Dominant unit CD34+ cell dose predicts engraftment after double-unit cord blood transplantation and is influenced by bank practice Journal Article

Authors: Purtill, D.; Smith, K.; Devlin, S.; Meagher, R.; Tonon, J.; Lubin, M.; Ponce, D. M.; Giralt, S.; Kernan, N. A.; Scaradavou, A.; Stevens, C. E.; Barker, J. N.
Article Title: Dominant unit CD34+ cell dose predicts engraftment after double-unit cord blood transplantation and is influenced by bank practice
Abstract: We investigated the unit characteristics associated with engraftment after double-unit cord blood (CB) transplantation (dCBT) and whether these could be reliably identified during unit selection. Cumulative incidence of neutrophil engraftment in 129myeloablative dCBT recipients was 95% (95% confidence interval:90-98%). When precryopreservation characteristics were analyzed, the dominant unit CD34+ cell dose was the only characteristic independently associated with engraftment (hazard ratio, 1.43; P=.002). When postthaw characteristics were also included, only dominant unit infused viable CD34+ cell dose independently predicted engraftment (hazard ratio, 1.95; P <.001). We then examined the determinants of infused viable CD34+ cell dose (precryopreservation count, postthaw recovery, and postthaw viability) in 402 units thawed at our center. This revealed close correlation between precryopreservation and postthaw CD34+ cell counts (r2=0.73). Median CD34+ cell recovery was 101%, although it ranged from 12% to 1480%. Notably, units from non-Netcord Foundation for the Accreditation of Cellular Therapy (Netcord-FACT)-accredited banks were more likely to have low recovery (P <.001). Furthermore, although median postthaw CD34+ cell viability was 92%, 33 (8%) units had <75%viableCD34+ cells. Units from non-Netcord-FACT-accreditedbanksand units with cryovolumes other than 24.5 to 26.0mLwere more likely to have poor postthaw viability. Precryopreservation CD34+ cell dose and banking practices should be incorporated into CB unit selection.
Keywords: child; controlled study; major clinical study; cancer incidence; cell viability; cd34 antigen; neutrophil count; cryopreservation; cord blood stem cell transplantation; engraftment; blood bank; infant; newborn; cell count; colony forming unit; human; article; double unit cord blood transplantation
Journal Title: Blood
Volume: 124
Issue: 19
ISSN: 0006-4971
Publisher: American Society of Hematology  
Date Published: 2014-11-06
Start Page: 2905
End Page: 2912
Language: English
DOI: 10.1182/blood-2014-03-566216
PROVIDER: scopus
PMCID: PMC4224191
PUBMED: 25185264
Notes: Export Date: 1 December 2014 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Nancy Kernan
    367 Kernan
  2. Sergio Andres Giralt
    499 Giralt
  3. Doris Ponce
    126 Ponce
  4. Juliet N Barker
    220 Barker
  5. Marissa N Lubin
    77 Lubin
  6. Katherine M Smith
    27 Smith
  7. Cladd Stevens
    17 Stevens
  8. Sean McCarthy Devlin
    277 Devlin
  9. Jo-Ann Tonon
    18 Tonon
  10. Richard Charles Meagher
    38 Meagher