Association between nondominant unit total nucleated cell dose and engraftment in myeloablative double-unit cord blood transplantation Journal Article

   

Authors:	Purtill, D.; Stevens, C. E.; Lubin, M.; Ponce, D.; Hanash, A.; Giralt, S.; Scaradavou, A.; Young, J. W.; Barker, J. N.
Article Title:	Association between nondominant unit total nucleated cell dose and engraftment in myeloablative double-unit cord blood transplantation
Abstract:	Sustained hematopoiesis after double-unit cord blood transplantation (dCBT) is mediated by 1 unit in nearly all patients. To investigate the associations between nondominant unit characteristics and neutrophil engraftment, we studied 129 consecutive myeloablative dCBT recipients. Ninety-five percent (95% confidence interval, 90 to 98) of patients engrafted. Detection of the nondominant unit 21 to 28 days after dCBT was not associated with improved neutrophil engraftment. In univariate analyses, nondominant unit characteristics (infused total nucleated cell [TNC] and viable CD3+ cell doses) were significantly associated with speed and success of neutrophil engraftment as were dominant unit characteristics (infused TNC; viable CD34+, viable CD3+, and viable CD3-56+16+ cell doses; and post-thaw CD34+ cell viability). In multivariate analysis, higher infused TNC dose of the nondominant unit was independently associated with improved neutrophil engraftment, even when this unit did not contribute to donor hematopoiesis. In further subgroup analysis, this association was only evident when the infused viable CD34+ cell dose of the dominant unit was low (<1.20 × 105/kg). These findings suggest nondominant units mediate a dose-dependent facilitation of engraftment in myeloablative dCBT and support continued investigation of dCBT biology and the clinical practice of dCBT in adults in whom low cell dose grafts are common. © 2015 American Society for Blood and Marrow Transplantation.
Keywords:	adolescent; adult; child; controlled study; aged; human cell; major clinical study; myeloproliferative disorder; cd3 antigen; cell viability; acute lymphoblastic leukemia; hodgkin disease; chimera; cord blood stem cell transplantation; engraftment; myeloablative conditioning; myelodysplastic syndrome; nonhodgkin lymphoma; donor; neutrophil; acute myeloblastic leukemia; graft versus host reaction; hematopoiesis; cell nucleus; calcineurin inhibitor; chronic lymphatic leukemia; granulocyte colony stimulating factor; myeloproliferative neoplasm; cord blood transplantation; aplasia; mycophenolate mofetil; human; male; female; article; double unit cord blood transplantation; double unit; nondominant unit total nucleated cell
Journal Title:	Biology of Blood and Marrow Transplantation
Volume:	21
Issue:	11
ISSN:	1083-8791
Publisher:	Elsevier Inc.
Date Published:	2015-11-01
Start Page:	1981
End Page:	1984
Language:	English
DOI:	10.1016/j.bbmt.2015.07.015
PROVIDER:	scopus
PMCID:	PMC4604060
PUBMED:	26211983
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84943451391&partnerID=40&md5=fe4017f0608342bbb4df7bf834b6a888
Notes:	Export Date: 2 November 2015 -- Source: Scopus

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