, University of Tokushima School of Medicine, Japan.
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60
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Bracho F, van de Ven C, Areman E, Hughes RM, Davenport V, Bradley MB, Cai JW, Cairo MS. A comparison of ex vivo expanded DCs derived from cord blood and mobilized adult peripheral blood plastic-adherent mononuclear cells: decreased alloreactivity of cord blood DCs. Cytotherapy 2004; 5:349-61. [PMID: 14578097 DOI: 10.1080/14653240310003017] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Cord blood (CB) has been used as an alternative source of transplantable allogeneic stem cells for a variety of malignant and non-malignant diseases. However, we have demonstrated delayed recovery of T- and B-cell function, and T-cell subsets post unrelated CB transplantation (UCBT), and deficiencies of CB mononuclear cells (MNC) in producing cytokines, including G-CSF, GM-CSF, M-CSF, IL-12, and IL-15. In this study we have investigated the ex vivo generation of DC from CB versus mobilized adult peripheral blood (APB) for later use as adoptive cellular immunotherapy. METHODS CB and APB-adherent MNC were cultured in serum-free media with GM-CSF IL-4, FLT-3 ligand, tumor growth factor-beta (TGF-beta), and tumor necrosis factor-alpha (TNF-alpha) for 7 days. Morphology, phenotype, immunohistochemistry, clonogenic activity, and alloreactivity in MLR were evaluated. RESULTS CB and APB monocyte-derived ex vivo expanded DC expressed similar DC markers CD83 (31.27+ 11.7% versus 34.0+ 5.2%, CB versus APB), CD1a (23.4+ 4.2% versus 27.6+ 6.3%), and CD80 (21.97+ 12.01% versus 27.7+ 5.95). Immunohistochemistry showed that cells with DC morphology expressed CDla but not CD14. Neither FLT-3 ligand nor TGF-fl enhanced DC expansion. Addition of 10% autologous plasma to CB cultures promoted greater cell survival and a 150% increase in CDla + /CD80+ cell recovery. CB DC were 62% as effective stimulators of adult allogeneic T-cels as APB DC (p < .05) in allogeneic MLR. DISCUSSION While phenotypically similar, CB and APB DC have differential potency in allogeneic MLR, which may account for the difference in GvHD and infection incidence and severity between UCBT and allogeneic stem cell transplantation, and may require a different approach for adoptive cellular immunotherapy. The mechanism(s) associated with these differences require further elucidation.
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Affiliation(s)
- F Bracho
- Department of Pediatrics and Lombardi Cancer Center, Georgetown University Hospital, Washington, DC, USA
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61
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Del Toro G, Satwani P, Harrison L, Cheung YK, Brigid Bradley M, George D, Yamashiro DJ, Garvin J, Skerrett D, Bessmertny O, Wolownik K, Wischhover C, van de Ven C, Cairo MS. A pilot study of reduced intensity conditioning and allogeneic stem cell transplantation from unrelated cord blood and matched family donors in children and adolescent recipients. Bone Marrow Transplant 2004; 33:613-22. [PMID: 14730337 DOI: 10.1038/sj.bmt.1704399] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Reduced intensity (RI) allogeneic stem cell transplantation (AlloSCT) was initially demonstrated in adults following HLA-matched family and unrelated adult donor AlloSCT. There is little information about RI AlloSCT in children. We report results of a pilot study of RI AlloSCT in 21 recipients (< or =21 years). Age: median 13 (0.5-21) years, 8F:13M, 14 unrelated cord blood units (UCB) (10 4/6, 4 5/6), two related BM (6/6, 5/6), four related PBSC (2 6/6, 2 5/6), and one related BM+PBSC (6/6). RI: fludarabine, busulfan (n=14); fludarabine, cyclophosphamide (n=4); fludarabine, melphalan (n=1); total body irradiation, fludarabine, cyclophosphamide (n=1); or fludarabine, cyclophosphamide, and etoposide (n=1). Graft-versus-host disease prophylaxis: FK506 0.03 mg/kg/day and mycophenolate mofetil 15 mg/kg/q 12 h. UCB median nuc/kg and CD34/kg was 4.3 x 10(7)/kg (0.9-10.8) and 1.9 x 10(5)/kg (0.3-6.9), and related BM/PBSC median nuc/kg and CD34/kg was 8.3 x 10(8) (4.7-18.9) and 5.0 x 10(6)/kg (4.6-6.4). Maximal chimerism following unrelated cord blood transplantation, 100% x 7, 98% x 1, 95% x 2, 55% x 1, and 0% x 3; related PBSC/BM, 100% x 5, 65% x 1, and 55% x 1. Graft failure occurred in 5/21 (24%). In summary, RI AlloSCT in children is feasible and tolerable (< or =25% GF) and results in > or =85% of recipients initially achieving > or =50% donor chimerism.
