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Devi S, Bongale AM, Tefera MA, Dixit P, Bhanap P. Fresh Umbilical Cord Blood-A Source of Multipotent Stem Cells, Collection, Banking, Cryopreservation, and Ethical Concerns. Life (Basel) 2023; 13:1794. [PMID: 37763198 PMCID: PMC10533013 DOI: 10.3390/life13091794] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/02/2023] [Accepted: 05/25/2023] [Indexed: 09/29/2023] Open
Abstract
Umbilical cord blood (UCB) is a rich source of hematopoietic cells that can be used to replace bone marrow components. Many blood disorders and systemic illnesses are increasingly being treated with stem cells as regenerative medical therapy. Presently, collected blood has been stored in either public or private banks for allogenic or autologous transplantation. Using a specific keyword, we used the English language to search for relevant articles in SCOPUS and PubMed databases over time frame. According to our review, Asian countries are increasingly using UCB preservation for future use as regenerative medicine, and existing studies indicate that this trend will continue. This recent literature review explains the methodology of UCB collection, banking, and cryopreservation for future clinical use. Between 2010 and 2022, 10,054 UCB stem cell samples were effectively cryopreserved. Furthermore, we have discussed using Mesenchymal Stem Cells (MSCs) as transplant medicine, and its clinical applications. It is essential for healthcare personnel, particularly those working in labor rooms, to comprehend the protocols for collecting, transporting, and storing UCB. This review aims to provide a glimpse of the details about the UCB collection and banking processes, its benefits, and the use of UCB-derived stem cells in clinical practice, as well as the ethical concerns associated with UCB, all of which are important for healthcare professionals, particularly those working in maternity wards; namely, the obstetrician, neonatologist, and anyone involved in perinatal care. This article also highlights the practical and ethical concerns associated with private UCB banks, and the existence of public banks. UCB may continue to grow to assist healthcare teams worldwide in treating various metabolic, hematological, and immunodeficiency disorders.
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Affiliation(s)
- Seeta Devi
- Department of Obstetrics and Gynecological Nursing, Symbiosis College of Nursing, Symbiosis International (Deemed University), Lavale, Pune 412 115, Maharashtra, India;
| | - Anupkumar M. Bongale
- Department of Artificial Intelligence and Machine Learning, Symbiosis Institute of Technology, Symbiosis International (Deemed University), Lavale, Pune 412 115, Maharashtra, India
| | | | | | - Prasad Bhanap
- HoD OBG Department, Symbiosis Medical College for Women (SMCW), Symbiosis International (Deemed University), Lavale, Pune 412 115, Maharashtra, India
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Huang Z, Liu W, Ma T, Zhao H, He X, Liu B. Slow Cooling and Controlled Ice Nucleation Enabling the Cryopreservation of Human T Lymphocytes with Low-Concentration Extracellular Trehalose. Biopreserv Biobank 2023; 21:417-426. [PMID: 36001824 DOI: 10.1089/bio.2022.0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Cryopreservation of human T lymphocytes has become a key strategy for supporting cell-based immunotherapy. However, the effects of ice seeding on the cryopreservation of cells under relatively slow cooling have not been well researched. The cryopreservation strategy with a nontoxic, single-ingredient, and injectable cryoprotective solution remains to be developed. We conducted ice seeding for the cells in a solution of normal saline with 1% (v/v) dimethyl sulfoxide (Me2SO), 0.1 M trehalose, and 4% (w/v) human serum albumin (HSA) under different slow cooling rates. With the positive results, we further applied seeding in the solution of 0.2 M trehalose and 4% (w/v) HSA under the same cooling rates. The optimal concentration of trehalose in the Me2SO-free solutions was then investigated under the optimized cooling rate with seeding, with control groups without seeding, and in a freezing container. In vitro toxicity of the cryoprotective solutions to the cells was also tested. We found that the relative viability of cells (1% [v/v] Me2SO, 0.1 M trehalose and 4% [w/v] HSA) was improved significantly from 88.6% to 94.1% with ice seeding, compared with that without seeding (p < 0.05). The relative viability of cells (0.2 M trehalose and 4% [w/v] HSA) with seeding was significantly higher than that without seeding, 96.3% and 92.0%, respectively (p < 0.05). With no significant difference in relative viability between the solutions of 0.2 M trehalose or 0.3 M trehalose with 4% (w/v) HSA (92.4% and 94.6%, respectively, p > 0.05), the solution of 0.2 M trehalose and 4% (w/v) HSA was selected as the optimized Me2SO-free solution. This strategy could cryopreserve human T lymphocytes without any toxic cryoprotectant and boost the application of cell products in humans by intravenous injection, with the osmolality of the low-concentration cryoprotective solution close to that of human plasma.
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Affiliation(s)
- Zhiyong Huang
- Institute of Bio-Thermal Science and Technology, University of Shanghai for Science and Technology, Shanghai, China
| | - Wei Liu
- Institute of Bio-Thermal Science and Technology, University of Shanghai for Science and Technology, Shanghai, China
| | | | | | - Xiaowen He
- Origincell Technology Group Co., Shanghai, China
| | - Baolin Liu
- Institute of Bio-Thermal Science and Technology, University of Shanghai for Science and Technology, Shanghai, China
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Babic A, Buchanan P, Gill A, Bloomquist J, Regan D, Bhatla D, Ferguson W. Analysis of outcomes of single-unit cord blood transplantation with umbilical cord blood units processed with two different red blood cell sedimentation reagents. Transfusion 2021; 61:1856-1866. [PMID: 34018206 DOI: 10.1111/trf.16428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 03/12/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Various processing methodologies are routinely used to reduce volume and red blood cell content of umbilical cord blood (UCB) units collected for hematopoietic stem cell transplantation. There is limited information regarding effects of UCB processing techniques on clinical outcomes. STUDY DESIGN AND METHODS Retrospective data analysis compared laboratory and clinical outcomes following single-unit UCB transplantation performed between 1999 and 2015. All UCB units were from St. Louis Cord Blood Bank and all were manually processed with either Hetastarch processed cord blood units (HCB) (n = 661) or PrepaCyte processed cord blood units (PCB) (n = 84). Additional sensitivity analysis focused on units transplanted from 2010 to 2015 and included 105 HCB and 84 PCB. RESULTS There were no significant differences in patient characteristics between the two groups. Pre-freeze total nucleated and CD34+ cell counts, cell doses/kg of recipient weight, and total colony-forming units (CFUs) were higher in PCB compared with HCB. Post-thaw, the PCB group had a significantly better total nucleated cell recovery, while there were no significant differences in cell viability, CFU recovery, or CD34+ cell recovery. Primary analysis demonstrated faster neutrophil and platelet engraftment for PCB but no differences in overall survival (OS), whereas sensitivity analysis found no effect of processing method on engraftment, but better OS in the HCB group compared with PCB group. CONCLUSION The UCB processing method had no significant impact on engraftment. However, we cannot completely exclude the effect of processing method on OS. Additional studies may be warranted to investigate the potential impact of the PCB processing method on clinical outcomes.
