1
|
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.
Collapse
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
| |
Collapse
|
2
|
McBride A, Ryan PY. Proteasome inhibitors in the treatment of multiple myeloma. Expert Rev Anticancer Ther 2014; 13:339-58. [PMID: 23477520 DOI: 10.1586/era.13.9] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Proteasome inhibition has been shown to be an effective strategy for the treatment of multiple myeloma, as demonstrated by the clinical activity of the first-in-class agent bortezomib. Recently, the second-generation proteasome inhibitor carfilzomib has been approved in the USA in the relapsed and refractory setting, and several other investigational agents are in clinical development, including MLN9708, marizomib, oprozomib and delanzomib. Here, the authors provide a comprehensive review of the key role of proteasome inhibitors in the myeloma treatment pathway, and highlight the similarities and differences in pharmacology, routes of administration, and efficacy and safety profiles between bortezomib, carfilzomib and investigational agents. The authors also evaluate the potential for further improving myeloma treatment through the ongoing development of novel proteasome inhibitors.
Collapse
Affiliation(s)
- Ali McBride
- James Cancer Hospital and Solove Research Institute & The Ohio State University, Columbus, OH 43210, USA.
| | | |
Collapse
|
3
|
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.
Collapse
Affiliation(s)
- Lawrence Petz
- StemCyte International Cord Blood Center, Covina, California 91722, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Chow R, Lin A, Tonai R, Bolanos R, Connor C, Mendoza A, Heminger R, Chow M, Ho E, Kang J, Gindy L, Fu C, Rao A, Gau JF, Wang BC, Klich I, Ratajczak J, Ratajczak M, Petz LD. Cell recovery comparison between plasma depletion/reduction- and red cell reduction-processing of umbilical cord blood. Cytotherapy 2011; 13:1105-19. [PMID: 21867465 DOI: 10.3109/14653249.2011.592524] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND AIMS Limited cell dose has hampered the use of cord blood transplantation (CBT) in adults. One method of minimizing nucleated cell loss in cord blood (CB) processing is to deplete or reduce plasma but not red blood cells - plasma depletion/reduction (PDR). METHODS The nucleated cell loss of PDR was studied, and determined to be less than 0.1% in the discarded supernatant plasma fraction in validation experiments. After testing and archival sampling, the median nucleated cell recovery for PDR processing was 90%, and median CD34(+) cell recovery 88%. In a CB bank inventory of 12 339 products with both pre- and post-processing total nucleated cells (TNC), PDR processing resulted in median post-processing TNC recoveries of 90.0% after testing and archival samples removal. Using the same 10 CB units divided into two halves, we compared directly the recovery of PDR against hydroxyethyl starch red cell reduction (RCR) for TNC, CD34(+) cells and colony-forming units (CFU-GM, CFU-E, CFU-GEMM and total CFU) after parallel processing. We also compared the loss of very small embryonic-like stem cells (VSEL). RESULTS We demonstrated significantly higher recoveries using PDR for TNC (124%), CD34(+) cells (121%), CFU-GM (225%), CFU-GEMM (201%), total CFU (186%) and VSEL (187%). The proportion of high TNC products was compared between 10 912 PDR and 38 819 RCR CB products and found to be 200% higher for products that had TNC ≥150 × 10(7) (P = 0.0001) for the PDR inventory. CONCLUSIONS Our data indicate that PDR processing of CB provides a significantly more efficient usage of this valuable and scarce resource.
Collapse
Affiliation(s)
- Robert Chow
- StemCyte International Cord Blood Center, Covina, California 91722, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|