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Affiliation(s)
- G Del Toro
- Department of Pediatrics, Children's Hospital New York-Presbyterian, Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY 10032, USA
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62
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Jaroscak J, Goltry K, Smith A, Waters-Pick B, Martin PL, Driscoll TA, Howrey R, Chao N, Douville J, Burhop S, Fu P, Kurtzberg J. Augmentation of umbilical cord blood (UCB) transplantation with ex vivo-expanded UCB cells: results of a phase 1 trial using the AastromReplicell System. Blood 2003; 101:5061-7. [PMID: 12595310 DOI: 10.1182/blood-2001-12-0290] [Citation(s) in RCA: 245] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Allogeneic stem cell transplantation with umbilical cord blood (UCB) cells is limited by the cell dose a single unit provides recipients. Ex vivo expansion is one strategy to increase the number of cells available for transplantation. Aastrom Biosciences developed an automated continuous perfusion culture device for expansion of hematopoietic stem cells (HSCs). Cells are expanded in media supplemented with fetal bovine serum, horse serum, PIXY321, flt-3 ligand, and erythropoietin. We performed a phase 1 trial augmenting conventional UCB transplants with ex vivo-expanded cells. The 28 patients were enrolled on the trial between October 8, 1997 and September 30, 1998. UCB cells were expanded in the device, then administered as a boost to the conventional graft on posttransplantation day 12. While expansion of total cells and colony-forming units (CFUs) occurred in all cases, the magnitude of expansion varied considerably. The median fold increase was 2.4 (range, 1.0-8.5) in nucleated cells, 82 (range, 4.6-266.4) in CFU granulocyte-macrophages, and 0.5 (range, 0.09-2.45) in CD34+ lineage negative (lin-) cells. CD3+ cells did not expand under these conditions. Clinical-scale ex vivo expansion of UCB is feasible, and the administration of ex vivo-expanded cells is well tolerated. Augmentation of UCB transplants with ex vivo-expanded cells did not alter the time to myeloid, erythroid, or platelet engraftment in 21 evaluable patients. Recipients of ex vivo-expanded cells continue to have durable engraftment with a median follow-up of 47 months (range, 41-51 months). A randomized phase 2 study will determine whether augmenting UCB transplants with ex vivo-expanded UCB cells is beneficial.
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Affiliation(s)
- Jennifer Jaroscak
- Pediatric and Adult Bone Marrow Transplant Programs, Duke University Medical Center, Durham, NC 27710, USA
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63
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Isoyama K, Ohnuma K, Ikuta K, Toyoda Y, Nakajima F, Yamada K, Nishihira H. Unrelated cord blood transplantation for second hemopoietic stem cell transplantation. Pediatr Int 2003; 45:268-74. [PMID: 12828579 DOI: 10.1046/j.1442-200x.2003.01717.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The Kanagawa Cord Blood Bank (KCBB) reports the treatment of 12 patients who received umbilical cord blood transplantation (CBT) from unrelated donors as their second hemopoietic stem cell transplantation (HSCT). METHODS Provided by the KCBB, between February 1997 and September 2000, 12 patients had unrelated CBT as a second HSCT. Six patients were male and six female; nine patients were in malignant, and three were in non-malignant conditions. The median age of the patients was 7.9 years (range, 2.2-28.0), and the median bodyweight was 22.5 kg (12.0-55.0). The HLA-A and -B serological and DR genotypical disparities between the patients and CBT donors were as follows: one patient was a 0-mismatch, six were 1-mismatches, and five were 2-mismatches. RESULTS The median time between first and second HSCT was 14.0 months (1.0-47.0). The overall survival rate was 25.0%, three years after CBT (Kaplan-Meier estimate). Mortality after CBT as a second HSCT accounted for nine cases, six from infection and three from treatment-related mortality other than infection. CONCLUSION Cord blood transplantation offers the advantage of rapid availability, absence of donor risk, and possibly less HLA restriction. In these contexts, unrelated CBT should be considered as a source of HSCT for a second transplant.