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Affiliation(s)
- Aleksandar Babic
- St. Louis Cord Blood Bank, SSM Health Cardinal Glennon Children's Hospital, St Louis, Missouri, USA.,Department of Pediatrics, St. Louis University School of Medicine, St Louis, Missouri, USA
| | - Paula Buchanan
- Center for Health Outcomes Research, St Louis University, St. Louis, Missouri, USA
| | - Ammara Gill
- Division of Hematology and Oncology, Adventist Health Rideout Cancer Center, Marysville, California, USA
| | - Jenni Bloomquist
- Clinical Data Quality, Center for International Blood and Marrow Transplant Research, Milwaukee, Wisconsin, USA.,Customer Ready Products, National Marrow Donor Program, Minneapolis, Minnesota, USA
| | - Donna Regan
- Customer Ready Products, National Marrow Donor Program, Minneapolis, Minnesota, USA
| | - Deepika Bhatla
- Department of Pediatrics, St. Louis University School of Medicine, St Louis, Missouri, USA
| | - William Ferguson
- St. Louis Cord Blood Bank, SSM Health Cardinal Glennon Children's Hospital, St Louis, Missouri, USA.,Department of Pediatrics, St. Louis University School of Medicine, St Louis, Missouri, USA
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4
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McKenna DH, Stroncek DF. Cellular Engineering. Transfus Med 2021. [DOI: 10.1002/9781119599586.ch19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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5
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Little AM, Akbarzad-Yousefi A, Anand A, Diaz Burlinson N, Dunn PPJ, Evseeva I, Latham K, Poulton K, Railton D, Vivers S, Wright PA. BSHI guideline: HLA matching and donor selection for haematopoietic progenitor cell transplantation. Int J Immunogenet 2021; 48:75-109. [PMID: 33565720 DOI: 10.1111/iji.12527] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 01/18/2023]
Abstract
A review of the British Society for Histocompatibility and Immunogenetics (BSHI) Guideline 'HLA matching and donor selection for haematopoietic progenitor cell transplantation' published in 2016 was undertaken by a BSHI appointed writing committee. Literature searches were performed and the data extracted were presented as recommendations according to the GRADE nomenclature.
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Affiliation(s)
- Ann-Margaret Little
- Histocompatibility and Immunogenetics Laboratory, Gartnavel General Hospital, Glasgow, UK.,Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Arash Akbarzad-Yousefi
- Histocompatibility and Immunogenetics Laboratory, NHS Blood and Transplant, Newcastle-Upon-Tyne, UK
| | - Arthi Anand
- Histocompatibility and Immunogenetics Laboratory, North West London Pathology, Hammersmith Hospital, London, UK
| | | | - Paul P J Dunn
- Transplant Laboratory University Hospitals of Leicester, Leicester General Hospital, Leicester, UK.,Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | | | - Katy Latham
- Cellular and Molecular Therapies, NHS Blood and Transplant, Bristol, UK
| | - Kay Poulton
- Transplantation Laboratory, Manchester Royal Infirmary, Manchester, UK
| | - Dawn Railton
- Tissue Typing Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | | | - Paul A Wright
- Transplantation Laboratory, Manchester Royal Infirmary, Manchester, UK
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Marinelli Busilacchi E, Costantini A, Mancini G, Bencivenga R, Olivieri J, Battaglini G, Velletri L, Viola N, Butini L, Capelli D, Poloni A, Olivieri A. A novel method to evaluate prethawing viability of cryopreserved CD34+ hematopoietic stem cells for autologous transplantation. Transfusion 2020; 60:1529-1535. [PMID: 32488938 DOI: 10.1111/trf.15825] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cryopreservation of CD34+ hematopoietic stem cells (HSCs) is associated with variable loss of viability. Although postfreezing CD34+ cell viability can be assessed on the sampling tube (bag tail) directly connected to the main bag (mother bag), results often underestimate the actual viability observed when the mother bag is thawed and reinfused. We assessed a novel method to measure postfreezing CD34+ cell viability, based on small bag (minibag) samples; results were compared with those obtained on the corresponding mother bags and bag tails. STUDY DESIGN AND METHODS Sixty-one apheresis procedures of 42 patients undergoing autologous HSC transplant were analyzed. Viable CD34+ cells were quantified with flow cytometry before controlled rate freezing (ICE-CUBE14M system, SY-LAB- IceCube, SIAD), after 10 days of storage (mini-bag and bag tail), and before reinfusion (aliquot from a thawed mother bag). Results were compared using Student's t test and Spearman's rho correlation test. RESULTS The mean CD34+ cell viability before cryopreservation was 99.3% (confidence interval [CI], 98.94-99.65%); the mean amount of CD34+ cells, white blood cells and neutrophils in the mother bag was 0.8 ± 1.1 × 109 /L, 63.4 ± 23.5 × 109 /L, and 25.7 ± 15.5 × 109 /L, respectively. Mother bags postthawing CD34+ cell viability was 72.3% (CI, 67.74-76.85%; p < 0.01 compared to prefreezing); no difference was observed with respect to minibags (73.7%; CI, 69.80-77.59%; p = NS), whereas significantly lower values were found for bag tails (58.6%; CI, 54.19-63.00%; p < 0.01 vs. both mini- and mother bags). CONCLUSION Compared to bag tails, minibags represent a more accurate tool to measure the CD34+ cell viability of the apheresis mother bag prior to reinfusion; in addition, minibags may could be of help for case-by-case calculation of the amount of apheresis to be infused to patients undergoing autologous HSC transplant.
