Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec;55(12):2298-2307.
doi: 10.1038/s41409-020-0959-5. Epub 2020 Jun 9.

Cord blood transplants supported by unrelated donor CD34+ progenitor cells

Alexandra Gomez-Arteaga  1 , Nina Orfali  1 , Danielle Guarneri  1 , Melissa M Cushing  2 , Usama Gergis  1 , Jingmei Hsu  1 , Yen-Michael S Hsu  2 , Sebastian A Mayer  1 , Adrienne A Phillips  1 , Stacy A Chase  1 , Asmaa E Mokhtar  1 , Tsiporah B Shore  1 , Koen Van Besien  3
Affiliations

Cord blood transplants supported by unrelated donor CD34+ progenitor cells

Alexandra Gomez-Arteaga et al. Bone Marrow Transplant. 2020 Dec.

Abstract

Alternative donor transplantation with the haplo-cord platform allows the use of a lower-dose single umbilical cord blood unit (CBU) by co-infusion of third-party CD34+-selected cells from a haploidentical relative, which provides early transient engraftment while awaiting durable CBU engraftment. In our experience, ~15% of patients lack a suitable haploidentical donor. Here we report 26 patients who underwent haplo-cord transplant using CD34+-selected partially matched unrelated donor grafts. Twenty-four were conditioned with fludarabine/melphalan +/- low-dose TBI (n = 16). Twenty-five received ATG and all received posttransplant tacrolimus and mycophenolate mofetil. Median time to neutrophil and platelet recovery was 11 and 18 days. CBU engraftment, with CD33 and CD3 >5% cord chimerism in the myeloid/lymphoid compartment by day +60, occurred in 20 of 24 patients (83%). Incidence of grade 2-4 acute graft-versus-host disease (GVHD) was 27% at day +100, and chronic GVHD was 4% at 1 year. Overall survival at 1 year was 54%. For patients in need of an alternative transplant who lack a haploidentical donor, haplo-cord transplantation using CD34+-selected partially matched unrelated donor grafts results in rapid engraftment with no increased rate of cord graft failure or GVHD.

PubMed Disclaimer

References

    1. Barker JN, Kurtzberg J, Ballen K, Boo M, Brunstein C, Cutler C, et al. Optimal practices in unrelated donor cord blood transplantation for hematologic malignancies. Biol Blood Marrow Transplant J Am Soc Blood Marrow Transplant. 2017;23:882–96. https://doi.org/10.1016/j.bbmt.2017.03.006 . - DOI
    1. Gutman JA, Ross K, Smith C, Myint H, Lee CK, Salit R, et al. Chronic graft versus host disease burden and late transplant complications are lower following adult double cord blood versus matched unrelated donor peripheral blood transplantation. Bone Marrow Transplant. 2016;51:1588–93. https://doi.org/10.1038/bmt.2016.186 . - DOI - PubMed
    1. Choe HK, van Besien K. Against the odds: haplo-cord grafts protect from GvHD and relapse. Bone Marrow Transplant. 2017;52:1590–1. https://doi.org/10.1038/bmt.2017.102 . - DOI - PubMed
    1. Ruggeri A, Labopin M, Sanz G, Piemontese S, Arcese W, Bacigalupo A, et al. Comparison of outcomes after unrelated cord blood and unmanipulated haploidentical stem cell transplantation in adults with acute leukemia. Leukemia. 2015;29:1891–900. https://doi.org/10.1038/leu.2015.98 . - DOI - PubMed
    1. Milano F, Gooley T, Wood B, Woolfrey A, Flowers ME, Doney K, et al. Cord-blood transplantation in patients with minimal residual disease. N. Engl J Med. 2016;375:944–53. https://doi.org/10.1056/NEJMoa1602074 . - DOI - PubMed - PMC

Publication types

LinkOut - more resources