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Affiliation(s)
- Keiichi Isoyama
- Department of Pediatrics, Showa University Fujigaoka Hospital, Japan
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64
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Abstract
BACKGROUND Processing and banking of umbilical cord blood requires the development of methods for short-term liquid storage. This study examines the conditions (temperature, time, and storage solution) for optimal storage of cord blood. STUDY DESIGN AND METHODS Cord blood obtained from normal donors was collected and divided into aliquots. Some of the aliquots were supplemented with a storage solution and undiluted cord blood was used as a control. MNC counts, percentage of cells that are CD34+45+, frequency of CFU-GM, and solution pH were monitored for up to 72 hours in storage at 4 degrees C and room temperature. RESULTS MNC counts, CD34+45+ cell recovery, and frequency of CFU-GM were all improved in samples diluted with a storage medium when compared to undiluted controls. MNC counts were higher when cells were stored at 4 degrees C. MNC counts and the frequency of CFU-GM were reduced at 72 hours when compared with 24 hours. CONCLUSIONS These results indicate that the recovery of cells from cord blood can be improved if samples are stored using a storage solution for 24 hours without significant cell losses. Some of the solutions determined to be effective in maintaining viability are approved for human applications, although not specifically cord blood preservation.
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Affiliation(s)
- Allison Hubel
- Department of Mechanical Engineering, University of Minnesota, 1100 Mechanical Engineering, 111 Church Steet SE, Minneapolis, MN 55455, USA.
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65
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Tsang KS, Wong APY, Cheung MS, Tang SH, Leung Y, Li CK, Lau TT, Ng MHL, Yuen PMP. Implication of maternal-cell contamination in the clinical banking of umbilical cord blood. Cytotherapy 2003; 4:375-83. [PMID: 12396838 DOI: 10.1080/146532402760271163] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND The increasing utilization of human UC blood (UCB) in transplantation has drawn attention to the need for rationalization of selection, collection, processing, testing, banking and release of UCB. However, the issue of maternal blood contamination has not been well addressed. There are concerns that maternal T cells might elicit GvHD post-UCB transplant. METHODS Maternal T cells in 58 male UCB allografts were enumerated using fluorescent in situ hybridization and flow cytometry. Obstetric factors, preceding labor, multi-parity and gestational age, were also analyzed. RESULTS Levels of maternal cells of 0.75-5.25% were found in 15.5% (9/58) UCB. There was no association of maternal-cell contamination with preceding labor [25% (2/8) with previous delivery versus 35.4% (17/48) first born, P = 0.702], nor any correlation with multi-parity [37.5% (3/8) para > or = 3 versus 16.7% (8/48) para < 3, P = 0.181]. Gestation age of newborns also exhibited no association with maternal-cell contamination (39.47 weeks in newborn UCB with maternal cells, versus 39.58 weeks without: P = 0.674). The extrapolated maternal T cells/kg in nine UCB transplants were 1.05 x 10(5) +/- 1.12 x 10(5) (3.40 x 10(4) - 3.18 x 10(5)). DISCUSSION In relation to the arbitrary threshold of 1 x 10(5) T cells/kg in HLA-mismatched transplants utilizing T-cell depleted BM, 22.2% (2/9) of UCB transplants having maternal-cell contamination might be at risk of GvHD. Data support the need for testing for maternal blood in UCB, and evaluating the clinical relevance of GvHD in patients post-UCB transplant. The establishment of guidelines and standards for release of such UCB collections would be advisable in evidence-based UCB transplantation.