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Affiliation(s)
- Elena Marinelli Busilacchi
- Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy.,Clinica di Ematologia, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | - Andrea Costantini
- Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy.,Servizio di Immunologia Clinica, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | - Giorgia Mancini
- Clinica di Ematologia, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | - Rossella Bencivenga
- Servizio di Medicina Trasfusionale, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | - Jacopo Olivieri
- Clinica Ematologica, Centro Trapianti e Terapie Cellulari "Carlo Melzi", Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Giovanna Battaglini
- Clinica di Ematologia, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | - Laura Velletri
- Clinica di Ematologia, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | - Nadia Viola
- Servizio di Immunologia Clinica, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | - Luca Butini
- Servizio di Immunologia Clinica, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | - Debora Capelli
- Clinica di Ematologia, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | - Antonella Poloni
- Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy.,Clinica di Ematologia, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | - Attilio Olivieri
- Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy.,Clinica di Ematologia, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
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7
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Vanegas D, Galindo CC, Páez-Gutiérrez IA, González-Acero LX, Medina-Valderrama PT, Lozano JC, Camacho-Rodríguez B, Perdomo-Arciniegas AM. Human Leukocyte Antigen and Red Blood Cells Impact Umbilical Cord Blood CD34 + Cell Viability after Thawing. Int J Mol Sci 2019; 20:E4875. [PMID: 31575081 PMCID: PMC6801469 DOI: 10.3390/ijms20194875] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 09/21/2019] [Accepted: 09/25/2019] [Indexed: 11/17/2022] Open
Abstract
Hematopoietic progenitor cell (HPC) transplantation is a treatment option for malignant and nonmalignant diseases. Umbilical cord blood (UCB) is an important HPC source, mainly for pediatric patients. It has been demonstrated that human leukocyte antigen (HLA) matching and cell dose are the most important features impacting clinical outcomes. However, UCB matching is performed using low resolution HLA typing and it has been demonstrated that the unnoticed mismatches negatively impact the transplant. Since we found differences in CD34+ viability after thawing of UCB units matched for two different patients (p = 0.05), we presumed a possible association between CD34+ cell viability and HLA. We performed a multivariate linear model (n = 67), comprising pre-cryopreservation variables and high resolution HLA genotypes separately. We found that pre-cryopreservation red blood cells (RBC), granulocytes, and viable CD34+ cell count significantly impacted CD34+ viability after thawing, along with HLA-B or -C (R2 = 0.95, p = 0.01; R2 = 0.56, p = 0.007, respectively). Although HLA-B*40:02 may have a negative impact on CD34+ cell viability, RBC depletion significantly improves it.
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Affiliation(s)
- Diana Vanegas
- Specialized researcher, Cord Blood Bank, Instituto Distrital de Ciencia, Biotecnología e Innovación en Salud. Cra. 32 # 12-81, 111611 Bogotá, Colombia.
| | - Cristian-Camilo Galindo
- Specialized researcher, Cord Blood Bank, Instituto Distrital de Ciencia, Biotecnología e Innovación en Salud. Cra. 32 # 12-81, 111611 Bogotá, Colombia.
| | - Iván-Aurelio Páez-Gutiérrez
- Specialized researcher, Cord Blood Bank, Instituto Distrital de Ciencia, Biotecnología e Innovación en Salud. Cra. 32 # 12-81, 111611 Bogotá, Colombia.
| | - Lorena-Xiomara González-Acero
- Specialized researcher, Cord Blood Bank, Instituto Distrital de Ciencia, Biotecnología e Innovación en Salud. Cra. 32 # 12-81, 111611 Bogotá, Colombia.
| | - Pavel-Tiberio Medina-Valderrama
- Specialized researcher, Cord Blood Bank, Instituto Distrital de Ciencia, Biotecnología e Innovación en Salud. Cra. 32 # 12-81, 111611 Bogotá, Colombia.
| | - Juan-Camilo Lozano
- Specialized researcher, Cord Blood Bank, Instituto Distrital de Ciencia, Biotecnología e Innovación en Salud. Cra. 32 # 12-81, 111611 Bogotá, Colombia.
| | - Bernardo Camacho-Rodríguez
- Director, Instituto Distrital de Ciencia, Biotecnología e Innovación en Salud. Cra. 32 # 12-81, 111611 Bogotá, Colombia.
| | - Ana-María Perdomo-Arciniegas
- Scientific leader, Cord Blood Bank, Instituto Distrital de Ciencia, Biotecnología e Innovación en Salud. Cra. 32 # 12-81, 111611 Bogotá, Colombia.
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Akel S, Murray C, Ferguson W, Babic A. Outcomes of processing of bone marrow harvests for hematopoietic stem cell transplantation in pediatric patients utilizing a novel red blood cell sedimentation kit. Transfusion 2019; 59:2375-2381. [DOI: 10.1111/trf.15337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/09/2019] [Accepted: 04/10/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Salem Akel
- St. Louis Cord Blood Bank and Cellular Therapy LaboratorySSM Health Cardinal Glennon Children's Hospital St. Louis Missouri
- Department of PediatricsSt Louis University School of Medicine St Louis Missouri
- Department of Bone Marrow Transplantation & Cellular TherapySt Jude Children's Research Hospital Memphis Tennessee
| | - Christianna Murray
- St. Louis Cord Blood Bank and Cellular Therapy LaboratorySSM Health Cardinal Glennon Children's Hospital St. Louis Missouri
| | - William Ferguson
- St. Louis Cord Blood Bank and Cellular Therapy LaboratorySSM Health Cardinal Glennon Children's Hospital St. Louis Missouri
- Department of PediatricsSt Louis University School of Medicine St Louis Missouri
| | - Aleksandar Babic
- St. Louis Cord Blood Bank and Cellular Therapy LaboratorySSM Health Cardinal Glennon Children's Hospital St. Louis Missouri
- Department of PediatricsSt Louis University School of Medicine St Louis Missouri
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9
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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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10
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Halldorsdottir AM, Atladottir S, Thorsteinsdottir MA, Arnason NA, Runarsson G, Jonsson T, Sigurjonsson OE, Reykdal S. To Wash or Not to Wash? Comparison of Patient Outcome after Infusion of Cryopreserved Autologous Hematopoietic Stem Cells before and after the Replacement of Manual Washing by Bedside Thawing. Acta Haematol 2018; 140:169-175. [PMID: 30300877 DOI: 10.1159/000492741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 08/04/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Prior to infusion, cryopreserved autologous peripheral blood stem cell (auto-PBSC) grafts can either be thawed at the bedside or thawed and washed at the laboratory. At our center, manual washing of grafts prior to infusion was discontinued in April 2012 and bedside thawing was implemented. METHODS This study compares the outcomes of two patient groups who received auto-PBSC either after post-thaw washing (n = 84) or bedside thawing (n = 83). RESULTS No life-threatening infusion-related side effects were reported in either group. There was no significant difference in the mean CD34+ cells/kg dose of infused auto-PBSC in the two groups (p = 0.41), nor in the number of days to neutrophils > 0.5 × 10(9)/L (p = 0.14), days to platelets > 20 × 10(9)/L (p = 0.64), or days to platelets > 50 × 10(9)/L (p = 0.62) after transplant. There was also no difference in the number of days on total parenteral nutrition (p = 0.69), days on G-CSF therapy (p = 0.48), or days with fever (p = 0.73). Finally, there was no significant difference in the number of red cell units transfused (p = 0.32), or platelet units transfused (p = 0.94) after the transplant. One-hundred-day mortality was identical in the two groups (2.4%). CONCLUSION Both thawing procedures are safe and result in acceptable engraftment and patient outcomes.
