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Scaradavou A. Cord blood beyond transplantation: can we use the experience to advance all cell therapies? Br J Haematol 2021; 194:14-27. [PMID: 33529385 DOI: 10.1111/bjh.17297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/01/2020] [Indexed: 12/15/2022]
Abstract
Unrelated cord blood (CB) units, already manufactured, fully tested and stored, are high-quality products for haematopoietic stem cell transplantation and cell therapies, as well as an optimal starting material for cell expansion, cell engineering or cell re-programming technologies. CB banks have been pioneers in the development and implementation of Current Good Manufacturing Practices for cell-therapy products. Sharing their technological and regulatory experience will help advance all cell therapies, CB-derived or not, particularly as they transition from autologous, individually manufactured products to stored, 'off-the shelf' treatments. Such strategies will allow broader patient access and wide product utilisation.
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Affiliation(s)
- Andromachi Scaradavou
- Stem Cell Transplantation and Cellular Therapies, Memorial Sloan Kettering (MSK) Kids, MSK Cancer Center, New York, NY, USA
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2
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Hussein E, DeFor T, Wagner JE, Sumstad D, Brunstein CG, McKenna DH. Evaluation of post-thaw CFU-GM: clinical utility and role in quality assessment of umbilical cord blood in patients receiving single unit transplant. Transfusion 2019; 60:144-154. [PMID: 31756003 DOI: 10.1111/trf.15592] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 10/06/2019] [Accepted: 10/06/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND The CFU assay is considered the only in vitro assay that assesses the biologic function of hematopoietic stem and progenitor cells (HSPC). STUDY DESIGN AND METHODS To investigate the impact of post-thaw CFU-GM counts on the quality of umbilical cord blood (UCB), we studied transplant outcomes in 269 patients receiving single UCB transplant. We also correlated the post-thaw CFU-GM counts of 1912 units with the pre-freeze and post-thaw graft characteristics, hoping to optimize selection criteria of UCB. Data analysis included: total nucleated cells, viability, CD34+, nucleated red blood cells (NRBC), hematocrit, frozen storage time, and cord blood bank (CBB). RESULTS We demonstrated an association between post-thaw CFU-GM dose and the speed of neutrophil and platelet engraftment (p < 0.01). Higher post-thaw CFU-GM dose showed an increased benefit for neutrophil and platelet engraftment (p < 0.01). Post-thaw CD34+ cell dose and CFU-GM dose were strongly correlated (r = 0.78). However, CFU-GM dose showed additional benefit for patients receiving the lowest quartile of CD34+ dose. HLA disparity did not adversely impact either neutrophil or platelet engraftment. Post-thaw CFU-GM/million nucleated cells plated showed moderate correlation with pre-freeze and post-thaw CD34+ and weak correlation with other parameters. Post-thaw CFU-GM was not influenced by storage time, but was impacted by the CBB from which the unit is obtained (p < 0.01). CONCLUSION Post-thaw CFU-GM is an effective measure of the quality and efficacy of the UCB graft, particularly adding valuable clinical information when the CD34+ cell dose is low. Consideration of pre-freeze CD34+ cell content and CBB as additional selection criteria is warranted.
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Affiliation(s)
- Eiman Hussein
- Department of Laboratory medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | - Todd DeFor
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - John E Wagner
- Blood and Marrow Transplant Program, Department of Pediatrics, Minneapolis, Minnesota
| | - Darin Sumstad
- Department of Laboratory medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | - Claudio G Brunstein
- Blood and Marrow Transplant Program, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - David H McKenna
- Department of Laboratory medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
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Kilbride P, Meneghel J, Lamb S, Morris J, Pouzet J, Jurgielewicz M, Leonforte C, Gibson D, Madrigal A. Recovery and Post-Thaw Assessment of Human Umbilical Cord Blood Cryopreserved as Quality Control Segments and Bulk Samples. Biol Blood Marrow Transplant 2019; 25:2447-2453. [PMID: 31499214 DOI: 10.1016/j.bbmt.2019.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/30/2019] [Accepted: 09/02/2019] [Indexed: 10/26/2022]
Abstract
Quality control (QC) segments conjoined to a bulk sample container are used to evaluate the viability and quality of cryopreserved umbilical cord blood (UCB). Such QC segments are typically attached lengths of sealed tubing that are cooled concurrently with the bulk sample, both containing material from the same donor. QC segments are thawed independently of the bulk sample to assess the quality of the cryopreserved product. In current practice, there is typically post-thaw variation between the QC segment and the bulk sample which if suggestive of inadequate performance, could lead to material being needlessly discarded. In this study, these performance differences were quantified. Two cooling protocols in common use, 1 with and 1 without a "plunge" step to induce ice nucleation, gave equivalent results that maintained the QC segment versus bulk sample differences. Ice nucleated at significantly lower temperatures in the QC segments compared with the bulk samples, a consequence of their lower volume, thereby enhancing damaging osmotic stress. A reduction in total viable cells of approximately 10% was recorded in the QC segments compared with comparable bulk samples. It has been shown that CD45+ cells are more adversely impacted by this lower ice nucleation temperature than CD34+ cells, which can result in altered composition of the post-thaw cell population.
