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Pucci G, Foti G, Surace R, Monteleone R, Princi D, Fabrizi E, Quattrone G, Miniero R, Liverani A, Talarico V. Evaluation of factors affecting total nucleated cells in umbilical cord blood collected for the Calabria Cord Blood Bank. Minerva Pediatr (Torino) 2024; 76:363-371. [PMID: 33305918 DOI: 10.23736/s2724-5276.20.06096-x] [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: 06/07/2024]
Abstract
BACKGROUND Total nucleated cell (TNC) count is the most important biological feature to consider in assessing the quality of umbilical cord blood (UCB) for hematopoietic stem cell (HSC) transplantation. Certain obstetric factors have been reported to increase TNC count in UCB units collected for transplantation. The aim of our study was to analyze how various maternal, neonatal and obstetric factors affected TNC count in the UCBs we collected for our cord blood bank in southern Italy. METHODS We performed a retrospective analysis of 634 medical records of UCBs collected by Calabria Cord Blood Bank (CCBB), Reggio Calabria, Italy, between January 1, 2010, and December 31, 2016. We analyzed various maternal, neonatal and obstetric variables factors and related this factor with the characteristic of TNC. RESULTS We found that the average number of TNCs was significantly greater in vaginal delivery than in caesarean delivery. We also found that TNCs were higher in the 40th week of pregnancy and when Apgar 1' scores were ≤9. The effect of a newborn's gender was less evident on TNC count. CONCLUSIONS Knowledge of factors predictive of a higher TNC count would help cord blood banks more efficiently identify donors likely to yield high-quality UCBs for transplantation.
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Affiliation(s)
- Giulia Pucci
- Calabria Cord Blood Bank, Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy
| | - Giovanni Foti
- Calabria Cord Blood Bank, Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy
| | - Rosangela Surace
- Calabria Cord Blood Bank, Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy
| | - Renza Monteleone
- Calabria Cord Blood Bank, Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy
| | - Domenica Princi
- Calabria Cord Blood Bank, Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy
| | - Enrico Fabrizi
- Department of Economic and Social Sciences (DISES), Sacro Cuore University of Piacenza, Piacenza, Italy
| | - Giuseppe Quattrone
- Department of Economic and Social Sciences (DISES), Sacro Cuore University of Piacenza, Piacenza, Italy
| | - Roberto Miniero
- Department of Pediatrics, Pugliese-Ciaccio Hospital of Catanzaro, Catanzaro, Italy
| | | | - Valentina Talarico
- Department of Pediatrics, Pugliese-Ciaccio Hospital of Catanzaro, Catanzaro, Italy -
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Eldjerou LK, Cogle CR, Rosenau EH, Lu X, Bennett CA, Sugrue MW, Hoyne J, Lambert A, Ashley L, Sazama K, Fields G, Wingard JR, Zubair AC. Vitamin D effect on umbilical cord blood characteristics: a comparison between African Americans and Caucasians. Transfusion 2015; 55:1766-71. [DOI: 10.1111/trf.13124] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 12/23/2014] [Accepted: 12/30/2014] [Indexed: 12/29/2022]
Affiliation(s)
- Lamis K. Eldjerou
- Departments of Pediatric Blood & Marrow Transplantation; Medicine and Biostatistics, University of Florida; Gainesville Florida
| | - Christopher R. Cogle
- Departments of Pediatric Blood & Marrow Transplantation; Medicine and Biostatistics, University of Florida; Gainesville Florida
| | - Emma H. Rosenau
- Departments of Pediatric Blood & Marrow Transplantation; Medicine and Biostatistics, University of Florida; Gainesville Florida
| | - Xiaomin Lu
- Departments of Pediatric Blood & Marrow Transplantation; Medicine and Biostatistics, University of Florida; Gainesville Florida
| | | | - Michele W. Sugrue
