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Lee JH, Cho BS, Kwag D, Min GJ, Park SS, Park S, Yoon JH, Lee SE, Eom KS, Kim YJ, Lee S, Min CK, Cho SG, Lee JW, Kim HJ. Haploidentical versus Double-Cord Blood Stem Cells as a Second Transplantation for Relapsed Acute Myeloid Leukemia. Cancers (Basel) 2023; 15:cancers15020454. [PMID: 36672403 PMCID: PMC9856318 DOI: 10.3390/cancers15020454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/23/2022] [Accepted: 01/05/2023] [Indexed: 01/12/2023] Open
Abstract
There are limited data on second stem cell transplantation (SCT2) outcomes with alternative donors for relapsed AML after the first stem cell transplantation (SCT1). We analyzed the outcomes of 52 adult AML patients who received SCT2 from haploidentical donors (HIT, N = 32) and double-cord blood (dCBT, N = 20) between 2008 and 2021. The HIT group received T-cell-replete peripheral blood stem cells after reduced-toxicity conditioning with anti-thymocyte globulin (ATG), while the dCBT group received myeloablative conditioning. For a median follow-up of 64.9 months, the HIT group, compared to the dCBT group, had earlier engraftment, superior 2-year overall survival (OS), disease-free survival (DFS), and non-relapse mortality (NRM) with similar relapse. Multivariate analysis demonstrated that HIT was significantly associated with better OS, DFS, and lower NRM than dCBT. Both longer remission duration after SCT1 and complete remission at SCT2 were significantly associated with a lower relapse rate. In addition, bone marrow WT1 measurable residual disease (MRD) positivity was significantly associated with inferior OS and higher relapse. This study suggests that T-cell-replete HIT with ATG-based GVHD prophylaxis may be preferred over dCBT as SCT2 for relapsed AML and that WT1-MRD negativity may be warranted for better SCT2 outcomes.
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Affiliation(s)
- Jong-Hyuk Lee
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Byung-Sik Cho
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Daehun Kwag
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Gi-June Min
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Sung-Soo Park
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Silvia Park
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Jae-Ho Yoon
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Sung-Eun Lee
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Ki-Seong Eom
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Yoo-Jin Kim
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Seok Lee
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Chang-Ki Min
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Seok-Goo Cho
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Jong-Wook Lee
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Hee-Je Kim
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Correspondence: ; Tel.: +82-2-2258-6054; Fax: +82-2-599-3589
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Arabkari V, Amirizadeh N, Nikougoftar M, Soleimani M. microRNA expression profiles in two- and three-dimensional culture conditions of human-umbilical-cord blood-derived CD34 + cells. J Cell Physiol 2019; 234:20072-20084. [PMID: 30953369 DOI: 10.1002/jcp.28606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 03/19/2019] [Indexed: 12/16/2022]
Abstract
Human umbilical cord blood (HUCB) is a suitable source of hematopoietic stem cells (HSCs) for therapeutic transplantation. Different approaches have been used to expand the number of HSCs to increase the rate of HSC transplantation success in patients, such as using different cocktails of cytokines, feeder cell layers, and biocompatible scaffolds. microRNAs (miRNAs) are small noncoding RNAs that regulate gene expression posttranscriptionally. They play crucial roles in hematopoiesis including stem cell proliferation, differentiation, stemness, and self-renewal properties. Here, we studied the UCB-derived CD34+ cell expansion and the miRNA signatures of CD34+ cells on two- and three-dimensional (2D and 3D) culture conditions. We successfully expanded the UCB-derived CD34+ cells in both liquid culture (2D) and on aminated polyethersulfone nanofiber scaffolds (3D). Next, we identified the miRNA signature of CD34+ cells and their target genes. We found 58 dysregulated miRNAs in 3D culture condition and 34 dysregulated miRNAs in 2D culture condition when compared to the freshly isolated CD34+ cells. Various types of target genes were also predicted in both conditions using two online databases.