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Affiliation(s)
- Peter Kilbride
- Asymptote, General Electric Healthcare, Cambridge, United Kingdom.
| | - Julie Meneghel
- Asymptote, General Electric Healthcare, Cambridge, United Kingdom
| | - Stephen Lamb
- Asymptote, General Electric Healthcare, Cambridge, United Kingdom
| | - John Morris
- Asymptote, General Electric Healthcare, Cambridge, United Kingdom
| | - Jerome Pouzet
- General Electric Healthcare, Biosafe SA, Eysins, Switzerland
| | - Monika Jurgielewicz
- Anthony Nolan Cell Therapy Centre, Nottingham Trent University, Nottingham, United Kingdom
| | - Christopher Leonforte
- Anthony Nolan Cell Therapy Centre, Nottingham Trent University, Nottingham, United Kingdom
| | - Daniel Gibson
- Anthony Nolan Cell Therapy Centre, Nottingham Trent University, Nottingham, United Kingdom
| | - Alejandro Madrigal
- Anthony Nolan Cell Therapy Centre, Nottingham Trent University, Nottingham, United Kingdom
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Dimas-González J, Nieto-Linares A, Millán-Rocha M, Salazar-Bailón JL, Lorenzo-Moreno BA, Rojo-Medina J. Thawing methods do not affect cell viability of CD45+ and CD34+ cells, but long-term cryopreservation of umbilical cord blood units generally decreases cell viability. Transfus Apher Sci 2019; 58:196-200. [PMID: 30902449 DOI: 10.1016/j.transci.2019.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 01/23/2019] [Accepted: 03/11/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Umbilical cord blood units (UCBUs) are collected and cryopreserved in biobanks for a future transplant. Hematopoietic stem cells and hematopoietic progenitor cells (HSC/HPC) present in UCB can be damaged due to factors such as the cryopreservation process, the thawing process, and prolonged storage time. METHODS UCBUs (n = 27) were obtained from the Biobank of the National Center of Blood Transfusion (NCBT) from Mexico. They contained three attached segments of UCBU, including 1.0-2.3 × 106 CD34+ cells prior to cryopreservation and were stored during the period from 2003 to 2015. Each UCB segment was thawed with three different methods and CD34 cells, CD45 cells, and 7-AAD were identified by flow cytometry. Furthermore, we carried out CFU assays, and trypan blue staining. RESULTS Viable CD45+ (vCD45+) cells, vCD34+ cells, CFU, and percentage of E-Clone were not statistically significant among three different thawing methods. The number of vCD45+ and vCD34+ cells diminished in the three thawing methods compared with the same cells prior to their cryopreservation (p < 0.0001). vCD45+ and vCD34+ cells diminished in the ≥10-year cryopreservation group (p < 0.001). In addition, percentage of recovery of vCD45+ and vCD34+ cells diminished in this same group (p = 0.013 and p < 0.0001, respectively). CONCLUSION The thawing methods did not affect either cell viability (vCD45+ and vCD34+ cells) or pluripotency (CFU, percentage of E-Clone) in attached segments of UCBUs. The ≥10-year cryopreservation time in attached segments of UCBUs alters the number of vCD45+ and vCD34+ cells; however, it does not affect their pluripotency.
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Affiliation(s)
- Jisela Dimas-González
- Centro Nacional de la Transfusión Sanguínea, Av. Othón de Mendizábal 195, Zacatenco, Gustavo A. Madero, 07360, Mexico City, Mexico..
| | - Adán Nieto-Linares
- Centro Nacional de la Transfusión Sanguínea, Av. Othón de Mendizábal 195, Zacatenco, Gustavo A. Madero, 07360, Mexico City, Mexico..
| | - Miriam Millán-Rocha
- Centro Nacional de la Transfusión Sanguínea, Av. Othón de Mendizábal 195, Zacatenco, Gustavo A. Madero, 07360, Mexico City, Mexico..
| | - José Luis Salazar-Bailón
- Centro Nacional de la Transfusión Sanguínea, Av. Othón de Mendizábal 195, Zacatenco, Gustavo A. Madero, 07360, Mexico City, Mexico..
| | - Bardo Abraham Lorenzo-Moreno
- Centro Nacional de la Transfusión Sanguínea, Av. Othón de Mendizábal 195, Zacatenco, Gustavo A. Madero, 07360, Mexico City, Mexico..
| | - Julieta Rojo-Medina
- Centro Nacional de la Transfusión Sanguínea, Av. Othón de Mendizábal 195, Zacatenco, Gustavo A. Madero, 07360, Mexico City, Mexico..