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Affiliation(s)
- Anna Margret Halldorsdottir
- The Blood Bank, Landspítali, The National University Hospital of Iceland, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Sveinlaug Atladottir
- Department of Hematology, Landspítali, The National University Hospital of Iceland, Reykjavik, Iceland
| | | | - Niels A Arnason
- The Blood Bank, Landspítali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Gudmundur Runarsson
- Department of Hematology, Landspítali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Torbjorn Jonsson
- The Blood Bank, Landspítali, The National University Hospital of Iceland, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Olafur E Sigurjonsson
- The Blood Bank, Landspítali, The National University Hospital of Iceland, Reykjavik, Iceland
- School of Science and Engineering, Reykjavik University, Reykjavik, Iceland
| | - Sigrun Reykdal
- Department of Hematology, Landspítali, The National University Hospital of Iceland, Reykjavik, Iceland
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11
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Mfarrej B, Bouchet G, Couquiaud J, Regimbaud L, Binninger S, Mercier M, Lemarié C, Houzé P, Chabannon C, Calmels B. Pre-clinical assessment of the Lovo device for dimethyl sulfoxide removal and cell concentration in thawed hematopoietic progenitor cell grafts. Cytotherapy 2017; 19:1501-1508. [DOI: 10.1016/j.jcyt.2017.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/08/2017] [Accepted: 09/07/2017] [Indexed: 12/26/2022]
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12
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Heneghan C, Smilow E, Tanhehco Y, Jin Z, Cofnas P, Schwartz S, Patel N, Carberry D, Silverman J, Huynh P, Hagan B, Tobin K, Bhatia M, George D, Garvin J, Satwani P. Safety of hematopoietic cell infusion in children with malignant and non-malignant diseases. Pediatr Transplant 2017; 21. [PMID: 28845921 DOI: 10.1111/petr.13038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2017] [Indexed: 12/25/2022]
Abstract
HPC infusions have been associated with a variety of adverse events related to either patient or HPC product-related factors. Studies documenting infusion-related AEs in children are limited. We reviewed HPC infusion records in 354 children. Infusion-related adverse events were classified as follows: grade 0-absent, grade I-mild, grade II-moderate, grade III-severe, grade IV-life-threatening, and grade V-death. The percentage of patients with grade 0, I, and II-IV AEs was as follows: 0 = 67%, I = 23.4%, and II-V = 9.6% (one patient had fatal anaphylactic reaction to dimethyl sulfoxide). The incidence of grade II-IV hypertension was 7.1%. There was a higher incidence of AEs with infusion of allogeneic bone marrow versus allogeneic PBSCs (47.4% vs 25.3%, P = .001). Cryopreserved products had a lower incidence of infusion-associated AEs compared with fresh HPC products (24% vs 39.4%, P = .003). Allogeneic HPC infusion volume (>100 mL) was a significant risk factor for infusion-associated AEs (P < .001). Patients >10 years who received autologous HPC infusions had higher risk of AEs when compared to patients <10 years (P = .01). Our study demonstrated that despite a high incidence of infusion-associated hypertension, HPC infusion is relatively safe in children. Investigating strategies to optimize management of hypertension in the setting of HPC infusion is warranted.
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Affiliation(s)
- Chelsea Heneghan
- Department of Nursing, Morgan Stanly Children's Hospital of New York Presbyterian, New York, NY, USA
| | - Elana Smilow
- Department of Nursing, Morgan Stanly Children's Hospital of New York Presbyterian, New York, NY, USA
| | - Yvette Tanhehco
- Department of Pathology, Columbia University, New York, NY, USA
| | - Zhezhen Jin
- Department of Biostatistics, Columbia University, New York, NY, USA
| | - Paige Cofnas
- Department of Nursing, Morgan Stanly Children's Hospital of New York Presbyterian, New York, NY, USA
| | - Sharon Schwartz
- Department of Nursing, Morgan Stanly Children's Hospital of New York Presbyterian, New York, NY, USA
| | - Nita Patel
- Department of Pathology, Columbia University, New York, NY, USA
| | | | - Justin Silverman
- Department of Pediatrics, Columbia University, New York, NY, USA
| | - Paul Huynh
- Department of Pediatrics, Columbia University, New York, NY, USA
| | - Brittany Hagan
- Department of Nursing, Morgan Stanly Children's Hospital of New York Presbyterian, New York, NY, USA
| | - Kim Tobin
- Department of Nursing, Morgan Stanly Children's Hospital of New York Presbyterian, New York, NY, USA
| | - Monica Bhatia
- Department of Pediatrics, Columbia University, New York, NY, USA
| | - Diane George
- Department of Pediatrics, Columbia University, New York, NY, USA
| | - James Garvin
- Department of Pediatrics, Columbia University, New York, NY, USA
| | - Prakash Satwani
- Department of Pediatrics, Columbia University, New York, NY, USA
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Pasha R, Elmoazzen H, Pineault N. Development and testing of a stepwise thaw and dilute protocol for cryopreserved umbilical cord blood units. Transfusion 2017; 57:1744-1754. [DOI: 10.1111/trf.14136] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 03/08/2017] [Accepted: 03/13/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Roya Pasha
- Canadian Blood Services, Centre for Innovation
| | - Heidi Elmoazzen
- Cord Blood Bank and Stem Cell Manufacturing; Canadian Blood Services
| | - Nicolas Pineault
- Canadian Blood Services, Centre for Innovation
- Department of Biochemistry, Microbiology and Immunology Department; University of Ottawa; Ottawa Ontario Canada
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Microfluidic Sorting of Cells by Viability Based on Differences in Cell Stiffness. Sci Rep 2017; 7:1997. [PMID: 28515450 PMCID: PMC5435733 DOI: 10.1038/s41598-017-01807-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 04/03/2017] [Indexed: 12/11/2022] Open
Abstract
The enrichment of viable cells is an essential step to obtain effective products for cell therapy. While procedures exist to characterize the viability of cells, most methods to exclude nonviable cells require the use of density gradient centrifugation or antibody-based cell sorting with molecular labels of cell viability. We report a label-free microfluidic technique to separate live and dead cells that exploits differences in cellular stiffness. The device uses a channel with repeated ridges that are diagonal with respect to the direction of cell flow. Stiff nonviable cells directed through the channel are compressed and translated orthogonally to the channel length, while soft live cells follow hydrodynamic flow. As a proof of concept, Jurkat cells are enriched to high purity of viable cells by a factor of 185-fold. Cell stiffness was validated as a sorting parameter as nonviable cells were substantially stiffer than live cells. To highlight the utility for hematopoietic stem cell transplantation, frozen samples of cord blood were thawed and the purity of viable nucleated cells was increased from 65% to over 94% with a recovery of 73% of the viable cells. Thus, the microfluidic stiffness sorting can simply and efficiently obtain highly pure populations of viable cells.