- Departments of Pediatric Blood & Marrow Transplantation; Medicine and Biostatistics, University of Florida; Gainesville Florida
| | - Jonathan Hoyne
- Department of Laboratory Medicine and Pathology; Mayo Clinic; Jacksonville Florida
| | - Amy Lambert
- Michigan Blood Cord Blood Bank; Grand Rapids Michigan
| | | | - Kathleen Sazama
- San Diego Blood Bank Cord Blood Program; San Diego California
| | - Gary Fields
- Department of Laboratory Medicine and Pathology; Mayo Clinic; Jacksonville Florida
| | - John R. Wingard
- Departments of Pediatric Blood & Marrow Transplantation; Medicine and Biostatistics, University of Florida; Gainesville Florida
| | - Abba C. Zubair
- Department of Laboratory Medicine and Pathology; Mayo Clinic; Jacksonville Florida
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Abstract
The field of neurogenetics is moving so rapidly that new discoveries are announced almost weekly. The tools available for the diagnosis of neurogenetic disorders have become powerful and complex, and raise new ethical dilemmas that did not exist just a few years ago. In addition to previous concerns about presymptomatic genetic testing and carrier testing, the widening availability of next-generation sequencing raises concerns about the reporting of incidental findings of unclear significance. Genetically targeted therapies have now been proven to be efficacious for a few neurogenetic diseases, and it is likely that gene therapies and cell-based therapies will soon be applied to other neurologic disorders. These therapies are generally quite expensive compared to other treatments. Given the cost constraints that will be needed in the healthcare system in the United States and other countries, and the likelihood that new genetically targeted therapies will be introduced, society will face difficult questions regarding its obligations to fund expensive therapies both for large populations and for small numbers of patients with rare diseases. Potential conflicts of interest involving both individuals and institutions will need ongoing vigilance. Scientific advances will continue to raise consequential ethical questions in the field of neurogenetics.
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Gutensohn K, Odendahl M, Kersten JF, Tonn T. Validation of cord blood split products prepared by an automated method. Transfus Med 2012; 23:48-54. [PMID: 23025789 DOI: 10.1111/j.1365-3148.2012.01191.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Revised: 05/06/2012] [Accepted: 09/05/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVES In this study, we studied whether the contents of the two compartments of automatically processed cord blood (CB) units are comparable with respect to cell counts and viability and therefore suitable for clinical therapy. BACKGROUND CB-derived stem cells are increasingly used for allogeneic transplantation. Many centres prepare the transplants by automated methods allowing to split the product into two portions. METHODS CB was collected at different sites in Germany and transported to a single centre for processing. Before and after cryopreservation laboratory analyses were performed to compare the quality of the two CB segments. RESULTS In total, 33 products were processed [mean collection volume: 18·6 ± 1·2 mL (range 15·2-20·2 mL) segment A; mean: 4·7 ± 0·3 mL (range 4·2-5·2 mL) segment B]. CD34+ cell counts, viability of CD34+ cells and many other haematological parameters showed a good comparibility between the two segments. However, lymphocyte counts and results of clonogenic assays were significantly different between the two segments of the split product. CONCLUSION We conclude that the preparation of the cord blood unit by the automated process results in a homogenous distribution of stem and progenitor cells. However, our findings show that the clonogenic capacity differs between the two segments.