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Ikemoto J, Yoshihara S, Kobayashi T, Kai S, Fujimori Y. Aldehyde dehydrogenase activity in cryopreserved cord blood cells for quality assessment prior to transplantation. Mol Med Rep 2018; 18:4530-4534. [PMID: 30221737 DOI: 10.3892/mmr.2018.9481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 02/09/2017] [Indexed: 11/06/2022] Open
Abstract
In umbilical cord blood transplantation (UCBT), the number of cluster of differentiation (CD)34+ cells and colony‑forming units (CFUs) in the cord blood (CB) graft positively correlate with patient survival. Therefore, these parameters are currently used for quality assessment of the cryopreserved CB cells in the attached segment that is considered representative of the CB in the main bag prior to UCBT. Since aldehyde dehydrogenase (ALDH) activity is high in hematopoietic stem cells, the number of ALDH‑bright (ALDHbr) cells was examined in comparison with the number of CD34+ cells and CFUs for the quality assessment of CB units. In the cryopreserved main bag, the number of ALDHbr cells in the CB unit exhibited positive correlation with the number of CD34+ cells, and with CFU‑granulocytes/macrophages and total CFU counts. Furthermore, the concentration of ALDHbr cells in the cryopreserved attached segment was not significantly different compared to that of the main bag, suggesting that the attached segment is representative of the main bag. In conclusion, the present study suggested that ALDHbr cell counts in the cryopreserved attached segments may serve as a quality assessment indicator for CB units prior to UCBT.
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Affiliation(s)
- Junko Ikemoto
- Center for Blood Transfusion and Cellular Therapy, Hyogo College of Medicine Hospital, Nishinomiya, Hyogo 663‑8501, Japan
| | - Satoshi Yoshihara
- Center for Blood Transfusion and Cellular Therapy, Hyogo College of Medicine Hospital, Nishinomiya, Hyogo 663‑8501, Japan
| | - Tamami Kobayashi
- Center for Blood Transfusion and Cellular Therapy, Hyogo College of Medicine Hospital, Nishinomiya, Hyogo 663‑8501, Japan
| | - Shunro Kai
- Center for Blood Transfusion and Cellular Therapy, Hyogo College of Medicine Hospital, Nishinomiya, Hyogo 663‑8501, Japan
| | - Yoshihiro Fujimori
- Center for Blood Transfusion and Cellular Therapy, Hyogo College of Medicine Hospital, Nishinomiya, Hyogo 663‑8501, Japan
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6
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Galindo CC, Vanegas Lozano DM, Camacho Rodríguez B, Perdomo-Arciniegas AM. Cord blood attached-segments are not homogeneous in post-thaw CD34 + cell viability and clonogenicity. Cryobiology 2018; 82:163-164. [PMID: 29604250 DOI: 10.1016/j.cryobiol.2018.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/03/2018] [Accepted: 03/27/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Cristian Camilo Galindo
- Cord Blood Bank, Instituto Distrital de Ciencia, Biotecnología e Innovación en Salud (IDCBIS), Bogotá DC, Colombia
| | - Diana María Vanegas Lozano
- Cord Blood Bank, Instituto Distrital de Ciencia, Biotecnología e Innovación en Salud (IDCBIS), Bogotá DC, Colombia
| | - Bernardo Camacho Rodríguez
- Director, Instituto Distrital de Ciencia, Biotecnología e Innovación en Salud (IDCBIS), Bogotá DC, Colombia
| | - Ana-María Perdomo-Arciniegas
- Cord Blood Bank Director, Instituto Distrital de Ciencia, Biotecnología e Innovación en Salud (IDCBIS), Bogotá DC, Colombia.