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Ballen K. Umbilical Cord Blood Transplantation: Challenges and Future Directions. Stem Cells Transl Med 2017; 6:1312-1315. [PMID: 28456009 PMCID: PMC5442719 DOI: 10.1002/sctm.17-0069] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 03/30/2017] [Indexed: 01/05/2023] Open
Abstract
Since the first successful allogeneic transplants performed in Seattle 50 years ago, the field of transplantation has evolved considerably, with improvements in human leukocyte antigen typing, patient selection, reduced intensity regimens, and graft-versus-host disease prophylaxis. A major breakthrough has been the availability of more donor options, first via the National Marrow Donor Program-Be the Match [Biol Blood Marrow Transplant 2008;14:2-7]. Then, in the 1990s, unrelated umbilical cord blood transplantation became available, first for children and then for adults [New Engl J Med 1996;35:157-166]. More recently mismatched unrelated transplants and haploidentical donor options became available [Blood 2011;118:282-288]. In 2017, there is a donor for almost every patient who needs a transplant. In this review, we will discuss the state of the science (and art) of cord blood transplant, focusing on successes, challenges, and future directions. Stem Cells Translational Medicine 2017;6:1312-1315.
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Lack of impact of umbilical cord blood unit processing techniques on clinical outcomes in adult double cord blood transplant recipients. Cytotherapy 2016; 19:272-284. [PMID: 27939176 DOI: 10.1016/j.jcyt.2016.10.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 10/25/2016] [Accepted: 10/27/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND AIMS Despite widespread use of umbilical cord blood (UCB) transplantation and distinct practice preferences displayed by individual UCB banks and transplant centers, little information exists on how processing variations affect patient outcomes. METHODS We reviewed 133 adult double UCB transplants performed at a single center: 98 after reduced-intensity and 35 after myeloablative conditioning. Processing associated with contributing UCB banks and units was surveyed to identify differences in practice. We analyzed effect of selected variables on clinical outcomes of engraftment, dominance, transplant-related mortality, and survival. RESULTS Eighty-eight percent of banks queried currently practice red blood cell (RBC) depletion before cryopreservation. This reflects a shift in practice because previously 65% of banks employed RBC-replete processing methods (i.e., cryopreservation or plasma/volume reduction). Neither neutrophil nor platelet engraftment was affected by processing conditions analyzed. RBC depletion was not associated with clinical outcomes, except in 17 recipients of 2 RBC-replete units, where survival was better than that observed in 116 recipients of ≥1 RBC-depleted units (hazard ratio 3.26, P = 0.004). When analyzed by attributes of the dominant unit, RBC depletion, time in storage, bank years in existence, and inventory size did not affect clinical outcomes. Postthaw viability and CD34 dose were factors impacting engraftment. Notably, all RBC-replete units in this cohort were washed in dextran-human serum albumin before infusion. DISCUSSION These findings support continued utilization of the entire existing pool of cord blood units, despite recent trends in processing, and have important implications for banking resources and UCB selection practices.