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Affiliation(s)
- K S Tsang
- Division of Hematology and Bone Marrow Transplantation, Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
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66
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Lee YH, Han JY, Seo SY, Kim KH, Lee YA, Lee HS, Hur WJ, Han H, Kwon HC, Kim JS, Kim HJ. Urokinase could increase the yield of progenitor cells during red cell depletion in elapsed and anticoagulated cord blood. Am J Hematol 2002; 71:336-9. [PMID: 12447968 DOI: 10.1002/ajh.10233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We assessed whether the urokinase could increase the yield of progenitor cells during processing in elapsed, anticoagulated cord blood (CB) after collection, and we also determined the optimal dose of urokinase. The total nucleated cell (TNC) counts after red cell depletion in 48-hr-elapsed CB were significantly higher in samples treated with 10,000 and 50,000 IU of urokinase/mL than in untreated samples or treated with 5,000 IU of urokinase/mL. The CD34(+) cell counts were significantly higher in samples treated with 10,000 IU of urokinase/mL than in untreated samples and in samples treated with 5,000 or 50,000 IU of urokinase/mL. In 6-, 12-, and 24-hr-elapsed CB, however, there were no significant differences of TNC, CD34(+) cells, or CFU-GM counts between untreated samples and samples treated with 10,000 IU of urokinase/mL. These findings suggest that the addition of 10,000 IU of urokinase/mL before red cell depletion in 48-hr-elapsed, anticoagulated CB could increase the yield of progenitor cells. However, there are no advantages in using urokinase for processing CB prior to 24 hr after collection.
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Affiliation(s)
- Young-Ho Lee
- Hematopoietic Stem Cell Transplantation Program, Dong-A Cancer Center, Dong-A University Hospital, Pusan 602-715, Korea.
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67
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Lasky LC, Lane TA, Miller JP, Lindgren B, Patterson HA, Haley NR, Ballen K. In utero or ex utero cord blood collection: which is better? Transfusion 2002; 42:1261-7. [PMID: 12423508 DOI: 10.1046/j.1537-2995.2002.t01-1-00177.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The relative nucleated cell count of umbilical cord blood (CB) correlates with improved engraftment and survival. This study compares two collection methods to assess CB content, including cell numbers. STUDY DESIGN AND METHODS The Massachusetts CB bank used trained obstetricians and midwives to collect CB in utero before the delivery of the placenta. The banks in California, Ohio, Oregon, and Minnesota used trained American Red Cross (ARC) personnel who collected CB ex utero after the delivery of the placenta. All banks processed CB by RBC sedimentation and volume reduction. RESULTS The volume and total nucleated cell count of collected CB before processing, as well as after processing CFU-GM and CD34+ cells, showed no advantage of either method. In utero collections resulted in more rejections of collected units (due to labeling problems, bacterial contamination, clotting, and delay between collection and processing) than ex utero collections. There were fewer medical exclusions after in utero collection. CONCLUSION CB can be collected successfully using either the in utero or ex utero methods; both methods produce comparable nucleated cell, MNC, CD34+, and CFU-GM numbers. Bacterial contamination, low volume, clotting, and delay until processing are generally higher with in utero collection.
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68
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Sasayama N, Kashiwakura I, Tokushima Y, Wada S, Murakami M, Hayase Y, Takagi Y, Takahashi TA. Expansion of megakaryocyte progenitors from cryopreserved leukocyte concentrates of human placental and umbilical cord blood in short-term liquid culture. Cytotherapy 2002; 3:117-26. [PMID: 12028834 DOI: 10.1080/14653240152584686] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Long-term severe thrombocytopenia following human placental and umbilical cord blood (CB) transplantation is a significant clinical problem. We studied the ex vivo expansion of megakaryocytic progenitor cells (CFU-Meg) from cryopreserved/thawed leukocyte concentrates (LC) of CB prepared by the Tokyo Cord Blood Bank protocol. The LC cells were cultured in serum-free culture medium supplemented with a combination of early-acting cytokines including thrombopoietin (TPO), flt3-ligand (FL), and stem cell factor (SCF). Combination of TPO plus FL, TPO plus SCF, and all of these cytokines together resulted in 8.9-, 7.7-, and 8.4-fold increases in CFU-Meg, respectively, by Day 5 of culture. Our results showed that this simple expansion strategy has the potential for expanding CFU-Meg from cryopreserved/thawed LC cells from CB.
