期刊
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
卷 21, 期 11, 页码 1981-1984出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2015.07.015
关键词
Cord blood transplantation; Engraftment; Double unit
资金
- Gabrielle's Angel Foundation for Cancer Research
- Society of Memorial Sloan Kettering Cancer Center
- Memorial Sloan Kettering Cancer Center Translational and Integrative Medicine Research Program
- National Cancer Institute, National Institutes of Health [P01 CA23766]
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 CD3(+), 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 x 10(5)/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. (C) 2015 American Society for Blood and Marrow Transplantation.
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