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17
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Cellular Engineering for the Production of New Blood Components. Transfus Med 2016. [DOI: 10.1002/9781119236504.ch18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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18
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Techniques of Blood Transfusion. Transfus Med 2016. [DOI: 10.1002/9781119236504.ch13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Roura S, Pujal JM, Gálvez-Montón C, Bayes-Genis A. Quality and exploitation of umbilical cord blood for cell therapy: Are we beyond our capabilities? Dev Dyn 2016; 245:710-7. [PMID: 27043849 DOI: 10.1002/dvdy.24408] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/03/2016] [Accepted: 03/29/2016] [Indexed: 02/06/2023] Open
Abstract
There is increasing interest in identifying novel stem cell sources for application in emerging cell therapies. In this context, umbilical cord blood (UCB) shows great promise in multiple clinical settings. The number of UCB banks has therefore increased worldwide, with the objective of preserving potentially life-saving cells that are usually discarded after birth. After a rather long and costly processing procedure, the resultant UCB-derived cell products are cryopreserved until transplantation to patients. However, in many cases, only a small proportion of administered cells engraft successfully. Thus, can we do any better regarding current UCB-based therapeutic approaches? Here we discuss concerns about the use of UCB that are not critically pondered by researchers, clinicians, and banking services, including wasting samples with small volumes and the need for more reliable quality and functional controls to ensure the biological activity of stem cells and subsequent engraftment and treatment efficacy. Finally, we appeal for collaborative agreements between research institutions and UCB banks in order to redirect currently discarded small-volume UCB units for basic and clinical research purposes. Developmental Dynamics 245:710-717, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Santiago Roura
- Heart Failure and Cardiac Regeneration (ICREC) Research Program, Germans Trias i Pujol Health Science Research Institute, Can Ruti Campus, Crta.Can Ruti-Camí Escoles s/n, 08916, Badalona, Spain
- Center of Regenerative Medicine in Barcelona, c/ Dr. Aiguader 88, 08003, Barcelona, Spain
| | - Josep Maria Pujal
- Cell Processing Laboratory, Edifici Giroemprèn, Pic de Peguera 11, Parc Científic i Tecnològic Universitat de Girona, 17003, Girona, Spain
| | - Carolina Gálvez-Montón
- Heart Failure and Cardiac Regeneration (ICREC) Research Program, Germans Trias i Pujol Health Science Research Institute, Can Ruti Campus, Crta.Can Ruti-Camí Escoles s/n, 08916, Badalona, Spain
| | - Antoni Bayes-Genis
- Heart Failure and Cardiac Regeneration (ICREC) Research Program, Germans Trias i Pujol Health Science Research Institute, Can Ruti Campus, Crta.Can Ruti-Camí Escoles s/n, 08916, Badalona, Spain
- Cardiology Service, Germans Trias i Pujol University Hospital, Crta.Can Ruti-Camí Escoles s/n, 08916, Badalona, Spain
- Department of Medicine, Crta. Can Ruti-Camí Escoles s/n, Universitat Autònoma de Barcelona, 08916, Badalona, Spain
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Lecchi L, Giovanelli S, Gagliardi B, Pezzali I, Ratti I, Marconi M. An update on methods for cryopreservation and thawing of hemopoietic stem cells. Transfus Apher Sci 2016; 54:324-36. [DOI: 10.1016/j.transci.2016.05.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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21
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Saccardi R, Tucunduva L, Ruggeri A, Ionescu I, Koegler G, Querol S, Grazzini G, Lecchi L, Nanni Costa A, Navarrete C, Pouthiers F, Larghero J, Regan D, Freeman T, Bittencourt H, Kenzey C, Labopin M, Baudoux E, Rocha V, Gluckman E. Impact of cord blood banking technologies on clinical outcome: a Eurocord/Cord Blood Committee (CTIWP), European Society for Blood and Marrow Transplantation and NetCord retrospective analysis. Transfusion 2016; 56:2021-9. [PMID: 27245270 DOI: 10.1111/trf.13661] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 01/24/2016] [Accepted: 01/29/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Techniques for banking cord blood units (CBUs) as source for hematopoietic stem cell transplantation have been developed over the past 20 years, aimed to improve laboratory efficiency without altering the biologic properties of the graft. A large-scale, registry-based assessment of the impact of the banking variables on the clinical outcome is currently missing. STUDY DESIGN AND METHODS A total of 677 single cord blood transplants (CBTs) carried out for acute leukemia in complete remission in centers affiliated with the European Society for Blood and Marrow Transplantation were selected. An extensive set of data concerning CBU banking were collected and correlations with clinical outcome were assessed. Clinical endpoints were transplant-related mortality, engraftment, and graft-versus-host disease (GVHD). RESULTS The median time between collection and CBT was 4.1 years (range, 0.2-16.3 years). Volume reduction (VR) of CBUs before freezing was performed in 59.2% of available reports; in half of these the frozen volume was less than 30 mL. Cumulative incidences of neutrophil engraftment on Day 60, 100-day acute GVHD (II-IV), and 4-year chronic GVHD were 87, 29, and 21 ± 2%. The cumulative incidence of nonrelapse mortality (NRM) at 100 days and 4-year NRM were, respectively, 16 ± 2 and 30 ± 2%. Neither the variables related to banking procedures nor the interval between collection and CBT influenced the clinical outcome. CONCLUSION These findings indicate a satisfactory validation of the techniques associated with CBU VR across the banks. Cell viability assessment varied among the banks, suggesting that efforts to improve the standardization of CBU quality controls are needed.
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Affiliation(s)
- Riccardo Saccardi
- Careggi University Hospital, Firenze, Italy.,Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, Paris, France
| | - Luciana Tucunduva
- Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, Paris, France
| | - Annalisa Ruggeri
- Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, Paris, France.,Hospital Saint Antoine, Service d'Hématologie et Thérapie Cellulaire, AP-HP, UPMC Univ Paris 06, UMR-S 938, CEREST-TC EBMT, Paris, France
| | | | - Gesine Koegler
- Dusseldorf Cord Blood Bank, University of Dusseldorf, Dusseldorf, Germany
| | | | | | - Lucilla Lecchi
- Milano Cord Blood Bank, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | - Fabienne Pouthiers
- Besançon Cord Blood Bank of the Etablissement Français du Sang, Besançon, France
| | | | - Donna Regan
- St Louis Cord Blood Bank & Cellular Therapy Laboratory, St Louis, Missouri
| | | | | | - Chantal Kenzey
- Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, Paris, France
| | - Myriam Labopin
- Hospital Saint Antoine, Service d'Hématologie et Thérapie Cellulaire, AP-HP, UPMC Univ Paris 06, UMR-S 938, CEREST-TC EBMT, Paris, France
| | - Etienne Baudoux
- NetCord Foundation and Liege Cord Blood Bank, University of Liege, Liege, Belgium
| | - Vanderson Rocha
- Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, Paris, France.,Churchill Hospital, Oxford University Hospitals, Oxford, UK
| | - Eliane Gluckman
- Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, Paris, France.,Monacord, Centre Scientifique de Monaco, Monaco
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Schwandt S, Korschgen L, Peters S, Kogler G. Cord blood collection and processing with hydroxyethyl starch or non-hydroxyethyl starch. Cytotherapy 2016; 18:642-52. [PMID: 27059201 DOI: 10.1016/j.jcyt.2016.02.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 01/12/2016] [Accepted: 02/07/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Collection and processing characteristics influencing quality of cord blood (CB) units play an essential role to cord blood banks (CBBs). At many CBBs, volume reduction is performed using hydroxyethyl starch (HES) and the Sepax (Biosafe) automated cell processing system. Due to the withdrawal of HES from the European market, a validation of the nonHES protocol was performed. METHODS This partially retrospective study identified CB characteristics such as gestational age and CB volume/cell count correlated with higher quality. For the nonHES validation, CB was analyzed for total nucleated cell (TNC), mononuclear cell (MNC) recovery, hematocrit (HCT) and colony-forming units (CFUs). Viabilities of CD34(+) and CD45(+) cells were determined by 7-aminoactinomycin D (7-AAD) and AnnexinV (AnnV) staining and compared for 21 mL and 42 mL buffy coat (BC) samples applying the HES/nonHES protocol. RESULTS Factors affecting the potency of CB transplants were the gestational age and the volume reduction to a defined BC volume. High initial cell counts and CB volumes correlated negatively with post-processing TNC recovery for lower BC volumes. Post-processing HES and nonHES results were comparable, but nonHES revealed a significantly lower post-thaw recovery of viable CD34(+) cells measured by 7-AAD/AnnV (21 mL: 45.4 ± 16.4%; 42 mL: 67.3 ± 14.5%) as compared with HES (21 mL: 72.7 ± 14.4%, P = 0.0164; 42 mL: 83.4 ± 14.7%, P = 0.0203). DISCUSSION Due to the lower post-thaw CD34(+) cell viability (AnnV(-)/7-AAD(-)) for nonHES samples, the use of HES is recommended, ideally combined with a high BC volume. The post-processing HCT has no statistically significant impact on the post-thaw CD34(+) cell viability (AnnV(-)/7-AAD(-)).