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Affiliation(s)
- N Sasayama
- Cell Processing Department, Institute of Medical Science, University of Tokyo, Minato-ku, Tokyo, Japan
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69
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Robinson KL, Ayello J, Hughes R, van de Ven C, Issitt L, Kurtzberg J, Cairo MS. Ex vivo expansion, maturation, and activation of umbilical cord blood-derived T lymphocytes with IL-2, IL-12, anti-CD3, and IL-7. Potential for adoptive cellular immunotherapy post-umbilical cord blood transplantation. Exp Hematol 2002; 30:245-51. [PMID: 11882362 DOI: 10.1016/s0301-472x(01)00781-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES We investigated whether umbilical cord blood (UCB) T cells could be ex vivo expanded and activated in short-term culture for potential utilization as adoptive cellular immunotherapy post-umbilical cord blood transplantation (UCBT). METHODS Fresh UCB mononuclear cells (MNCs) were isolated by Ficoll density centrifugation. Cryopreserved UCB mononuclear cells were thawed and washed with 2.5% human serum albumin and 5% dextrose in isotonic saline. The nonadherent MNC fraction were then plated in a serum-free cocktail of IL-2, IL-12, and anti-CD3 with and without IL-7 for 48 hours. Proliferation, cytotoxicity, TH1 (IFN-gamma), CD25, and CD45RO assays were performed. RESULTS Proliferation studies demonstrated a significant increase in the proliferative ability of the UCB MNCs incubated in anti-CD3, IL-2, IL-12, and IL-7 (fresh--p < 0.005, and thawed--p < 0.001). The combination of all four agonists significantly induced expression of CD45 RO (fresh--p < 0.05, and thawed--p < 0.001) in both the CD4(+) and CD8(+) T cells expressing CD25 (fresh UCB--p < 0.01 [CD4] and p < 0.005 [CD8], respectively; thawed UCB--p < 0.001 [CD4] and p < 0.001 [CD8]). Intracellular cytokine profiles also revealed a significant increase in the production of IFN-gamma (TH1 cells) (fresh UCB--p < 0.005, and thawed UCB--p < 0.001). The combination also significantly increased the killing of K562-labeled target cells (fresh--p < 0.0001, and thawed--0.731 +/- 0.03 vs 0.16 +/- 0.01) (p < 0.001). CONCLUSIONS These data suggest that the ex vivo combination of IL-2, IL-12, anti-CD3, and IL-7 significantly enhances the proliferation, activation, maturation, and cytotoxic potential of UCB T cells of both fresh and thawed UCB MNC. Further studies, however, are required to determine whether these ex vivo--expanded MNC could also potentially exacerbate acute or chronic graft-vs-host disease and/or other toxicities if utilized post-UCBT.
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70
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Ballen KK, Valinski H, Greiner D, Shultz LD, Becker PS, Hsieh CC, Stewart FM, Quesenberry PJ. Variables to predict engraftment of umbilical cord blood into immunodeficient mice: usefulness of the non-obese diabetic--severe combined immunodeficient assay. Br J Haematol 2001; 114:211-8. [PMID: 11472370 DOI: 10.1046/j.1365-2141.2001.02904.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Umbilical cord blood is an alternative stem cell source for patients without matched family donors. In this study, we examined several parameters that have not been studied in detail -- radiation dose, cell dose, age of mice, and maternal and neonatal characteristics of the cord blood donor -- that affect engraftment of cord blood in non-obese diabetic-severe combined immunodeficient (NOD--scid) mice. Engraftment, measured using flow cytometry analyses of human CD45(+) cells, was highest in 400 cGy-treated mice. Successful engraftment was demonstrated up to 6 months, with a mean engraftment of 31% (range 0--67%) of human cells in recipient bone marrow. Engraftment was skewed to B lymphocytes. The radiation dose of 350 cGy resulted in superior survival of the murine recipients compared with 400 cGy (P = 0.03). The sex of the NOD--scid recipients had a significant effect on survival (female superior to male, P = 0.01), but not on engraftment. There were high levels of variability among different cord units and among animals injected with the same cord unit. This variability may limit the clinical usefulness of the NOD--scid mice as hosts for the quantification of human stem cells.
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Affiliation(s)
- K K Ballen
- University of Massachusetts Cancer Center, Worcester, MA, USA.