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7
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Cord blood attached segment: is this a relevant quality control to predict a good hematopoietic stem cell graft? Bone Marrow Transplant 2017; 52:1353-1354. [PMID: 28692031 DOI: 10.1038/bmt.2017.150] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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8
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Castillo N, García-Cadenas I, Barba P, Martino R, Azqueta C, Ferrà C, Canals C, Sierra J, Valcárcel D, Querol S. Post-Thaw Viable CD45 + Cells and Clonogenic Efficiency are Associated with Better Engraftment and Outcomes after Single Cord Blood Transplantation in Adult Patients with Malignant Diseases. Biol Blood Marrow Transplant 2015; 21:2167-2172. [DOI: 10.1016/j.bbmt.2015.08.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 08/12/2015] [Indexed: 11/12/2022]
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9
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Patterson J, Moore CH, Palser E, Hearn JC, Dumitru D, Harper HA, Rich IN. Detecting primitive hematopoietic stem cells in total nucleated and mononuclear cell fractions from umbilical cord blood segments and units. J Transl Med 2015; 13:94. [PMID: 25784613 PMCID: PMC4374586 DOI: 10.1186/s12967-015-0434-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 02/11/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rare hematopoietic stem cell populations are responsible for the transplantation engraftment process. Umbilical cord blood (UCB) is usually processed to the total nucleated cell (TNC), but not to the mononuclear cell (MNC) fraction. TNC counts are used to determine UCB unit storage, release for transplantation and correlation with time to engraftment. However, the TNC fraction contains varying concentrations of red blood cells, granulocytes, platelets and other cells that dilute and mask the stem cells from being detected. This does not allow the quality and potency of the stem cells to be reliably measured. METHODS 63 UCB segments and 10 UCB units plus segments were analyzed for the response of both primitive lympho-hematopoietic and primitive hematopoietic stem cells in both the TNC and MNC fractions. The samples were analyzed using a highly sensitive, standardized and validated adenosine triphosphate (ATP) bioluminescence stem cell proliferation assay verified against the colony-forming unit (CFU) assay. Dye exclusion and metabolic viability were also determined. RESULTS Regardless of whether the cells were derived from a segment or unit, the TNC fraction always produced a significantly lower and more variable stem cell response than that derived from the MNC fraction. Routine dye exclusion cell viability did not correspond with metabolic viability and stem cell response. Paired UCB segments produced highly variable results, and the UCB segment did not produce similar results to the unit. DISCUSSION The TNC fraction underestimates the ability and capacity of the stem cells in both the UCB segment and unit and therefore provides an erroneous interpretation of the of the results. Dye exclusion viability can result in false positive values, when in fact the stem cells may be dead or incapable of proliferation. The difference in response between the segment and unit calls into question the ability to use the segment as a representative sample of the UCB unit. It is apparent that present UCB processing and testing methods are inadequate to properly determine the quality and potency of the unit for release and use in a patient.
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Affiliation(s)
- John Patterson
- />Beth-Ell College of Nursing and Health Science, University of Colorado at Colorado Springs, Colorado Springs, Colorado USA
| | - Cally H Moore
- />Department of Biological Engineering, University of Colorado, Boulder, Colorado USA
| | - Emily Palser
- />Department of Biology, University of Colorado at Colorado Springs, Colorado Springs, Colorado USA
| | - Jason C Hearn
- />HemoGenix, Inc, 1485 Garden of the Gods Road, Suite 152, Colorado Springs, CO 80906 USA
| | - Daniela Dumitru
- />HemoGenix, Inc, 1485 Garden of the Gods Road, Suite 152, Colorado Springs, CO 80906 USA
| | - Holli A Harper
- />HemoGenix, Inc, 1485 Garden of the Gods Road, Suite 152, Colorado Springs, CO 80906 USA
| | - Ivan N Rich
- />HemoGenix, Inc, 1485 Garden of the Gods Road, Suite 152, Colorado Springs, CO 80906 USA
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10
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Lee HR, Shin S, Yoon JH, Roh EY, Song EY, Han KS, Kim BJ. Attached Segment has Higher CD34+ Cells and CFU-GM than the Main Bag after Thawing. Cell Transplant 2015; 24:305-10. [DOI: 10.3727/096368914x678544] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
A contiguous segment attached to the cord blood unit (CBU) is required for verifying HLA types, cell viability, and, possibly, potency before transplantation since such a segment is considered to be representative of the CBU. However, little is known regarding the characteristics of contiguous segments in comparison to main bag units due to the difficulty experienced in accessing a large number of cryopreserved CBUs. In this study, we used 245 nonconforming CBUs for allogeneic transplantation. After thawing the cryopreserved CBU, the number of total nucleated cells (TNCs), CD34+ cells, and CFUs in CB from main bags and segments, as well as cell viability and apoptosis, were examined. The comparative analysis showed that the number of TNCs was significantly higher in CB from main bags, whereas the numbers of CD34+ cells and CFU-GM were significantly higher in CB from segments. While the cell viability of TNCs in segments was higher, the proportion of apoptotic TNCs was also higher. In contrast, no difference was observed between the proportion of apoptotic CD34+ cells in main bags and segments. In the correlation analysis, the numbers of TNCs, CD34+ cells, and CFU-GM in main bags were highly correlated with those in segments, indicating that CB from segments is indeed representative of CB in main bags. Taken together, we conclude that segments have higher CD34+ cells and CFU-GM and lower TNCs than the main cryopreserved bag, although the two compartments are highly correlated with each other.