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Affiliation(s)
- Svenja Schwandt
- Institute for Transplantation Diagnostics and Cell Therapeutics, Heinrich-Heine-University Medical Center, Duesseldorf, Germany
| | - Lutz Korschgen
- Institute for Transplantation Diagnostics and Cell Therapeutics, Heinrich-Heine-University Medical Center, Duesseldorf, Germany
| | - Svenja Peters
- Institute for Transplantation Diagnostics and Cell Therapeutics, Heinrich-Heine-University Medical Center, Duesseldorf, Germany
| | - Gesine Kogler
- Institute for Transplantation Diagnostics and Cell Therapeutics, Heinrich-Heine-University Medical Center, Duesseldorf, Germany.
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Adverse reactions during stem cell infusion in children treated with autologous and allogeneic stem cell transplantation. Bone Marrow Transplant 2016; 51:680-6. [PMID: 26752147 DOI: 10.1038/bmt.2015.331] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 11/19/2015] [Accepted: 11/24/2015] [Indexed: 11/08/2022]
Abstract
Adverse reactions (ARs) during the infusion of cellular therapy products (CTPs) are common in patients undergoing hematopoietic stem cell transplantation (HSCT). We retrospectively studied pediatric patients undergoing autologous and allogeneic HSCT to determine the incidence and grade of ARs during stem cell infusion and their predictors. We analyzed data from 213 patients (120 allogeneic and 93 autologous) who received at least 1 CTP, totaling 361 infusion episodes. Serious ARs, defined as grade 2 and 3, occurred in 25 and 11% of infusions, respectively. No grade 4 or 5 ARs were noted. Independent risk factors for developing a serious AR included stem cell source (PBSC vs marrow (odds ratio (OR) 1.8, 95% confidence interval (CI): 0.4-9); cord vs marrow (OR 7.3, 95% CI: 1.3-40), overall P=0.0001) but manipulated CTPs were protective (OR 0.4, 95% CI: 0.2-0.7, P=0.004). Unlike previous adult studies, WBC and granulocyte content were not found to be risk factors in this pediatric population. These data suggest that children tolerate higher WBC content during infusion of CTPs and support the use of manipulated CTP, as indicated, to reduce the risk of adverse infusion reactions.
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24
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Jawdat D. Banking of Human Umbilical Cord Blood Stem Cells and Their Clinical Applications. RECENT ADVANCES IN STEM CELLS 2016. [DOI: 10.1007/978-3-319-33270-3_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Zhu F, Heditke S, Kurtzberg J, Waters-Pick B, Hari P, Margolis DA, Keever-Taylor CA. Hydroxyethyl starch as a substitute for dextran 40 for thawing peripheral blood progenitor cell products. Cytotherapy 2015; 17:1813-9. [DOI: 10.1016/j.jcyt.2015.08.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 08/11/2015] [Accepted: 08/24/2015] [Indexed: 01/15/2023]
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Murphy A, McKenna D, McCullough J. Cord blood banking and quality issues. Transfusion 2015; 56:645-52. [PMID: 26597621 DOI: 10.1111/trf.13388] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 09/09/2015] [Accepted: 09/15/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Food and Drug Administration guidelines are designed to assure the quality and safety of the cord blood product used for transplantation. It is valuable to determine whether the actions called for in these guidelines are effective. STUDY DESIGN AND METHODS We applied our cell therapy quality system to all cord blood units shipped into our cellular therapy laboratory for transplant at the University of Minnesota between 2011 and 2013. The quality issues were categorized as likely, potentially, or unlikely to have a clinical impact. RESULTS A total of 249 units of umbilical cord blood (UCB) were received from 16 cord blood banks. A total of 159 units (64%) had a total of 245 issues. Of these, 117 (48%) pertained to medical history, 120 (49%) to quality control, and eight (3%) to labeling and documentation. Units with quality issues were no more likely to fail to engraft, and no specific kind of quality issue was associated with failure to engraft. Compared to a similar study 10 years ago, there was a decrease in the number of issues per unit. DISCUSSION The cost of collecting, testing, processing, and storing UCB is very high. However, there may be activities that do not contribute to the quality or safety of the cord blood. The guidelines could be reviewed to determine their value based on years of experience.
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Affiliation(s)
- Amanda Murphy
- Department of Pathology and Laboratory Medicine, University of Minnesota, Minneapolis, Minnesota
| | - David McKenna
- Department of Pathology and Laboratory Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Jeffrey McCullough
- Department of Pathology and Laboratory Medicine, University of Minnesota, Minneapolis, Minnesota
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Umbilical cord blood donation: public or private? Bone Marrow Transplant 2015; 50:1271-8. [PMID: 26030051 DOI: 10.1038/bmt.2015.124] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 04/15/2015] [Indexed: 02/01/2023]
Abstract
Umbilical cord blood (UCB) is a graft source for patients with malignant or genetic diseases who can be cured by allogeneic hematopoietic cell transplantation (HCT), but who do not have an appropriately HLA-matched family or volunteer unrelated adult donor. Starting in the 1990s, unrelated UCB banks were established, accepting donations from term deliveries and storing UCB units for public use. An estimated 730 000 UCB units have been donated and stored to date and ~35 000 UCB transplants have been performed worldwide. Over the past 20 years, private and family banks have grown rapidly, storing ~4 million UCB units for a particular patient or family, usually charging an up-front and yearly storage fee; therefore, these banks are able to be financially sustainable without releasing UCB units. Private banks are not obligated to fulfill the same regulatory requirements of the public banks. The public banks have released ~30 times more UCB units for therapy. Some countries have transitioned to an integrated banking model, a hybrid of public and family banking. Today, pregnant women, their families, obstetrical providers and pediatricians are faced with multiple choices about the disposition of their newborn's cord blood. In this commentary, we review the progress of UCB banking technology; we also analyze the current data on pediatric and adult unrelated UCB, including the recent expansion of interest in transplantation for hemoglobinopathies, and discuss emerging studies on the use of autologous UCB for neurologic diseases and regenerative medicine. We will review worldwide approaches to UCB banking, ethical considerations, criteria for public and family banking, integrated banking ideas and future strategies for UCB banking.