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Affiliation(s)
- Vahid Arabkari
- Blood Transfusion Research Center, High Institute for Education and Research in Transfusion Medicine, Iran Blood Transfusion Organization, Tehran, Iran
| | - Naser Amirizadeh
- Blood Transfusion Research Center, High Institute for Education and Research in Transfusion Medicine, Iran Blood Transfusion Organization, Tehran, Iran
| | - Mahin Nikougoftar
- Blood Transfusion Research Center, High Institute for Education and Research in Transfusion Medicine, Iran Blood Transfusion Organization, Tehran, Iran
| | - Masoud Soleimani
- Department of Hematology, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Porada CD, Atala AJ, Almeida-Porada G. The hematopoietic system in the context of regenerative medicine. Methods 2015; 99:44-61. [PMID: 26319943 DOI: 10.1016/j.ymeth.2015.08.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 07/06/2015] [Accepted: 08/23/2015] [Indexed: 12/16/2022] Open
Abstract
Hematopoietic stem cells (HSC) represent the prototype stem cell within the body. Since their discovery, HSC have been the focus of intensive research, and have proven invaluable clinically to restore hematopoiesis following inadvertent radiation exposure and following radio/chemotherapy to eliminate hematologic tumors. While they were originally discovered in the bone marrow, HSC can also be isolated from umbilical cord blood and can be "mobilized" peripheral blood, making them readily available in relatively large quantities. While their ability to repopulate the entire hematopoietic system would already guarantee HSC a valuable place in regenerative medicine, the finding that hematopoietic chimerism can induce immunological tolerance to solid organs and correct autoimmune diseases has dramatically broadened their clinical utility. The demonstration that these cells, through a variety of mechanisms, can also promote repair/regeneration of non-hematopoietic tissues as diverse as liver, heart, and brain has further increased their clinical value. The goal of this review is to provide the reader with a brief glimpse into the remarkable potential HSC possess, and to highlight their tremendous value as therapeutics in regenerative medicine.
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Affiliation(s)
- Christopher D Porada
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, 391 Technology Way, Winston-Salem, NC 27157-1083, United States.
| | - Anthony J Atala
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, 391 Technology Way, Winston-Salem, NC 27157-1083, United States.
| | - Graça Almeida-Porada
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, 391 Technology Way, Winston-Salem, NC 27157-1083, United States.
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Basford C, Forraz N, Habibollah S, Hanger K, McGuckin C. The cord blood separation league table: a comparison of the major clinical grade harvesting techniques for cord blood stem cells. Int J Stem Cells 2014; 3:32-45. [PMID: 24855539 DOI: 10.15283/ijsc.2010.3.1.32] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2010] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Well over 1 million Umbilical Cord Blood units (UCB) have been stored globally in the last 10 years. Already, over 20,000 transplants been performed using UCB for haematopoietic reconstitution alone, now this potential is joined by regenerative medicine. However, more needs to be known about processing of this stem cell source for it to reach full potential. METHODS AND RESULTS IN THIS STUDY WE EVALUATED FIVE SEPARATION METHODS: plasma depletion, density gradient, Hetastarch, a novel method known as PrepaCyte-CB and an automated centrifugal machine. Sepax gives the highest recovery of nucleated cells, an average of 78.8% (SD±21.36). When looking at CD34+ haematopoietic stem cells PrepaCyte-CB provided the greatest recovery at 74.47% (SD±8.89). For volume reduction density gradient was the most effective leaving 0.03×10(6) RBC/ml, 8 times more efficient than its nearest competitor PrepaCyte-CB (p<0.05). Finally PrepaCyte-CB processing left samples with the highest clonogenic potential after processing and more significantly after cryopreservation: 9.23 CFU/10(8) cells (SD±2.33), 1.5 fold more effective than its nearest rival Sepax (p<0.05). CONCLUSIONS PrepaCyte-CB was the most flexible method; the only processing type unaffected by volume. Results indicate that processing choice is important depending on your final intended use.