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Affiliation(s)
- K Gutensohn
- Department of Transfusion Medicine, University Hospital Hamburg Eppendorf, Hamburg, Germany
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5
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Ballen KK, Klein JP, Pedersen TL, Bhatla D, Duerst R, Kurtzberg J, Lazarus HM, LeMaistre CF, McCarthy P, Mehta P, Palmer J, Setterholm M, Wingard JR, Joffe S, Parsons SK, Switzer GE, Lee SJ, Rizzo JD, Majhail NS. Relationship of race/ethnicity and survival after single umbilical cord blood transplantation for adults and children with leukemia and myelodysplastic syndromes. Biol Blood Marrow Transplant 2012; 18:903-12. [PMID: 22062801 PMCID: PMC3874400 DOI: 10.1016/j.bbmt.2011.10.040] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Accepted: 10/25/2011] [Indexed: 12/15/2022]
Abstract
The relationship of race/ethnicity with outcomes of umbilical cord blood transplantation (UCBT) is not well known. We analyzed the association between race/ethnicity and outcomes of unrelated single UCBT for leukemia and myelodysplastic syndromes. Our retrospective cohort study consisted of 885 adults and children (612 whites, 145 blacks, and 128 Hispanics) who received unrelated single UCBT for leukemia and myelodysplastic syndromes between 1995 and 2006 and were reported to the Center for International Blood and Marrow Transplant Research. A 5-6/6 HLA-matched unit with a total nucleated cell count infused of ≥2.5 × 10(7)/kg was given to 40% white and 42% Hispanic, but only 21% black patients. Overall survival at 2 years was 44% for whites, 34% for blacks, and 46% for Hispanics (P = .008). In multivariate analysis adjusting for patient, disease, and treatment factors (including HLA match and cell dose), blacks had inferior overall survival (relative risk of death, 1.31; P = .02), whereas overall survival of Hispanics was similar (relative risk, 1.03; P = .81) to that of whites. For all patients, younger age, early-stage disease, use of units with higher cell dose, and performance status ≥80 were independent predictors of improved survival. Black patients and white patients infused with well-matched cords had comparable survival; similarly, black and white patients receiving units with adequate cell dose had similar survival. These results suggest that blacks have inferior survival to whites after single UCBT, but outcomes are improved when units with a higher cell dose are used.
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Affiliation(s)
- Karen K Ballen
- Division of Hematology/Oncology, Massachusetts General Hospital, Boston, MA 02114, USA.
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6
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Petz L, Jaing TH, Rosenthal J, Karanes C, Nademanee A, Chan LL, Graham ML, Lin HP, Tan P, Wang BC, Fu C, Chow M, Forman S, Chow R. Analysis of 120 pediatric patients with nonmalignant disorders transplanted using unrelated plasma-depleted or -reduced cord blood. Transfusion 2011; 52:1311-20. [PMID: 22098396 DOI: 10.1111/j.1537-2995.2011.03452.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Unrelated cord blood (CB) is an important stem cell source for unrelated hematopoietic cell transplantation (HCT) of patients with nonmalignant disorders. Processing methods to prepare red blood cell-reduced CB units incur significant nucleated cell loss. In contrast, plasma depletion or reduction (PDR) processing of CB units entails the removal of only a portion of the plasma with minimal nucleated cell loss. However, there are relatively limited data regarding outcomes of CB transplants using units processed by PDR. STUDY DESIGN AND METHODS A Center for International Blood and Marrow Transplant Research (CIBMTR)-audited analysis was performed on 120 pediatric patients with nonmalignant disorders transplanted between November 2001 and January 2008 at 29 US and 17 international centers using PDR CB units from two CB banks. RESULTS Transplant characteristics were as follows: median age, 3.5 years (range, 0.1-14 years); median patient weight, 15 kg (range, 4-61 kg); 58% male; HLA matches (intermediate-resolution HLA-A and HLA-B and high-resolution HLA-DRB1) of the units used in these patients six of six in 26, five of six in 48, four of six in 47, and three of six or two of six in 6; median prefreeze total nucleated cell dose, 10.5×10(7)/kg; median prefreeze CD34+ dose, 3.7×10(5)/kg; and nonmyeloablative regimen in 24%. The median times to myeloid and platelet engraftment were 21 and 49 days, respectively. The cumulative incidence of reported Grade II to IV acute graft-versus-host disease (aGVHD) was 38±5%, and 19±4% had Grade III to IV aGVHD. The Kaplan-Meier estimates of 3-year transplant-related mortality, overall survival, and disease-free survival were 20±4, 79±4, and 70±6%, respectively. CONCLUSION These data demonstrate the effectiveness of PDR CB units for HCT.
