Title | Cord blood transplants supported by unrelated donor CD34 progenitor cells. |
Publication Type | Journal Article |
Year of Publication | 2020 |
Authors | Gomez-Arteaga A, Orfali N, Guarneri D, Cushing MM, Gergis U, Hsu JM, Hsu Y-MS, Mayer SA, Phillips AA, Chase SA, Mokhtar AE, Shore TB, Van Besien K |
Journal | Bone Marrow Transplant |
Volume | 55 |
Issue | 12 |
Pagination | 2298-2307 |
Date Published | 2020 12 |
ISSN | 1476-5365 |
Keywords | Cord Blood Stem Cell Transplantation, Fetal Blood, Graft vs Host Disease, Humans, Transplantation Conditioning, Unrelated Donors |
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. |
DOI | 10.1038/s41409-020-0959-5 |
Alternate Journal | Bone Marrow Transplant |
PubMed ID | 32518291 |
Related Faculty:
Melissa Cushing, M.D.