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Affiliation(s)
- Hye Ryun Lee
- Department of Laboratory Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Sue Shin
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Laboratory Medicine, Seoul National University Boramae Hospital, Seoul, Korea
- Seoul Metropolitan Government Public Cord Blood Bank (Allcord), Seoul, Korea
| | - Jong Hyun Yoon
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Laboratory Medicine, Seoul National University Boramae Hospital, Seoul, Korea
- Seoul Metropolitan Government Public Cord Blood Bank (Allcord), Seoul, Korea
| | - Eun Youn Roh
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Laboratory Medicine, Seoul National University Boramae Hospital, Seoul, Korea
- Seoul Metropolitan Government Public Cord Blood Bank (Allcord), Seoul, Korea
| | - Eun Young Song
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kyou Sup Han
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Byoung Jae Kim
- Department of Obstetrics and Gynecology, Seoul National University Boramae Hospital, Seoul, Korea
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Purtill D, Smith K, Devlin S, Meagher R, Tonon J, Lubin M, Ponce DM, Giralt S, Kernan NA, Scaradavou A, Stevens CE, Barker JN. Dominant unit CD34+ cell dose predicts engraftment after double-unit cord blood transplantation and is influenced by bank practice. Blood 2014; 124:2905-12. [PMID: 25185264 PMCID: PMC4224191 DOI: 10.1182/blood-2014-03-566216] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 06/25/2014] [Indexed: 01/09/2023] Open
Abstract
We investigated the unit characteristics associated with engraftment after double-unit cord blood (CB) transplantation (dCBT) and whether these could be reliably identified during unit selection. Cumulative incidence of neutrophil engraftment in 129 myeloablative dCBT recipients was 95% (95% confidence interval: 90-98%). When precryopreservation characteristics were analyzed, the dominant unit CD34(+) cell dose was the only characteristic independently associated with engraftment (hazard ratio, 1.43; P = .002). When postthaw characteristics were also included, only dominant unit infused viable CD34(+) cell dose independently predicted engraftment (hazard ratio, 1.95; P < .001). We then examined the determinants of infused viable CD34(+) cell dose (precryopreservation count, postthaw recovery, and postthaw viability) in 402 units thawed at our center. This revealed close correlation between precryopreservation and postthaw CD34(+) cell counts (r(2) = 0.73). Median CD34(+) cell recovery was 101%, although it ranged from 12% to 1480%. Notably, units from non-Netcord Foundation for the Accreditation of Cellular Therapy (Netcord-FACT)-accredited banks were more likely to have low recovery (P < .001). Furthermore, although median postthaw CD34(+) cell viability was 92%, 33 (8%) units had <75% viable CD34(+) cells. Units from non-Netcord-FACT-accredited banks and units with cryovolumes other than 24.5 to 26.0 mL were more likely to have poor postthaw viability. Precryopreservation CD34(+) cell dose and banking practices should be incorporated into CB unit selection.
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Affiliation(s)
- Duncan Purtill
- Adult Bone Marrow Transplantation Service, Department of Medicine
| | | | - Sean Devlin
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
| | | | | | - Marissa Lubin
- Adult Bone Marrow Transplantation Service, Department of Medicine
| | - Doris M Ponce
- Adult Bone Marrow Transplantation Service, Department of Medicine, Weill Cornell Medical College, New York, NY; and
| | - Sergio Giralt
- Adult Bone Marrow Transplantation Service, Department of Medicine, Weill Cornell Medical College, New York, NY; and
| | - Nancy A Kernan
- Bone Marrow Transplantation Service, Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Andromachi Scaradavou
- Bone Marrow Transplantation Service, Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Cladd E Stevens
- Adult Bone Marrow Transplantation Service, Department of Medicine
| | - Juliet N Barker
- Adult Bone Marrow Transplantation Service, Department of Medicine, Weill Cornell Medical College, New York, NY; and
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12
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Quality controls on cord blood unit contiguous segments: Recommendation of the SFGM-TC. ACTA ACUST UNITED AC 2014; 62:218-20. [DOI: 10.1016/j.patbio.2014.05.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Accepted: 05/14/2014] [Indexed: 11/21/2022]
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13
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Querol S. Cord blood banking: current status. Hematology 2012; 17 Suppl 1:S185-8. [PMID: 22507816 DOI: 10.1179/102453312x13336169157013] [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: 10/31/2022] Open
Abstract
OBJECTIVES Cord blood is increasingly used as a hematopoietic progenitor cell source for bone marrow transplantation. METHODS Development of cord blood banks for altruistic use was essential to open the possibility of opting for cord blood therapy for patients lacking a conventional donor. RESULTS Cord blood has major advantages as a resource for donor provision. First, it universalizes the access to the therapy since it allows transplantation of partially matched HLA grafts, benefiting ethnicities less represented in the adult volunteer list. Second, it is an off-the-shelf, ready-to-use source that avoids donor risk and attrition. Third, potentially it has better long term sustainability if a defined optimal size of the inventory is achieved; currently, more than 80% of patients, regardless ethnicity, can find a reliable cord blood donor with the current worldwide inventory. CONCLUSION In order that this approach may definitely solve the problem of an equitable access to the therapy, two aspects need to be improved: the quality of CB inventories (driven by a higher stringency of regulatory requirements), and clinical outcomes, particularly understanding the appropriate donor selection and focusing research on accelerating the speed of engraftment and immune reconstitution.
