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Transplantation of 2 partially HLA-matched umbilical cord blood units to enhance engraftment in adults with hematologic malignancy
Open accessAbstract
Limited umbilical cord blood (UCB) cell dose compromises the outcome of adult UCB transplantation. Therefore, to augment graft cell dose, we evaluated the safety of the combined transplantation of 2 partially human leukocyte antigen (HLA)–matched UCB units. Twenty-three patients with high-risk hematologic malignancy (median age, 24 years; range, 13-53 years) received 2 UCB units (median infused dose, 3.5 × 107 nucleated cell [NC]/kg; range, 1.1-6.3 × 107 NC/kg) after myeloablative conditioning. All evaluable patients (n = 21) engrafted at a median of 23 days (range, 15-41 days). At day 21, engraftment was derived from both donors in 24% of patients and a single donor in 76% of patients, with 1 unit predominating in all patients by day 100. Although neither nucleated or CD34+ cell doses nor HLA-match predicted which unit would predominate, the predominating unit had a significantly higher CD3+ dose (P < .01). Incidences of grades II-IV and III-IV acute GVHD were 65% (95% confidence interval [CI], 42%-88%) and 13% (95% CI, 0%-26%), respectively. Disease-free survival was 57% (95% CI, 35%-79%) at 1 year, with 72% (95% CI, 49%-95%) of patients alive if they received transplants while in remission. Therefore, transplantation of 2 partially HLA-matched UCB units is safe, and may overcome the cell-dose barrier that limits the use of UCB in many adults and adolescents.
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Nonparametric Estimation from Incomplete Observations
Kaplan, E. L., & Meier, P. (1958) · Journal of the American Statistical Association · doi:10.1080/01621459.1958.10501452 · Cited by 39,158
Cited by
Hematopoietic Stem-Cell Transplantation
Copelan, E. A. (2006) · New England Journal of Medicine · doi:10.1056/nejmra052638 · Cited by 2,522
Brunstein, C. G., Miller, J. S., Cao, Q., McKenna, D. H., Hippen, K. L., Curtsinger, J., DeFor, T., Levine, B. L., June, C. H., Rubinstein, P., et al. (2011) · Blood · doi:10.1182/blood-2010-07-293795 · Cited by 1,045
Self-citationDelaney, C., Heimfeld, S., Brashem-Stein, C., Voorhies, H., Manger, R. L., & Bernstein, I. D. (2010) · Nature Medicine · doi:10.1038/nm.2080 · Cited by 771
Ruggeri, L., Mancusi, A., Capanni, M., Urbani, E., Carotti, A., Aloisi, T., Stern, M., Pende, D., Perruccio, K., Burchielli, E., et al. (2007) · Blood · doi:10.1182/blood-2006-07-038687 · Cited by 616
Hematopoietic stem cell transplantation for patients with AML in first complete remission
Cornelissen, J. J., & Blaise, D. (2016) · Blood · doi:10.1182/blood-2015-07-604546 · Cited by 346
Metadata
- Authors
- Barker, J. N., Weisdorf, D. J., DeFor, T. E., Blazar, B. R., McGlave, P. B., Miller, J. S., Verfaillie, C. M., & Wagner, J. E.
- Venue
- Blood
- Publisher
- American Society of Hematology
- Published
- 2005-02-01
- Volume
- 105
- Issue
- 3
- Pages
- 1343-1347
- ISSN
- 0006-4971 (ISSN-L)
- 1528-0020
- OpenAlex
- W2136590050
- Cited by
- 865
- References
- 1
- FWCI
- 25.10
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Barker, J. N., Weisdorf, D. J., DeFor, T. E., Blazar, B. R., McGlave, P. B., Miller, J. S., Verfaillie, C. M., & Wagner, J. E. (2005). Transplantation of 2 partially HLA-matched umbilical cord blood units to enhance engraftment in adults with hematologic malignancy. Blood. https://doi.org/10.1182/blood-2004-07-2717
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