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71
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72
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Ohnuma K, Isoyama K, Ikuta K, Toyoda Y, Nakamura J, Nakajima F, Tsuchida M, Ohira M, Suminoe A, Hara T, Nishihira H. Cord blood transplantation from HLA-mismatched unrelated donors as a treatment for children with haematological malignancies. Br J Haematol 2001; 112:981-7. [PMID: 11298596 DOI: 10.1046/j.1365-2141.2001.02614.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Factors influencing the outcome for 39 children with haematological malignancy who were subjected to a cord blood transplantation (CBT) from genotypically HLA-mismatched unrelated donors were analysed. This retrospective study included 21 children with acute lymphoblastic leukaemia, 15 with acute myelogenous leukaemia and one each with chronic myelogenous leukaemia, refractory anaemia with myelodysplastic syndrome (MDS) and juvenile myelomonocytic leukaemia (JMML). Those subjected to CBT during the first or second complete remission (CR) and MDS without blasts were assigned to the standard-risk (SR) group (n = 16). Patients in third or subsequent remission, relapse or partial remission with refractory leukaemia at the time of CBT were considered to be in advanced phase, and placed in the high-risk (HR) group (n = 11). JMML and the second CR after a relapse (n = 8), or bone marrow failure after a rejection (n = 3), following haematopoietic stem cell transplantation (HSCT) in the first CR were included in the high-risk group. Kaplan-Meier estimates for neutrophil and platelet recovery were 83.7 +/- 12.2 at d 60 and 55.4 +/- 16.6% at d 100 respectively. The incidence of grades II-VI acute graft-versus-host disease was 58.5 +/- 16.8%. The Kaplan-Meier estimate for 3-year event-free survival (EFS) was 49.2 +/- 16.6. From multivariate analysis, the most important factor influencing EFS was disease status at CBT: SR patients had a 3-year EFS of 75.0 +/- 21.6%, compared with 29.6 +/- 20.6% for those with HR disease (P = 0.013, RR 4.746, 95% CI 1.382-16.298). These data confirm that HLA-mismatched, unrelated CBT is a feasible procedure to cure a significant proportion of children with leukaemia, especially if conducted in a favourable phase of the disease.
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Affiliation(s)
- K Ohnuma
- Division of Clinical Immunology, Advanced Clinical Research Centre, Institute of Medical Science, University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Topkyo 108-8639, Japan.
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73
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Yang H, Acker JP, Abley D, McGann LE, Akabutu J. High-efficiency volume reduction of cord blood using pentastarch. Bone Marrow Transplant 2001; 27:457-61. [PMID: 11313677 DOI: 10.1038/sj.bmt.1702807] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2000] [Accepted: 10/30/2000] [Indexed: 11/09/2022]
Abstract
Human umbilical cord blood (UCB) has been used successfully to treat a variety of genetic, hematological, and oncologic disorders. However, the low number of hematopoietic progenitor cells available in donated cord blood samples limits transplantation of cord blood to children and small adults. Reduction of the volume of umbilical cord blood is widely used in cord blood banking to reduce the storage requirements in large-scale UCB banks. Unfortunately, during the volume reduction process, up to 40% or more of the progenitor cells are lost using current reduction methods. This study describes a highly reproducible, double collection technique using Pentaspan to reduce UCB volume by red cell depletion. This results in the preservation of critical hematopoietic progenitor cells. The final volume of the leukocyte concentrates (LC) was 19.8 +/- 0.4 ml with 95% red cell depletion. The recovery of nucleated cells (NC), mononuclear cells (MNC), CD34(+) cells and colony-forming units (CFU) following double collection was 89%, 94%, 96%, and 106%, respectively. This is significantly higher than the recovery from single collections, where recovery was 74%, 77%, 84%, and 91% for NC, MNC, CD34(+) and CFU, respectively. The double collection technique provides an efficient and highly reproducible method for the preparation of UCB for long-term storage and transplantation.
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Affiliation(s)
- H Yang
- Alberta Cord Blood Bank, Edmonton, Alberta, Canada
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74
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Laughlin MJ. Umbilical cord blood for allogeneic transplantation in children and adults. Bone Marrow Transplant 2001; 27:1-6. [PMID: 11244431 DOI: 10.1038/sj.bmt.1702740] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Early clinical reports outlining outcomes for primarily pediatric patients undergoing UCB transplantation, point to delayed time to hematopoietic recovery, and favorable incidence and severity of graft-versus-host disease. Intensive clinical and laboratory research is ongoing focused on strategies to foster UCB allogeneic donor engraftment, thereby allowing wider application of this stem cell source for patients requiring allogeneic transplantation.