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14
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Ponce DM, Lubin M, Gonzales AM, Byam C, Wells D, Ferrante R, Heller G, Giralt S, Papadopoulos EB, Kernan NA, Scaradavou A, Barker JN. The use of back-up units to enhance the safety of unrelated donor cord blood transplantation. Biol Blood Marrow Transplant 2012; 18:648-51. [PMID: 22245598 DOI: 10.1016/j.bbmt.2011.12.588] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Accepted: 12/30/2011] [Indexed: 12/20/2022]
Abstract
The inability to obtain additional stem cells is a disadvantage of unrelated donor cord blood transplantation (CBT). Moreover, in the event of problems with unit shipment, compromised unit quality, thaw mishaps, or graft failure, the time to secure a back-up graft could be unacceptable. Emergent shipment of 1 to 2 back-up units that have been previously typed and reserved could overcome this limitation. However, the advantages of this approach are not established. Therefore, we present our use of back-up units over a 5.5-year period. Six of 121 CBT recipients (5%) required back-up unit infusion. Indications included shipment mishaps (n = 2), poor unit viability (n = 2), significant infusion reaction (n = 1), and graft failure (n = 1). Lack of back-up units would have caused transplantation delay or infusion of inferior-quality units. Five of the 6 patients achieved sustained donor engraftment. We demonstrate that back-up units are emergently required in a significant minority of patients, supporting the incorporation of at least 1 back-up unit in cord blood (CB) selection algorithms to enhance CBT safety.
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Affiliation(s)
- Doris M Ponce
- Adult Bone Marrow Transplantation, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA
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Abstract
PURPOSE OF REVIEW The timing represents a relevant prognostic factor of outcome for patients with hematological malignancies undergoing an allogeneic hematopoietic stem cell transplant (ASCT). In this review, the most recent studies and own transplant center policy on the donor search will be summarized in order to design an algorithm of donor identification driving towards a timely ASCT. RECENT FINDINGS Nowadays, volunteer-unrelated, umbilical cord blood and haploidentical-related donors represent the three alternative sources of hematopoietic stem cells for patients who lack a human leukocyte antigen identical sibling, so that an alternative donor can potentially be found for about all patients eligible for an ASCT. To date, all retrospective studies comparing transplants from these alternative donors have shown no substantial differences in terms of final outcome of patients grafted for hematological malignancies. The policy of a widespread search for an alternative donor has been progressively increasing in the past years. SUMMARY All patients with hematological malignancy for whom the intention to treatment includes an allogeneic transplant should proceed with a well timed ASCT, whatever the stem cell source. The therapeutic policy following the concept of 'donor versus no donor' should presently be changed according to the concept of 'transplant versus no transplant'.
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Spellman S, Hurley CK, Brady C, Phillips-Johnson L, Chow R, Laughlin M, McMannis J, Reems JA, Regan D, Rubinstein P, Kurtzberg J. Guidelines for the development and validation of new potency assays for the evaluation of umbilical cord blood. Cytotherapy 2011; 13:848-55. [DOI: 10.3109/14653249.2011.571249] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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17
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Barini R, Ferraz UC, Acácio GL, Machado IN. Does the time between collecting and processing umbilical cord blood samples affect the quality of the sample? EINSTEIN-SAO PAULO 2011; 9:207-11. [PMID: 26760817 DOI: 10.1590/s1679-45082011gs1809] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To assess the association between the time from umbilical cord blood collection until processing and the quality of the sample. METHODS Umbilical cord blood samples collected during the third stage of labor were placed in temperature-controlled boxes for the transport of biological material and sent to an umbilical cord blood bank, where the number of nucleated cells, viable cells and CD34+ cells were counted, and samples were additionally tested for contamination at the following time intervals: up to 24 hours, up to 48 hours and up to 72 hours following sampling. Data were analyzed using the multivariate analysis of variance (MANOVA) and compared using McNemar's χ2 test. Significance was defined at p < 0.05. RESULTS Means and medians of the number of nucleated cells, viable cells and CD34+ cells decreased significantly (p < 0.0001) as a function of the increased time between sampling and analysis, the difference between 24 and 48 hours being less than the difference between 24 and 72 hours. A linear correlation was found between the mean number of viable cells and CD34+ cells at the three moments of analysis. Contamination testing was negative in all samples. CONCLUSION The increase in time interval from sampling until analysis negatively affected the number of nucleated cells, viable cells and CD34+ cells but was not associated with specimen contamination. A linear correlation was found between decrease in the number of viable cells and CD34+ cells.