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Affiliation(s)
- Lawrence Petz
- StemCyte International Cord Blood Center, Covina, California 91722, USA
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7
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GVHD after unrelated cord blood transplant in children: characteristics, severity, risk factors and influence on outcome. Bone Marrow Transplant 2010; 46:668-75. [PMID: 20676147 DOI: 10.1038/bmt.2010.174] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We reviewed our experience in 79 children who had unrelated cord blood transplant (UCBT) between 1996 and 2007 with a major focus on GVHD, comparing both traditional and National Institute of Health (NIH) criteria. The cumulative incidence (CI) of acute GVHD (aGVHD, by day +100) was 0.42 for grade II-IV and 0.22 for grade III-IV. The CI of all aGVHD (NIH, that is, no time limit) at 1 year was 0.45 for grade II-IV and 0.32 for grade III-IV. Infused CD34 cell dose (>1 × 10(5)/kg), pretransplant bacterial infection and nonmalignant disorders were risk factors for grade II-IV aGVHD on univariate analysis. Infused CD34 cell dose remained significant on multivariate analysis. At 1 year, the CI of chronic GVHD (cGVHD) using the Seattle criteria was 0.27, whereas that for cGVHD (NIH) was 0.08. By NIH criteria, the classic form of cGVHD was uncommon (5%) after UCBT. Instead, the acute (71%) and overlap (24%) GVHD variants predominated. Grade II-IV aGVHD was a significant risk factor for cGVHD by both Seattle and NIH criteria. We conclude that GVHD after day +100 after UCBT typically carries features of aGVHD. Moreover, and in marked contrast to adult unrelated donor hematopoietic stem cell transplantation, the GVHD observed in this series did not adversely affect survival.
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8
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Kang PB, Lidov HGW, White AJ, Mitchell M, Balasubramanian A, Estrella E, Bennett RR, Darras BT, Shapiro FD, Bambach BJ, Kurtzberg J, Gussoni E, Kunkel LM. Inefficient dystrophin expression after cord blood transplantation in Duchenne muscular dystrophy. Muscle Nerve 2010; 41:746-50. [PMID: 20513101 DOI: 10.1002/mus.21702] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We report a boy who received two allogeneic stem cell transplantations from umbilical cord donors to treat chronic granulomatous disease (CGD). The CGD was cured after the second transplantation, but 2.5 years later he was diagnosed with Duchenne muscular dystrophy (DMD). Examinations of his DNA, muscle tissue, and myoblast cultures derived from muscle tissue were performed to determine whether any donor dystrophin was being expressed. The boy was found to have a large-scale deletion on the X chromosome that spanned the loci for CYBB and DMD. The absence of dystrophin led to muscle histology characteristic of DMD. Analysis of myofibers demonstrated no definite donor cell engraftment. This case suggests that umbilical cord-derived hematopoietic stem cell transplantation will not be efficacious in the therapy of DMD without additional interventions that induce engraftment of donor cells in skeletal muscle.
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Affiliation(s)
- Peter B Kang
- Program in Genomics and Division of Genetics, Children's Hospital Boston and Harvard Medical School, 300 Longwood Avenue, Boston, Massachusetts 02115, USA
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9
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Factors affecting mortality following myeloablative cord blood transplantation in adults: a pooled analysis of three international registries. Bone Marrow Transplant 2010; 46:70-6. [PMID: 20436518 DOI: 10.1038/bmt.2010.83] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A retrospective analysis was conducted to examine factors affecting early mortality after myeloablative, single-unit cord blood transplantation (CBT) for hematological malignancies in adolescents and adults. Data were collected from the three main CBT registries pooling 514 records of unrelated, single, unmanipulated, first myeloablative allogeneic CBTs conducted in North America or Europe from 1995 to 2005, with an HLA match ≥ 4/6 loci, in patients aged 12-55. Overall 100-day, 180-day and 1-year survival (Kaplan-Meier method) were 56, 46 and 37%, respectively, with no significant heterogeneity across registries. Multivariate analysis showed cell dose < 2.5 × 10⁷/kg (odds ratio (OR) 2.76, P < 0.0001), older age (P = 0.002), advanced disease (P = 0.02), positive CMV sero-status (OR 1.37 P = 0.11), female gender (OR 1.43, P = 0.07) and limited CBT center experience (< 10 records contributed, OR 2.08, P = 0.0003) to be associated with higher 100-day mortality. A multivariate model predictive of 1-year mortality included similar prognostic factors except female gender. Transplant year did not appear as a significant independent predictor. This is the first analysis to pool records from three major CBT registries in the United States and Europe. In spite of some differences in practice patterns, survival was remarkably homogeneous. The resulting model may contribute to better understanding factors affecting CBT outcomes.
