Cord blood units with low CD34+ cell viability have a low probability of engraftment after double unit transplantation Journal Article
| Authors: | Scaradavou, A.; Smith, K. M.; Hawke, R.; Schaible, A.; Abboud, M.; Kernan, N. A.; Young, J. W.; Barker, J. N. |
| Article Title: | Cord blood units with low CD34+ cell viability have a low probability of engraftment after double unit transplantation |
| Abstract: | Double unit cord blood (CB) transplantation (CBT) appears to augment engraftment despite only one unit engrafting in most patients. We hypothesized that superior unit quality, as measured by a higher percentage of viable cells postthaw, would determine the engrafting unit. Therefore, we prospectively analyzed 46 double-unit transplants postthaw using flow cytometry with modified gating that included all dead cells. Using a 75% threshold (mean viability minus 2 SD), 20% of units had low CD34+ cell viability, with viability varying according to the bank of origin. Further, in the 44 patients with single unit engraftment, CD34+ cell viability was higher in engrafting units (P = .0016). Although either unit engrafted if both had high CD34+ viability, units with <75% viability were very unlikely to engraft: in 16 patients who received one high and one low CD34+ viability unit, only 1 of 16 units with viability <75% engrafted (P = .0006). Further, in the single patient without engraftment of either unit, both had CD34+ viability <75%. Finally, poor CD34+ viability correlated with lower colony forming units (CFUs) (P = .02). Our data suggests one mechanism by which double unit CBT can improve engraftment is by increasing the probability of transplanting at least one unit with adequate viability and the potential to engraft. © 2010 American Society for Blood and Marrow Transplantation. |
| Keywords: | adolescent; adult; child; clinical article; controlled study; school child; treatment outcome; aged; middle aged; leukemia; transplantation, homologous; young adult; acute granulocytic leukemia; fludarabine; flow cytometry; prospective study; prospective studies; cell viability; cell survival; cd34 antigen; acute lymphoblastic leukemia; hodgkin disease; postoperative complications; cord blood stem cell transplantation; engraftment; myeloablative conditioning; nonhodgkin lymphoma; nonmyeloablative conditioning; blood preservation; fetal blood; lymphoma; graft versus host reaction; transplantation conditioning; cyclosporin a; mycophenolic acid 2 morpholinoethyl ester; chronic lymphatic leukemia; granulocyte colony stimulating factor; antigens, cd34; graft recipient; colony forming unit; prolymphocytic leukemia; acute biphenotypic leukemia |
| Journal Title: | Biology of Blood and Marrow Transplantation |
| Volume: | 16 |
| Issue: | 4 |
| ISSN: | 1083-8791 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2010-04-01 |
| Start Page: | 500 |
| End Page: | 508 |
| Language: | English |
| DOI: | 10.1016/j.bbmt.2009.11.013 |
| PUBMED: | 19932758 |
| PROVIDER: | scopus |
| PMCID: | PMC4606455 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 7" - "Export Date: 20 April 2011" - "CODEN: BBMTF" - "Source: Scopus" |
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