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Affiliation(s)
- Ricardo Barini
- Universidade Estadual de Campinas - UNICAMP, Campinas, SP, BR
| | | | | | - Isabela Nelly Machado
- College of Medical Science, Universidade Estadual de Campinas - UNICAMP, Campinas, SP, BR
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18
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Barker JN, Byam C, Scaradavou A. How I treat: the selection and acquisition of unrelated cord blood grafts. Blood 2011; 117:2332-9. [PMID: 21149636 PMCID: PMC3062405 DOI: 10.1182/blood-2010-04-280966] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Accepted: 10/26/2010] [Indexed: 12/24/2022] Open
Abstract
Use of unrelated donor cord blood (CB) as an alternative stem cell source is increasing, and yet there is little information to guide transplant centers in the unique aspects of the search and selection of CB grafts. There is no mechanism to easily access the global inventory of CB units, nor is the product information provided by all banks standardized. To address these challenges, this manuscript reviews the logistics of the search, selection process, and acquisition of CB grafts as practiced by our center. Topics include who should be considered for a CB search, how to access the global CB inventory, and how to balance total nucleated cell dose and human leukocyte antigen match in unit selection. We discuss aspects of unit quality and other graft characteristics (processing methods, unit age, availability of attached segments, infectious disease, and hemoglobinopathy screening) to be considered. We incorporate these considerations into a unit selection algorithm, including how to select double-unit grafts. We also describe how we plan for unit shipment and the role of backup grafts. This review aims to provide a framework for CB unit selection and help transplantation centers perform efficient CB searches.
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Affiliation(s)
- Juliet N Barker
- Allogeneic Bone Marrow Transplant Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
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19
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Boo M, Ballen K, Maiers M. Cord Blood Unit Access and Selection: 2010 and Beyond: Best Practices and Emerging Trends in Cord Blood Unit Selection. Biol Blood Marrow Transplant 2011; 17:S46-51. [DOI: 10.1016/j.bbmt.2010.11.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Accepted: 07/18/2010] [Indexed: 11/29/2022]
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20
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Querol S, Gomez SG, Pagliuca A, Torrabadella M, Madrigal JA. Quality rather than quantity: the cord blood bank dilemma. Bone Marrow Transplant 2010; 45:970-8. [PMID: 20190835 DOI: 10.1038/bmt.2010.7] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2009] [Accepted: 12/02/2009] [Indexed: 11/08/2022]
Abstract
Growing inventories of cord blood units have facilitated access to umbilical cord cell transplantation for many patients lacking conventional stem cell donors. They are in principle 'off-the-shelf', 'fit-for-use', as well as safe and effective therapy products. Cellular enumeration is used as a surrogate of graft potency, and users rely on the rigorous assessment carried out in banks to avoid poor engraftment after thawing (loss of cells or poor function), when the patient's situation is critical. However, in practice, when units are selected, initially on the basis of HLA matching and cell dose assessment, their absolute quality remains uncertain. Unfortunately, quality-related issues (particularly related to viability) are not uncommon in cord blood transplantation. The reasons for potency failures are diverse, but a lack of thorough validation during critical steps of the process and of appropriate use of quality-control tools for timely detection of problematic units are significant contributors. Moreover, incongruence between different sets of standards and regulations, and lack of common quality systems between banks result in a highly heterogeneous international inventory. Therefore, this complicates the matter for the end user of the product. To ameliorate this situation, it is essential to improve quality at each of the critical manufacturing steps wherein potency can be threatened, thereby creating homogeneous inventories of units with excellent quality and quantity.
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Affiliation(s)
- S Querol
- The Anthony Nolan Research Institute, The Anthony Nolan Trust, London, UK
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21
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Quality assessment of cord blood units selected for unrelated transplantation: A Transplant Center perspective. Transfus Apher Sci 2010; 42:289-97. [DOI: 10.1016/j.transci.2010.03.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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22
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23
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Abstract
Abstract
McCullough and colleagues show that problems with cord banking still exist. To improve the results of cord transplantations, more attention should be given to ensuring quality standards rather than just collecting more units.