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Affiliation(s)
- Christina Basford
- Newcastle Centre for Cord Blood, Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, NE1 3BZ, United Kingdom
| | - Nicolas Forraz
- CTI-LYON, Cell Therapy Research Institute, Parc Technologique de Lyon-St Priest, Cèdre 1, 97 Allée Alexandre Borodine, 69800 SAINT PRIEST LYON, France
| | - Saba Habibollah
- Newcastle Centre for Cord Blood, Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, NE1 3BZ, United Kingdom
| | - Kendal Hanger
- Newcastle Centre for Cord Blood, Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, NE1 3BZ, United Kingdom
| | - Colin McGuckin
- CTI-LYON, Cell Therapy Research Institute, Parc Technologique de Lyon-St Priest, Cèdre 1, 97 Allée Alexandre Borodine, 69800 SAINT PRIEST LYON, France
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Abstract
Cord blood (CB) is an important alternative source of hematopoietic stem cells (HSCs) for transplantation today. The principal drawbacks of cord blood transplantation are the limited number of hematopoietic stem cells and a long time to engraftment. Several promising approaches for engraftment enhancement are under intensive investigation. Such are transplantation with two cord blood units, co transplantation of cord blood and haploidentical HSCs and different methods for expansion of cord blood hematopoietic stem cells. In addition there are several ways for improving of homing of HSCs such as co- infusion of CB hematopoietic stem cells and mesenchymal stem cells, administration of parathyroid hormone (PTH), intra- bone transplantation and targeting the CXCR4/SDF1 system. These strategies are expected to increase the availability of transplantation to adults, for whom the chance to find a cord blood suitable for a single unit transplant is small. Recent advances in elucidation of the molecular mechanisms responsible for the proliferation and self-renewal of hematopoietic stem cells may bring further improvement of the outcomes of cord blood transplantation. This review summarizes the recent progress in the field of cord blood derived hematopoietic stem cells. It presents the strategies applied and points out directions for the future.
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Sideri A, Neokleous N, Brunet De La Grange P, Guerton B, Le Bousse Kerdilles MC, Uzan G, Peste-Tsilimidos C, Gluckman E. An overview of the progress on double umbilical cord blood transplantation. Haematologica 2011; 96:1213-20. [PMID: 21546497 DOI: 10.3324/haematol.2010.038836] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Umbilical cord blood transplantation has been increasingly used over the past years for both malignant and non-malignant hematologic and other diseases as an alternative to mismatched-related or matched-unrelated bone marrow or peripheral blood hematopoietic stem cell transplantation. A disadvantage of cord blood is its low cell content which limits cord blood transplantation to generally low weight recipients, such as children. Various alternatives have been used to overcome this limitation, including co-infusion of two partially HLA-matched cord blood units. According to Eurocord Registry data, this strategy has been applied in approximately 993 adult patients with hematologic diseases since the first double umbilical cord blood transplantation in 1999. In fact, since 2005, the number of adult patients receiving double umbilical cord blood transplantation has surpassed the number of adults transplanted with single cord blood units. The engraftment rate is comparable for both single and double umbilical cord blood transplantation, although the latter is accompanied by a higher incidence of grade II acute graft-versus-host disease and lower leukemia relapse for patients in first complete remission. In the majority of patients undergoing double umbilical cord blood transplantation, transient chimerism, due to the presence of cells from both donor units early post transplant, is replaced by sustained dominance of one unit from which long-term hematopoiesis is derived. Although the biology and the factors that determine unit dominance have not been clarified, the implication of immune-mediated mechanisms has been reported. Preliminary data have demonstrated the safety of double umbilical cord blood transplantation. Ongoing clinical trials and prolonged follow up of the patients will clarify the immunology and determine the efficacy of this approach. We present here a brief overview of the clinical experience on double umbilical cord blood transplantation and its underlying biology.
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Affiliation(s)
- Anastasia Sideri
- Stem-Health Hellas, Hygeia Hospital, 4 Er. Stavrou & Kifisias Avenue, Athens, Greece.