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Affiliation(s)
- M J Laughlin
- Department of Medicine, Case Western Reserve University, University Hospitals Ireland Cancer Center, Cleveland, Ohio, USA
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75
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Alonso JM, Regan DM, Johnson CE, Oliver DA, Fegan R, Lasky LC, Wall DA. A simple and reliable procedure for cord blood banking, processing, and freezing: St Louis and Ohio Cord Blood Bank experiences. Cytotherapy 2001; 3:429-33. [PMID: 11953027 DOI: 10.1080/146532401317248036] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
BACKGROUND In UC blood banking, volume and RBC reduction of the collected UC blood allows more efficient long-term storage and decreases infusion-related hemolysis and DMSO toxicity. However, high cell yields are imperative. At the St Louis Cord Blood Bank, we have systematically addressed processing/freezing and have developed a simple processing/freezing procedure. METHOD The methodology is a modification of the hetastarch sedimentation and volume reduction approach of Rubinstein at the New York Placental Blood Program. Cord blood is mixed with a 1:5 v/v ratio of hetastarch. The product is incubated for 45 min in an inverted position in a refrigerated centrifuge (4 degrees C), and then is spun for 5 min at 50 g. RBC concentrate is drained from the bottom. The volume drained is calculated to remove 80% of RBC. The UC blood unit is then resuspended and spun for 13 min at 420 g. Plasma is expressed from the top. RESULTS A final product volume of 27 mL (range 16-58 mL) was obtained from an original 50-200 mL of UC blood collected. The average yield of total nucleated cells pre- and post-processing was 90% for the first 4055 UC blood units banked. Pre- and post-processing CFU and CD34 yields were tested in a cohort and were similarly conserved. With a processing time of 3 h for a single cord, this process is time efficient and lends itself well to processing several units at the same time. The technique has been exported to other laboratories with similar yields. DISCUSSION This simple methodology results in reliable yields and is well suited to larger scale banking.
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Affiliation(s)
- J M Alonso
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Pediatric Research Institute, Cardinal Glennon Children's Hospital/Saint Louis University, St Louis, MO, USA
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76
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Rogers I, Sutherland, Holt D, Macpate F, Lains A, Hollowell S, Cruickshank B, Casper RF. Human UC-blood banking: impact of blood volume, cell separation and cryopreservation on leukocyte and CD34(+) cell recovery. Cytotherapy 2001; 3:269-76. [PMID: 12171715 DOI: 10.1080/146532401317070907] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND UC blood represents an increasingly useful source of hematopoietic stem cells for BMT, although, currently, low cell numbers generally limit its use to pediatric patients. We have determined parameters that influence the recovery of viable cells during processing and cryopreservation, in an effort to set guidelines for determining whether a sample will yield sufficient cells to be of use in the transplant setting. METHODS UC blood was collected from donors from January 1996 to December 1999. Volume was reduced using Ficoll, followed by cryopreservation under liquid nitrogen. Total leukocyte and CD34(+)-cell counts were determined prior to processing and a subset of samples was also assessed post-processing and post-cryopreservation. RESULTS Outcomes for 3816 samples were analyzed to determine the correlation between cell number, cell type, volume, and time between collection and processing. A positive relationship was observed between volume and cell number for both leukocytes and the CD34(+) cells. This correlation allowed us to determine the number of leukocytes and CD34(+) cells expected from a sample based on volume, and to set guidelines for determining the practicality of storing any given sample prior to processing and cryopreservation. DISCUSSION Measuring blood volume gives a very useful indication of the total leukocyte and CD34(+) cell number. The majority (75%) of cord-blood samples contain sufficient leukocytes for a pediatric transplant, and the number of cells available can be determined prior to processing by measuring blood volume.
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Affiliation(s)
- I Rogers
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, The University of Toronto, Toronto, Ontario, Canada
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77
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Ballen KK, Wilson M, Wuu J, Ceredona AM, Hsieh C, Stewart FM, Popovsky MA, Quesenberry PJ. Bigger is better: maternal and neonatal predictors of hematopoietic potential of umbilical cord blood units. Bone Marrow Transplant 2001; 27:7-14. [PMID: 11244432 DOI: 10.1038/sj.bmt.1702729] [Citation(s) in RCA: 120] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2000] [Accepted: 09/21/2000] [Indexed: 11/09/2022]
Abstract
Umbilical cord blood (CB) is a useful stem cell source for patients without matched family donors. CB banking is expensive, however, because only a small percentage of the cord units stored are used for transplantation. In this study, we determined whether maternal factors, such as race, age, and smoking status have an effect on laboratory parameters of hematopoietic potential, such as viability, cell counts, CD34+ cell counts, and CFU-GM. We studied the effect of neonatal characteristics such as birth order, birth weight, gestational age, and sex of the baby on the same laboratory parameters. Race and maternal age had no effect on these laboratory parameters. In multivariate analysis, babies of longer gestational age had higher cell counts, but lower CD34+ cell counts and CFU-GM. Bigger babies had higher cell counts, more CD34+ cells, and more CFU-GM. Women with fewer previous live births also produced cord units with higher cell counts, CFU-GM, and CD34+ cell counts. Specifically, each 500 g increase in birth weight contributed to a 28% increase in CD34+ cell counts, each week of gestation contributed to a 9% decrease in CD34+cell counts, and each previous birth contributed to a 17% decrease in CD34+ cell counts (all P < 0.05). These data may be used to select the optimal cord blood donors and allow CB banks efficient resource allocation.
