Influence of infused cell dose and HLA match on engraftment after double-unit cord blood allografts Journal Article

Authors: Avery, S.; Shi, W.; Lubin, M.; Gonzales, A. M.; Heller, G.; Castro-Malaspina, H.; Giralt, S.; Kernan, N. A.; Scaradavou, A.; Barker, J. N.
Article Title: Influence of infused cell dose and HLA match on engraftment after double-unit cord blood allografts
Abstract: The influence of cell dose and human leukocyte antigen (HLA) match on double-unit cord blood (CB) engraftment is not established. Therefore, we analyzed the impact of cell dose and high-resolution HLA match on neutrophil engraftment in 84 double-unit CB transplant recipients. The 94% sustained engraftment rate was accounted for by 1 unit in nearly all patients. Higher CD3+ cell doses (P = .04) and percentage of CD34+ cell viability (P = .008) were associated with unit dominance. After myeloablative conditioning, higher dominant unit total nucleated cell (TNC), CD34+ cell, and colony-forming unit doses were associated with higher sustained engraftment and faster neutrophil recovery (P = .07, P = .0008, and P < .0001, respectively). Total infused TNC (P = .0007) and CD3+ cell doses (P = .001) also significantly influenced engraftment. At high-resolution extensive donor-recipient HLA disparity was frequent, but had no influence on engraftment (P = .66), or unit dominance (P = .13). Although the unit-unit HLA match also did not affect sustained engraftment (P = 1.0), recipients of units closely (7-10 to 10-10) HLA-matched to each other were more likely to demonstrate initial engraftment of both units (P < .0001). Our findings have important implications for unit selection and provide further insight into double-unit biology. © 2011 by The American Society of Hematology.
Keywords: adolescent; adult; child; preschool child; school child; aged; major clinical study; cell viability; cd34 antigen; engraftment; graft failure; hla matching; myeloablative conditioning; neutrophil; infant; umbilical cord blood; cd3+ t lymphocyte; colony forming unit
Journal Title: Blood
Volume: 117
Issue: 12
ISSN: 0006-4971
Publisher: American Society of Hematology  
Date Published: 2011-03-24
Start Page: 3277
End Page: 3285
Language: English
DOI: 10.1182/blood-2010-08-300491
PROVIDER: scopus
PMCID: PMC3069669
PUBMED: 21149633
Notes: --- - "Cited By (since 1996): 1" - "Export Date: 23 June 2011" - "CODEN: BLOOA" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Nancy Kernan
    380 Kernan
  2. Glenn Heller
    303 Heller
  3. Weiji Shi
    111 Shi
  4. Sergio Andres Giralt
    535 Giralt
  5. Juliet N Barker
    227 Barker
  6. Sharon Avery
    6 Avery
  7. Marissa N Lubin
    78 Lubin