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Reich-Slotky R, Bachegowda LS, Ancharski M, Mendeleyeva L, Rubinstein P, Rennert H, Shore T, van Besien K, Cushing M. How we handled the dextran shortage: an alternative washing or dilution solution for cord blood infusions. Transfusion 2015; 55:1147-53. [DOI: 10.1111/trf.13015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 12/02/2014] [Accepted: 12/02/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Ronit Reich-Slotky
- Department of Transfusion Medicine and Cellular Therapy; New York Presbyterian Hospital/Weill Cornell Medical Center; New York New York
| | - Lohith S. Bachegowda
- Department of Transfusion Medicine and Cellular Therapy; New York Presbyterian Hospital/Weill Cornell Medical Center; New York New York
- National Cord Blood Program; New York Blood Center; New York New York
| | - Michael Ancharski
- Department of Transfusion Medicine and Cellular Therapy; New York Presbyterian Hospital/Weill Cornell Medical Center; New York New York
| | - Lyubov Mendeleyeva
- Department of Transfusion Medicine and Cellular Therapy; New York Presbyterian Hospital/Weill Cornell Medical Center; New York New York
| | - Pablo Rubinstein
- National Cord Blood Program; New York Blood Center; New York New York
| | | | - Tsiporah Shore
- Department of Medicine; Weill Cornell Medical College; New York New York
| | - Koen van Besien
- Department of Medicine; Weill Cornell Medical College; New York New York
| | - Melissa Cushing
- Department of Transfusion Medicine and Cellular Therapy; New York Presbyterian Hospital/Weill Cornell Medical Center; New York New York
- Department of Pathology and Laboratory Medicine
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Navarrete C. Cord Blood Banking. CORD BLOOD STEM CELLS AND REGENERATIVE MEDICINE 2015. [PMCID: PMC7150031 DOI: 10.1016/b978-0-12-407785-0.00015-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Castillo N, García-Cadenas I, García O, Barba P, Diaz-Heredia C, Martino R, Azqueta C, Ferrà C, Canals C, Elorza I, Olivé T, Badell I, Sierra J, Duarte R, Valcárcel D, Querol S. Few and nonsevere adverse infusion events using an automated method for diluting and washing before unrelated single cord blood transplantation. Biol Blood Marrow Transplant 2014; 21:682-7. [PMID: 25545727 DOI: 10.1016/j.bbmt.2014.12.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 12/15/2014] [Indexed: 12/30/2022]
Abstract
Graft dilution and DMSO washing before cord blood (CB) administration using an automated system may offer low incidence of adverse infusion events (AIE), ensuring reproducible cell yields. Hence, we analyzed the incidences and significance of immediate AIE, cellular yield, and engraftment after single CB infusion. One hundred and fifty-seven patients (median age, 20 years; range, 1 to 60) received a single CB unit for treatment of hematologic and nonhematologic malignancies with myeloablative conditioning after graft dilution and washing. The median total nucleated cell (TNC) doses was 3.4 × 10(7)/kg (range, 2 to 26) and the median post-thaw recovery was 84% (range, 45 to 178). The cumulative incidence of neutrophil engraftment at 50 days was 84% (95% confidence interval [CI], 83 to 93). A total of 118 immediate AIE were observed in fifty-two (33%) patients. All reported AIE were transient, graded from 1 to 2 by Common Terminology Adverse Events version 4. The most frequent toxicity was cardiovascular but without any life-threatening reaction. Infused TNC, recipient's weight, and rate of infusion per kilogram were risk factors associated with cardiovascular AIE in multivariate analysis (odds ratio [OR], 1.2 (95% CI, 1.1 to 1.4); P < .001; OR, .94 (95% CI, .9 to .97); P < .001; and OR, 1.5 (95% CI, 1.2 to 1.8); P < .001; respectively). In summary, use of an automated method for graft washing before CB administration showed low incidence of AIE without compromising cell yields and engraftment. Infused TNC dose, recipient's weight, and rate of infusion per kilogram were risk factors associated with infusion reactions.
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Affiliation(s)
- Nerea Castillo
- Adult Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
| | - Irene García-Cadenas
- Hospital Universitari de la Santa Creu i Sant Pau, IIB Sant Pau and Jose Carreras Research Institutes, Barcelona, Spain
| | - Olga García
- Adult Hematology Department, Institut Català d'Oncologia-Badalona, Barcelona, Spain
| | - Pere Barba
- Adult Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Rodrigo Martino
- Hospital Universitari de la Santa Creu i Sant Pau, IIB Sant Pau and Jose Carreras Research Institutes, Barcelona, Spain
| | - Carmen Azqueta
- Cell Therapy Laboratory, Banc de Sang i Teixits, Barcelona, Spain
| | - Christelle Ferrà
- Adult Hematology Department, Institut Català d'Oncologia-Badalona, Barcelona, Spain
| | - Carme Canals
- Cell Therapy Laboratory, Banc de Sang i Teixits, Barcelona, Spain
| | - Izaskun Elorza
- Adult Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Teresa Olivé
- Adult Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Isabel Badell
- Hospital Universitari de la Santa Creu i Sant Pau, IIB Sant Pau and Jose Carreras Research Institutes, Barcelona, Spain
| | - Jorge Sierra
- Hospital Universitari de la Santa Creu i Sant Pau, IIB Sant Pau and Jose Carreras Research Institutes, Barcelona, Spain
| | - Rafael Duarte
- Adult Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain
| | - David Valcárcel
- Adult Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Sergio Querol
- Cell Therapy Laboratory, Banc de Sang i Teixits, Barcelona, Spain
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