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10
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Abstract
Spinal cord injury (SCI) results in loss of nervous tissue and consequently loss of motor and sensory function. There is no treatment available that restores the injury-induced loss of function to a degree that an independent life can be guaranteed. Transplantation of stem cells or progenitors may support spinal cord repair. Stem cells are characterized by self-renewal and their ability to become any cell in an organism. Promising results have been obtained in experimental models of SCI. Stem cells can be directed to differentiate into neurons or glia in vitro, which can be used for replacement of neural cells lost after SCI. Neuroprotective and axon regeneration-promoting effects have also been credited to transplanted stem cells. There are still issues related to stem cell transplantation that need to be resolved, including ethical concerns. This paper reviews the current status of stem cell application for spinal cord repair.
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11
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Tewarie RSN, Hurtado A, Bartels RH, Grotenhuis A, Oudega M. Stem cell-based therapies for spinal cord injury. J Spinal Cord Med 2009; 32:105-14. [PMID: 19569457 PMCID: PMC2678281 DOI: 10.1080/10790268.2009.11760761] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Spinal cord injury (SCI) results in loss of nervous tissue and consequently loss of motor and sensory function. There is no treatment available that restores the injury-induced loss of function to a degree that an independent life can be guaranteed. Transplantation of stem cells or progenitors may support spinal cord repair. Stem cells are characterized by self-renewal and their ability to become any cell in an organism. Promising results have been obtained in experimental models of SCI. Stem cells can be directed to differentiate into neurons or glia in vitro, which can be used for replacement of neural cells lost after SCI. Neuroprotective and axon regeneration-promoting effects have also been credited to transplanted stem cells. There are still issues related to stem cell transplantation that need to be resolved, including ethical concerns. This paper reviews the current status of stem cell application for spinal cord repair.
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Affiliation(s)
- Rishi S. Nandoe Tewarie
- 1Radboud University Medical Center, Nijmegen, Department of Neurosurgery, The Netherlands; 2International Center for Spinal Cord Injury, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland; 3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Andres Hurtado
- 1Radboud University Medical Center, Nijmegen, Department of Neurosurgery, The Netherlands; 2International Center for Spinal Cord Injury, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland; 3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ronald H Bartels
- 1Radboud University Medical Center, Nijmegen, Department of Neurosurgery, The Netherlands; 2International Center for Spinal Cord Injury, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland; 3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Andre Grotenhuis
- 1Radboud University Medical Center, Nijmegen, Department of Neurosurgery, The Netherlands; 2International Center for Spinal Cord Injury, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland; 3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Martin Oudega
- 1Radboud University Medical Center, Nijmegen, Department of Neurosurgery, The Netherlands; 2International Center for Spinal Cord Injury, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland; 3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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12
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Beziat V, Nguyen S, Lapusan S, Hervier B, Dhedin N, Bories D, Uzunov M, Boudifa A, Trebeden-Negre H, Norol F, Marjanovic Z, Marie JP, Vernant JP, Debre P, Rio B, Vieillard V. Fully functional NK cells after unrelated cord blood transplantation. Leukemia 2009; 23:721-8. [PMID: 19151772 DOI: 10.1038/leu.2008.343] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Promising results of umbilical cord blood transplantation (UCBT) from unrelated donors have been reported in patients with hematologic disorders. These transplants, having potential to trigger beneficial donor-versus-recipient natural killer (NK) cell-mediated alloreaction, we have conducted the first extensive analysis of the phenotypic and functional properties of NK cells after UCBT. NK cells from 25 patients with high-risk hematologic malignancies were compared with cells derived from both healthy adult and CB cells. We found that following UCBT, NK cells display not only some phenotypic features associated with maturity but also unique characteristics that make them fully functional against leukemic blasts. We propose that this full functionality of alloreactive donor-derived NK may drive graft-versus-leukemia reactions after UCBT.