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Abstract
PURPOSE OF REVIEW This review summarizes the current status of double-unit cord blood transplantation (CBT) to improve engraftment, reduce transplant-related mortality, and improve disease-free survival. RECENT FINDINGS Transplantation of cord blood provides a potentially curative therapy for many patients without a suitably human leukocyte antigen-matched related or unrelated donor. Single-unit CBT outcomes have been compromised, however, in adults and larger children by limited cell dose. The introduction of double-unit CBT has improved engraftment and transplant-related mortality in adult patients transplanted for hematologic malignancies, with recent data also suggesting a protection against relapse. These improved outcomes are seen despite only a single unit being responsible for sustained donor hematopoiesis in nearly all patients. The study of double-unit CBT provides unique insights into transplant biology, with emerging data suggesting unit dominance is related to unit viability and unit-versus-unit immune interactions. Multiple unit CBT further serves as a platform to test novel graft manipulations. SUMMARY The development of double-unit CBT now allows the majority of patients, regardless of size or racial/ethnic background, access to transplant therapy. Ongoing investigation will serve to further improve outcomes and expand the role of CBT in the future.
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Proctor SJ, Chapman CE, Sharples R, Lucraft HL, Wilkinson J, Conn J, Middleton PG. Enhanced engraftment of a very low-dose cord blood unit in an adult haemopoietic transplant by addition of six mismatched viable cord units. Stem Cells Int 2010; 2010:431909. [PMID: 21048848 PMCID: PMC2956468 DOI: 10.4061/2010/431909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Revised: 06/25/2009] [Accepted: 08/05/2009] [Indexed: 11/29/2022] Open
Abstract
The report describes the feasibility of the addition of multiple viable HLA-mismatched unrelated cord blood units, to a low cell number matched unrelated cord, to assist clinical engraftment. An ablative stem cell transplant was performed in an adult with relapsed acute lymphoblastic leukaemia (ALL), using a single HLA-matched cord blood unit (mononuclear cell dose 0.8 × 107), supported by six mismatched cord blood units (one unit per 10 kg recipient weight). No adverse reaction occurred following the infusion of mismatched units and engraftment of the suboptimal-dose matched unit occurred rapidly, with no molecular evidence of engraftment of mismatched cords. Early molecular remission of ALL was demonstrated using a novel PCR for a mitochondrial DNA mutation in the leukaemic clone. The cell dose of the matched cord was well below that recommended to engraft a 70 kg recipient. We suggest that a factor or factors in the mismatched cords enhanced/supported engraftment of the matched cord.
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Affiliation(s)
- Stephen J Proctor
- Haematological oncology Group, Academic Haematology, Medical School, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
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Kelly SS, Parmar S, De Lima M, Robinson S, Shpall E. Overcoming the barriers to umbilical cord blood transplantation. Cytotherapy 2010; 12:121-30. [PMID: 20196692 DOI: 10.3109/14653240903440111] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Umbilical cord blood (UCB) transplantation (UCBT) has seen a marked increase in utilization in recent years, especially in the pediatric population; however, graft failure, delayed engraftment and profound delay in immune reconstitution leads to significant morbidity and mortality in adults. The lack of cells available for post-transplant therapies, such as donor lymphocyte infusions, has also been considered a disadvantage. To overcome the cell-dose barrier, the combination of two UCB units is becoming commonplace in adolescent and adult populations, and is currently being studied in pediatrics as well. In some studies, the use of two UCB units appears to have a positive impact on outcomes; however, engraftment is still suboptimal. A possible additional way to improve outcome and extend applicability of UCBT is via ex vivo expansion. Studies to develop optimal expansion conditions are still in the exploratory phase; however, recent studies suggest expanded UCB is safe and can improve outcomes. The ability to transplant across HLA disparities, rapid procurement time and decreased graft-versus-host disease (GvHD) seen with UCBT makes it a promising stem cell source and, while barriers exist, consistent progress is being made to overcome them.
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Affiliation(s)
- Susan Staba Kelly
- Department of Pediatrics, University of Texas MD Anderson Cancer Center, Houston, Texas 77030-4009, USA.
