Journal ArticleDOI
Outcomes among 562 Recipients of Placental-Blood Transplants from Unrelated Donors
Pablo Rubinstein,Carmelita Carrier,Andromachi Scaradavou,Joanne Kurtzberg,John W. Adamson,Anna Rita Migliaccio,Richard L. Berkowitz,Michael F. Cabbad,Dobrila Nl,Patricia E. Taylor,Richard E. Rosenfield,Cladd E. Stevens +11 more
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TLDR
Placental blood is a useful source of allogeneic hematopoietic stem cells for bone marrow reconstitution and is associated with the severity of GVHD, type of leukemia, and stage of the disease.Abstract:
Background A program for banking, characterizing, and distributing placental blood, also called umbilical-cord blood, for transplantation provided grafts for 562 patients between August 24, 1992, and January 30, 1998. We evaluated this experience. Methods Placental blood was stored under liquid nitrogen and selected for specific patients on the basis of HLA type and leukocyte content. Patients were prepared for the transplantation of allogeneic hematopoietic cells in the placental blood and received prophylaxis against graft-versus-host disease (GVHD) according to routine procedures at each center. Results Outcomes at 100 days after transplantation were known for all 562 patients, and outcomes at 1 year for 94 percent of eligible recipients. The cumulative rates of engraftment among the recipients, according to actuarial analysis, were 81 percent by day 42 for neutrophils (median time to engraftment, 28 days) and 85 percent by day 180 for platelets (median, day 90). The speed of myeloid engraftment was as...read more
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Journal ArticleDOI
Transplants of Umbilical-Cord Blood or Bone Marrow from Unrelated Donors in Adults with Acute Leukemia
Vanderson Rocha,Myriam Labopin,Guillermo Sanz,William Arcese,Rainer Schwerdtfeger,Alberto Bosi,Niels Jacobsen,Tapani Ruutu,Marcos de Lima,Jürgen Finke,Francesco Frassoni,Eliane Gluckman +11 more
TL;DR: Cord blood from an unrelated donor is an alternative source of hematopoietic stem cells for adults with acute leukemia who lack an HLA-matched bone marrow donor.
Journal ArticleDOI
Transplantation of unrelated donor umbilical cord blood in 102 patients with malignant and nonmalignant diseases: influence of CD34 cell dose and HLA disparity on treatment-related mortality and survival.
John E. Wagner,Juliet N. Barker,Todd E. DeFor,K. Scott Baker,Bruce R. Blazar,Cindy R. Eide,Anne I. Goldman,John H. Kersey,William Krivit,Margaret L. MacMillan,Paul J. Orchard,Charles Peters,Daniel J. Weisdorf,Norma K.C. Ramsay,Stella M. Davies +14 more
TL;DR: There is a high probability of survival in recipients of UCB grafts that are disparate in no more than 2 human leukocyte antigens when the grafts contain at least 1.7 x 10(5) CD34(+) cells per kilogram of recipient's body weight, and graft selection should be based principally on CD34 cell dose when multiple UCB units exist with an HLA disparity of 2 or less.
Journal ArticleDOI
Outcomes after Transplantation of Cord Blood or Bone Marrow from Unrelated Donors in Adults with Leukemia
Mary J. Laughlin,Mary Eapen,Pablo Rubinstein,John E. Wagner,Mei Jei Zhang,Richard E. Champlin,Cladd E. Stevens,Juliet N. Barker,Robert Peter Gale,Hillard M. Lazarus,David I. Marks,Jon J. van Rood,Andromachi Scaradavou,Mary M. Horowitz +13 more
TL;DR: HLA-mismatched cord blood should be considered an acceptable source of hematopoietic stem-cell grafts for adults in the absence of an HLA-matched adult donor.
Journal ArticleDOI
Transplantation of 2 partially HLA-matched umbilical cord blood units to enhance engraftment in adults with hematologic malignancy
Juliet N. Barker,Daniel J. Weisdorf,Todd E. DeFor,Bruce R. Blazar,Philip B. McGlave,Jeffrey S. Miller,Catherine M. Verfaillie,John E. Wagner +7 more
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.
Journal ArticleDOI
Hematopoietic Engraftment and Survival in Adult Recipients of Umbilical-Cord Blood from Unrelated Donors
Mary J. Laughlin,Juliet N. Barker,Barbara Bambach,Omer N. Koc,David A. Rizzieri,John E. Wagner,Stanton L. Gerson,Hillard M. Lazarus,Mitchell S. Cairo,Cladd E. Stevens,Pablo Rubinstein,Joanne Kurtzberg +11 more
TL;DR: Umbilical-cord blood from unrelated donors can restore hematopoiesis in adults who receive myeloablative therapy and is associated with acceptable rates of severe acute and chronic GVHD.
References
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TL;DR: Reports of GVHD prevention trials should include an accurate description of the grading system used and should report actuarial rates of grades II-IV and III-IV GV HD corrected for graft failure and potential interventions for early relapse.
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Mary M. Horowitz,Robert Peter Gale,Paul M. Sondel,John M. Goldman,J. H. Kersey,HJ Kolb,A. A. Rimm,O Ringden,C. Rozman,Bruno Speck +9 more
TL;DR: The results explain the efficacy of allogeneic bone marrow transplantation in eradicating leukemia, provide evidence for a role of the immune system in controlling human cancers, and suggest future directions to improve leukemia therapy.
Journal ArticleDOI
Hematopoietic reconstitution in a patient with fanconi's anemia by means of umbilical-cord blood from an hla-identical sibling
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TL;DR: It is necessary to select patients suitable for vaginal or laparoscopic mesh placement for Fanconi's anemia preoperatively on the basis of prior history and once they provide informed consent for surgery.