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Miura J, Minegishi M, Itoh T, Kitaura T, Fukawa N, Takahashi H, Suzuki A, Kudo Y, Narita A, Sato Y, Suzuki M, Wada Y, Takeyama Y, Watanabe T, Tsuchiya S. Quality evaluation of umbilical cord blood progenitor cells cryopreserved with a small-scale automated liquid nitrogen system. Cryobiology 2008; 57:178-81. [PMID: 18682250 DOI: 10.1016/j.cryobiol.2008.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2008] [Revised: 05/20/2008] [Accepted: 07/05/2008] [Indexed: 11/16/2022]
Abstract
The performance of a small-scale automated cryopreservation and storage system (Mini-BioArchive system) used in the banking of umbilical cord blood (UCB) units was evaluated. After thawing the units, the viability and recovery of cells, as well as the recovery rate of hematopoietic progenitor cells (HPCs) such as CD34+ cells, colony-forming unit-granulocyte-macrophage (CFU-GM), and total CFU were analyzed. Twenty UCB units cryopreserved using the automated system and stored for a median of 34 days were analyzed. Mean CD34+ cell viabilities before freezing were 99.8+/-0.5% and after thawing were 99.8+/-0.4% in the large bag compartments and 99.7+/-0.5% in the small compartments. The mean recovery values for total nucleated cells, CD34+ cells, CFU-GM, and total CFU were 94.8+/-16.0%, 99.3+/-18.6%, 103.9+/-20.6%, and 94.3+/-12.5%, respectively in the large compartments, and 95.8+/-25.9%, 106.8+/-23.9%, 101.3+/-23.3%, and 93.8+/-19.2%, respectively in the small compartments. A small-scale automated cryopreservation and storage system did not impair the clonogenic capacity of UCB HPCs. This cryopreservation system could provide cellular products adequate for UCB banking and HPC transplantation.
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Affiliation(s)
- Junko Miura
- Division of Blood Transfusion, Tohoku University Hospital, 1-1 Seiryomachi, Aoba-ku, Sendai, Miyagi Prefecture 980-8574, Japan
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25
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Shim JS, Cho B, Kim M, Park GS, Shin JC, Hwang HK, Kim TG, Oh IH. Early apoptosis in CD34+ cells as a potential heterogeneity in quality of cryopreserved umbilical cord blood. Br J Haematol 2006; 135:210-3. [PMID: 16925791 DOI: 10.1111/j.1365-2141.2006.06270.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The increased use of umbilical cord blood (UCB) raises issues regarding the quality of cryopreserved UCB. This study investigated whether early apoptosis of CD34+ cells is part of the functional heterogeneity of cryopreserved UCB. Annexin V binding of CD34+ PI(-) cells showed wide variations in both fresh and cryopreserved UCBs, with greater variation among units frozen for > 5 years. Xenotransplantation of sorted cells into non-obese diabetic severe combined immunodeficient mice demonstrated that the Annexin V assay identified most repopulating activities in UCB units. Thus, early apoptosis of CD34+ cells could influence the outcome of transplantation using cryopreserved UCB.
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Affiliation(s)
- Jae-Seung Shim
- Catholic Cell Therapy Centre and Department of Cellular Medicine, The Catholic University of Korea, Seoul, Korea
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Wagner E, Duval M, Dalle JH, Morin H, Bizier S, Champagne J, Champagne MA. Assessment of cord blood unit characteristics on the day of transplant: comparison with data issued by cord blood banks. Transfusion 2006; 46:1190-8. [PMID: 16836567 DOI: 10.1111/j.1537-2995.2006.00870.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Selection of a cord blood (CB) unit for allogeneic transplantation relies on graft characterization results provided by cord blood banks (CBBs). The goal was to compare the graft characterization results obtained upon thawing and washing to those provided by CBBs at selection. STUDY DESIGN AND METHODS With tests that assess CB graft characteristics known to impact engraftment, CB units have been analyzed after thaw and before infusion. Our results were compared to data provided by CBBs to determine the impact on engraftment and assess how CBB-supplied information can affect future CB unit selection. RESULTS Variability was noted as to the type of information provided by the different CBBs. Also, variability was found between the information provided by CBBs and the graft characterization results obtained upon thawing and washing. In some cases, CB measures known to be predictive of engraftment were found much lower than reported by CBBs. Only the total nucleated cell count, which is the main CB graft selection criterion besides HLA matching, correlated favorably. CONCLUSIONS Our data reveal a high degree of variability in graft characteristics provided by CBBs and often poor correlation with results obtained on thawed and washed CB units. We suggest that standardized laboratory procedures aimed at graft characterization should be used by both CBBs and transplant centers to avoid unacceptable discrepancies.
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Affiliation(s)
- Eric Wagner
- Division of Hematology-Oncology, CHU Sainte-Justine, Université de Montréal, Montréal, Québec, Canada
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