"No wash" albumin-dextran dilution for double-unit cord blood transplantation is safe with high rates of sustained donor engraftment Journal Article
| Authors: | Dahi, P. B.; Ponce, D. M.; Devlin, S.; Evans, K. L.; Lubin, M. N.; Gonzales, A. M.; Tonon, J.; Meagher, R.; Giralt, S.; Kernan, N. A.; Scaradavou, A.; Barker, J. N. |
| Article Title: | "No wash" albumin-dextran dilution for double-unit cord blood transplantation is safe with high rates of sustained donor engraftment |
| Abstract: | Washing cord blood (CB) grafts involves product manipulation and may result in cell loss. We investigated double-unit CB transplantation (CBT) using red blood cell (RBC)-depleted units diluted with albumin-dextran in patients with hematologic malignancies. One-hundred thirty-six patients (median age, 43 years; range, 4 to 71; median weight, 69 kilograms (kg); range, 24 to 111) underwent transplantation with a 4/6 to 6/6 HLA-matched graft. Patients ≤ 20 kg were excluded, as they only received washed units. Units were diluted a median of 8 fold to a median volume of 200 mL/unit. The median infused total nucleated cell doses were 2.7 (larger unit) and 2.0 (smaller unit) x 107/kg, respectively, and the median post-thaw recovery was 86%. Units were infused consecutively (median, 45 minutes/unit). While only 17 patients (13%) had no infusion reactions, reactions in the remaining 119 patients were almost exclusively mild-moderate (by CTCAE v4 criteria 12 grade 1, 43 grade 2, 63 grade 3) with only 1 patient (< 1%) having a severe (grade 4) reaction. Moreover, most were easily treated. Grade 2 to 3 hypertension was the most common in 101 (74%) patients. The cumulative incidence of sustained donor-derived neutrophil engraftment was high: 95% in myeloablative and94% in nonmyeloablative CBT recipients. With appropriate supportive care, double-unit CBT with RBC-depleted grafts infused after albumin-dextran dilution is safe with high rates of engraftment in patients > 20 kg. © 2014 American Society for Blood and Marrow Transplantation. |
| Keywords: | adolescent; adult; child; preschool child; school child; aged; middle aged; young adult; major clinical study; hypertension; retrospective study; albumin; cord blood stem cell transplantation; engraftment; hematologic malignancy; hla matching; myeloablative conditioning; neutrophil; erythrocyte; cord blood transplantation; infusion reactions; human; male; female; article |
| Journal Title: | Biology of Blood and Marrow Transplantation |
| Volume: | 20 |
| Issue: | 4 |
| ISSN: | 1083-8791 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2014-04-01 |
| Start Page: | 490 |
| End Page: | 494 |
| Language: | English |
| DOI: | 10.1016/j.bbmt.2013.12.561 |
| PROVIDER: | scopus |
| PMCID: | PMC3970430 |
| PUBMED: | 24361912 |
| DOI/URL: | |
| Notes: | Export Date: 1 August 2014 -- CODEN: BBMTF -- Source: Scopus |
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