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Notch-mediated expansion of human cord blood progenitor cells capable of rapid myeloid reconstitution

TLDR
This is the first instance of rapid engraftment derived from ex vivo expanded stem/progenitor cells in humans, and when cord blood progenitors expanded ex vivo in the presence of Notch ligand were infused in a clinical setting after a myeloablative preparative regimen for stem cell transplantation, the time to neutrophil recovery was substantially shortened.
Abstract
Delayed myeloid engraftment after cord blood transplantation (CBT) is thought to result from inadequate numbers of progenitor cells in the graft and is associated with increased early transplant-related morbidity and mortality. New culture strategies that increase the number of cord blood progenitors capable of rapid myeloid engraftment after CBT would allow more widespread use of this stem cell source for transplantation. Here we report the development of a clinically relevant Notch-mediated ex vivo expansion system for human CD34(+) cord blood progenitors that results in a marked increase in the absolute number of stem/progenitor cells, including those capable of enhanced repopulation in the marrow of immunodeficient nonobese diabetic-severe combined immunodeficient (NOD-SCID) mice. Furthermore, when cord blood progenitors expanded ex vivo in the presence of Notch ligand were infused in a clinical setting after a myeloablative preparative regimen for stem cell transplantation, the time to neutrophil recovery was substantially shortened. To our knowledge, this is the first instance of rapid engraftment derived from ex vivo expanded stem/progenitor cells in humans.

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Hematopoiesis: A Human Perspective

TL;DR: This work highlights 2 decades of studies focusing on isolation and molecular regulation of human HSCs, therapeutic applications, and early lineage commitment steps, and compares mouse and humanized models to identify both conserved and species-specific mechanisms that will aid future preclinical research.
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Hematopoietic stem cell niche maintenance during homeostasis and regeneration

TL;DR: Recently discovered intrinsic mechanisms, microenvironmental interactions and communication with surrounding cells involved in HSC regulation, during homeostasis and in regeneration after injury are highlighted and their implications for regenerative therapy are discussed.
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Umbilical cord blood transplantation: the first 25 years and beyond

TL;DR: The results for adult umbilical cord blood transplantation have improved, with greater emphasis on cord blood units of sufficient cell dose and human leukocyte antigen match and with the use of double umbilicals Cord blood units and improved supportive care techniques.
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Revised map of the human progenitor hierarchy shows the origin of macrophages and dendritic cells in early lymphoid development

TL;DR: A comprehensive analysis of the human hematopoietic hierarchy is provided by clonally mapping the developmental potential of seven progenitor classes from neonatal cord blood and adult bone marrow to show that human hepatopoiesis does not follow a rigid model of myeloid-lymphoid segregation.
References
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Journal ArticleDOI

Transplantation of 2 partially HLA-matched umbilical cord blood units to enhance engraftment in adults with hematologic malignancy

TL;DR: Patients with high-risk hematologic malignancy received 2 partially HLA-matched UCB units and disease-free survival was 57% at 1 year, with 72% of patients alive if they received transplants while in remission.
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Processing and cryopreservation of placental/umbilical cord blood for unrelated bone marrow reconstitution.

TL;DR: Almost all the hematopoietic colony-forming cells present in PCB units can be recovered in a uniform volume of 20 ml by using rouleaux formation induced by hydroxyethyl starch and centrifugation to reduce the bulk of erythrocytes and plasma and, thus, concentrate leukocytes.
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Pluripotent, cytokine-dependent, hematopoietic stem cells are immortalized by constitutive Notch1 signaling.

TL;DR: It is demonstrated that constitutive Notch1 signaling in hematopoietic cells established immortalized, cytokine-dependent cell lines that generated progeny with either lymphoid or myeloid characteristics both in vitro and in vivo.
Journal ArticleDOI

Umbilical cord blood transplantation after nonmyeloablative conditioning: impact on transplantation outcomes in 110 adults with hematologic disease

TL;DR: The use of UCB after a nonmyeloablative conditioning as a strategy for extending the availability of transplantation therapy, particularly for older patients, is supported.
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