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Affiliation(s)
- K K Ballen
- University of Massachusetts Cancer Center, Worcester, MA, USA
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78
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Ohnuma K, Isoyama K, Ikuta K, Toyoda Y, Nakamura J, Nakajima F, Nishihira H. The influence of HLA genotyping compatibility on clinical outcome after cord blood transplantation from unrelated donors. JOURNAL OF HEMATOTHERAPY & STEM CELL RESEARCH 2000; 9:541-50. [PMID: 10982254 DOI: 10.1089/152581600419224] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We performed retrospective DNA typing of class I (A, B, Cw) and class II (DRB1, DQB1, DPB1) HLA alleles in 27 unrelated cord blood transplantation (CBT) cases donated from a single cord blood bank (Kanagawa Cord Blood Bank). The influence of HLA genotype matching on clinical outcome was evaluated. From Cox's model, we found that incompatibility of two or more HLA alleles between the donor and recipient of an unrelated CBT was suggested to be a risk factor for a worse event-free survival (EFS) (p = 0.04; RR, 4.06; 95% CI, 1.06-15.61). Furthermore, mismatches including HLA-DRB1 alleles had an adverse effect on EFS (p = 0.04; RR, 4.91; 95% CI, 1.01-24.02). For definite conclusions on the role of HLA allele typing in unrelated CBT, more accumulation of data and analysis will be required.
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Affiliation(s)
- K Ohnuma
- Department of Oncology, Kanagawa Children's Medical Center, Yokohama, Japan
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79
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Godinho MI, de Sousa ME, Carvalhais A, Barbosa IL. Umbilical cord blood processing with the Optipress II blood extractor. Cytotherapy 2000; 2:439-44. [PMID: 12044224 DOI: 10.1080/146532400539387] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND We have previously shown that UC blood (UCB) units can be volume-reduced manually, in a closed system, without major losses of nucleated and CD34(+) cells and without the addition of exogenous material. Our aim was to use an automated method for the separation of the UCB components using the Optipress II, extractor, with the 'buffy-coat' collection in a standardized volume. METHODS After centrifugation, the 51 UCB units were separated into the three blood components, plasma, buffy coat (BC) and red cells, using the Optipress II. The final volume of the BC fraction, rich in nucleated and progenitor CD34(+) cells, was set at 30 mL. The nucleated and CD34(+) cell content of the UCB collections and the resulting BC were evaluated. RESULTS The UCB units were grouped according to the volume collected: Group I < 80 mL and Group II > or = 80 mL. Standardization of the BC at 30 mL resulted in significant volume reduction for both groups, with median values of 51% in Group I and 70% in Group II. The nucleated and CD34(+) cell recoveries in the BC from Group I were 88% and 99% respectively; for Group II they were 80% and 97%. DISCUSSION This semi-automated method of volume reduction efficiently reduces low, as well as high volume UCB units, with good nucleated- and progenitor-cell yields. Being a closed system and free of external material, the risk of contamination is minimized. The resulting fractions are then available for validation studies of the unit, effectively fulfilling the main requisites for UCB banking.
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Affiliation(s)
- M I Godinho
- Serviçio de Immuno-Hemoterapia, Instituto Português de Oncologia de Francisco Gentil, Porto, Portugal
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Broxmeyer HE. Cord Blood Transplantation Study Standard Operating Procedures: an evolving document will improve cord blood unit quality. JOURNAL OF HEMATOTHERAPY 1998; 7:479-80. [PMID: 9919940 DOI: 10.1089/scd.1.1998.7.479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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