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Affiliation(s)
- V Beziat
- INSERM U543, Hôpital Pitié-Salpêtrière, Paris, France
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13
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Lim CK, Sun L, Feng Q, Law P, Chua WT, Lim SN, Hwang WYK. Effect of anti-CD52 antibody alemtuzumab on ex-vivo culture of umbilical cord blood stem cells. J Hematol Oncol 2008; 1:19. [PMID: 18947412 PMCID: PMC2582233 DOI: 10.1186/1756-8722-1-19] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2008] [Accepted: 10/23/2008] [Indexed: 11/24/2022] Open
Abstract
Background Excessive maturation of hematopoietic cells leads to a reduction of long-term proliferative capability during cord blood (CB) expansion. In this study, we report the effects of anit-CD52 (Alemtuzumab, Campath) on both short- and long-term ex vivo expansion of CB hematopoietic stem cells (HSC) by evaluating the potential role of Alemtuzumab in preserving the repopulating capability in CB HSC and nonlymphoid progenitors. Methods Ex vivo expansion experiments were carried out using freshly purified CB CD34+ cells in StemSpan™ SFEM medium in the presence of stem cell factor, Flt3-Ligand and thrombopoietin at 50 ng/ml. Alemtuzumab (10 μg/ml) was used to deplete CD52+ cells during the cultures. Flow cytometry was used to monitor CB HSC and their differentiation. Colony forming unit (CFU) assays and long term culture-initiating cell (LTC-IC) assays were performed on cells obtained from day 0 (before culture) and day 14 after cultures. Secondary cultures was performed using CD34+ cells isolated at 35 days from primary cultures and further cultured in StemSpan™ SFEM medium for another 14 days to confirm the long term effect of alemtuzumab in liquid cultures. Results Compared to cytokines alone, addition of alemtuzumab resulted in a significant increase in total nucleated cells, absolute CD34+ cells, myeloid and megakaryocytic progenitors, multi-lineage and myeloid CFU and LTC-IC. Conclusion The results from current study suggested that the use of alemtuzumab for ex vivo expansion of CBHSC maybe advantageous. Our findings may improve current technologies for CBHSC expansion and increase the availability of CB units for transplantation. However, in vivo studies using animal models are likely needed in further studies to test the hematopoietic effects using such expanded CB products.
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Affiliation(s)
- Che K Lim
- Department of Hematology, Singapore General Hospital, Outram Road, Singapore.
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14
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van de Ven C, Collins D, Bradley MB, Morris E, Cairo MS. The potential of umbilical cord blood multipotent stem cells for nonhematopoietic tissue and cell regeneration. Exp Hematol 2007; 35:1753-65. [PMID: 17949892 DOI: 10.1016/j.exphem.2007.08.017] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2007] [Revised: 08/08/2007] [Accepted: 08/13/2007] [Indexed: 12/19/2022]
Abstract
Stem cells have been isolated from human embryos, fetal tissue, umbilical cord blood (UCB), and also from "adult" sources. Adult stem cells are found in many tissues of the body and are capable of maintaining, generating, and replacing terminally differentiated cells. A source of pluripotent stem cells has been recently identified in UCB that can also differentiate across tissue lineage boundaries into neural, cardiac, epithelial, hepatocytic, and dermal tissue. Thus, UCB may provide a future source of stem cells for tissue repair and regeneration. Its widespread availability makes UCB an attractive source for tissue regeneration. UCB-derived stem cells offer multiple advantages over adult stem cells, including their immaturity, which may play a significant role in reduced rejection after transplantation into a mismatched host and their ability to produce larger quantities of homogenous tissue or cells. While research with embryonic stem cells continues to generate considerable controversy, human umbilical stem cells provide an alternative cell source that has been more ethically acceptable and appears to have widespread public support. This review will summarize the in vitro and in vivo studies examining UCB stem cells and their potential use for therapeutic application for nonhematopoietic tissue and cell regeneration.