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Stanevsky A, Shimoni A, Yerushalmi R, Nagler A. Double umbilical cord blood transplant: more than a cell dose? Leuk Lymphoma 2010; 51:975-82. [DOI: 10.3109/10428191003699886] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Basford C, Forraz N, Habibollah S, Hanger K, McGuckin CP. Umbilical cord blood processing using Prepacyte-CB increases haematopoietic progenitor cell availability over conventional Hetastarch separation. Cell Prolif 2009; 42:751-61. [PMID: 19758367 DOI: 10.1111/j.1365-2184.2009.00646.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Currently the most frequently used method for umbilical cord blood separation in many hospitals across the UK and the rest of the world, where small-to-medium amounts of samples are processed, is Hetastarch, a mechanical, starch-based method, which causes red cell agglutination by rouleaux formation. AIM In this study, a novel method (Prepa-Cyte-CB), in comparison with Hetastarch as part of an FDA-approved clinical study, was evaluated. MATERIALS AND METHODS Validation of data included recovery of nucleated and CD34+ cells, red blood cell reduction, colony forming unit potential, flow cytometric analysis and sterility tests. RESULTS PrepaCyte-CB, in comparison with Hetastarch offers fast, reliable separation with improved recovery of nucleated cells, 72.03% (+/-8.48 SD) compared to 58.09% (+/-20.06 SD), and CD34+ haematopoietic progenitor cells, 76% (+/-19.54 SD) compared to 64.19% (+/-29.77 SD). PrepaCyte-CB was also 12-fold more efficient in removing red blood cells and haemoglobin (P < 0.001) than Hetastarch. CONCLUSIONS These results show that PrepaCyte-CB offers superior separation of UCB when compared to Hetastarch.
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Affiliation(s)
- C Basford
- Newcastle Centre for Cord Blood, Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, UK
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Ahn MS, Eom YW, Park JS, Choi JH, Kang SY, Lee HW, Yang MS, Kim HE, Jang IK, Lee JE, Kim YJ, Kim HC, Jeong SH. Difference in Viability of CD34+ Cells in Cryopreserved Cord Blood According to Evaluation Methods. THE KOREAN JOURNAL OF HEMATOLOGY 2009. [DOI: 10.5045/kjh.2009.44.2.92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Mi Sun Ahn
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
| | - Young-woo Eom
- Biomedical Research Institute, LifeCord Inc., Suwon, Korea
| | - Joon Seong Park
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
| | - Jin-Hyuk Choi
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
| | - Seok Yun Kang
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
| | - Hyun Woo Lee
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
| | - Mal Sook Yang
- Biomedical Research Institute, LifeCord Inc., Suwon, Korea
| | - Hyo Eun Kim
- Biomedical Research Institute, LifeCord Inc., Suwon, Korea
| | - In Keun Jang
- Biomedical Research Institute, LifeCord Inc., Suwon, Korea
| | - Jong Eun Lee
- Biomedical Research Institute, LifeCord Inc., Suwon, Korea
| | - Young Jin Kim
- Biomedical Research Institute, LifeCord Inc., Suwon, Korea
| | - Hugh Chul Kim
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
| | - Seong Hyun Jeong
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
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Wall DA, Chan KW. Selection of cord blood unit(s) for transplantation. Bone Marrow Transplant 2008; 42:1-7. [PMID: 18469873 DOI: 10.1038/bmt.2008.100] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Selection of cord blood (CB) units for transplantation involves combining both cell dose and HLA matching as independent yet overlapping variables. Cell dose and cell yield at the time of transplant are critical given that the transplants are being performed with minimal cells for reliable engraftment. In transplants for malignant disorders, the greater allogenicity and lower relapse rate associated with the less well-matched units balance any benefit of better HLA matching on TRM. The only factor that has repeatedly been associated with improved outcome post CB transplant is cell dose. The CB inventories are rapidly increasing in size and the quality of CB units being banked (larger, better characterized) is improving. With this, some of our current limitations in CB availability will soon become moot. Explorations into CB expansion and multiple CB unit transplants are addressing the limited cell doses attainable with a single CB collection. At this point, one must conclude that bigger is better when selecting CB units for transplantation.
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Affiliation(s)
- D A Wall
- 1Pediatric Blood and Marrow Transplantation Program, Texas Transplant Institute, San Antonio, Texas 78229, USA.
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