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Affiliation(s)
- Carmella van de Ven
- Department of Pediatrics, Columbia University and Morgan Stanley Children's Hospital New York-Presbyterian, New York, NY 10032, USA
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15
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Rodrigues EF, de Souza DC, Camargo A, Tavares RDC, Bouzas LF, Ornellas MH, Fernandez TDS. Cytogenetic biclonality in a child with hypocellular primary myelodysplastic syndrome. ACTA ACUST UNITED AC 2007; 178:70-2. [PMID: 17889712 DOI: 10.1016/j.cancergencyto.2007.05.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2007] [Revised: 05/21/2007] [Accepted: 05/31/2007] [Indexed: 11/28/2022]
Abstract
A 13-year-old boy with hypocellular primary myelodysplastic syndrome, classified as refractory cytopenia, underwent umbilical cord blood transplantation. Cytogenetic analysis revealed two rare biclonal chromosomal aberrations, del(17)(p12) and del(11)(q23). Cytogenetic analysis was a valuable tool in diagnosis, in clinical decision-making, and in treatment and follow-up. To our knowledge, this is the first reported case of cytogenetic biclonality involving chromosomes 17 and 11.
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Affiliation(s)
- Eliane Ferreira Rodrigues
- Cytogenetic Laboratory, Bone Marrow Transplant Center, National Cancer Institute (INCA), Praça Cruz Vermelha, CEP 20230-130, Rio de Janeiro, RJ, Brazil
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16
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Chow R, Nademanee A, Rosenthal J, Karanes C, Jaing TH, Graham ML, Tsukahara E, Wang B, Gjertson D, Tan P, Forman S, Petz LD. Analysis of hematopoietic cell transplants using plasma-depleted cord blood products that are not red blood cell reduced. Biol Blood Marrow Transplant 2007; 13:1346-57. [PMID: 17950921 DOI: 10.1016/j.bbmt.2007.07.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2007] [Accepted: 07/21/2007] [Indexed: 11/26/2022]
Abstract
Limited cell dose hampers wider use of cord blood transplantation (CBT). By depleting plasma but not RBC during processing, nucleated cell (NC) loss is reduced to <0.1% which increases significantly the proportion of high cell dose products-3-fold for products with NC >or=200 x 10(7). Clinical outcome for plasma depleted (PD) CBT was previously unavailable. A retrospective audited analysis was performed on 118 PD CBT, with mean and median NC doses of 7.6 x 10(7)/kg and 5.6 x 10(7)/kg, respectively, for this mostly pediatric population. The median times to engraftment and engraftment rates for ANC 500 and platelet 20K were 22 and 50 days, respectively, and 90% +/- 3% and 77% +/- 5%, respectively. The incidences of grade III-IV acute graft-versus-host disease (aGVHD) and extensive chronic GVHD (cGVHD) were 13% +/- 4% and 17% +/- 6%, respectively. Relapse rate for malignancies was 25% +/- 6% and 100-day treatment-related mortality (TRM) was 16% +/- 3%. With a median follow-up of 557 days, the 1-year overall survival and relapse-free survival are 65% +/- 5% and 51% +/- 6%, respectively. These results demonstrate that PD CBT is safe and effective, and that eliminating RBC reduction or depletion improves cell recovery during CB processing, resulting in a larger proportion of the inventory with high NC number.
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Affiliation(s)
- Robert Chow
- StemCyte International Cord Blood Center, Arcadia, California 91722, USA.
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