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Cord blood transplants supported by unrelated donor CD34+ progenitor cells.
Bone Marrow Transplant. 2020 Jun 09 [Online ahead of print]BM

Abstract

Alternative donor transplantation with the haplo-cord platform allows the use of a lower-dose single umbilical cord blood unit (CBU) by co-infusion of third-party CD34+-selected cells from a haploidentical relative, which provides early transient engraftment while awaiting durable CBU engraftment. In our experience, ~15% of patients lack a suitable haploidentical donor. Here we report 26 patients who underwent haplo-cord transplant using CD34+-selected partially matched unrelated donor grafts. Twenty-four were conditioned with fludarabine/melphalan +/- low-dose TBI (n = 16). Twenty-five received ATG and all received posttransplant tacrolimus and mycophenolate mofetil. Median time to neutrophil and platelet recovery was 11 and 18 days. CBU engraftment, with CD33 and CD3 >5% cord chimerism in the myeloid/lymphoid compartment by day +60, occurred in 20 of 24 patients (83%). Incidence of grade 2-4 acute graft-versus-host disease (GVHD) was 27% at day +100, and chronic GVHD was 4% at 1 year. Overall survival at 1 year was 54%. For patients in need of an alternative transplant who lack a haploidentical donor, haplo-cord transplantation using CD34+-selected partially matched unrelated donor grafts results in rapid engraftment with no increased rate of cord graft failure or GVHD.

Authors+Show Affiliations

Department of Medicine, Division of Hematology/Oncology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA.Department of Medicine, Division of Hematology/Oncology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA.Department of Medicine, Division of Hematology/Oncology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA.Department of Pathology, Division of Hematology/Oncology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA.Department of Medicine, Division of Hematology/Oncology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA.Department of Medicine, Division of Hematology/Oncology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA.Department of Pathology, Division of Hematology/Oncology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA.Department of Medicine, Division of Hematology/Oncology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA.Department of Medicine, Division of Hematology/Oncology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA.Department of Medicine, Division of Hematology/Oncology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA.Department of Medicine, Division of Hematology/Oncology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA.Department of Medicine, Division of Hematology/Oncology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA.Department of Medicine, Division of Hematology/Oncology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA. kov9001@med.cornell.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32518291

Citation

Gomez-Arteaga, Alexandra, et al. "Cord Blood Transplants Supported By Unrelated Donor CD34+ Progenitor Cells." Bone Marrow Transplantation, 2020.
Gomez-Arteaga A, Orfali N, Guarneri D, et al. Cord blood transplants supported by unrelated donor CD34+ progenitor cells. Bone Marrow Transplant. 2020.
Gomez-Arteaga, A., Orfali, N., Guarneri, D., Cushing, M. M., Gergis, U., Hsu, J., Hsu, Y. S., Mayer, S. A., Phillips, A. A., Chase, S. A., Mokhtar, A. E., Shore, T. B., & Van Besien, K. (2020). Cord blood transplants supported by unrelated donor CD34+ progenitor cells. Bone Marrow Transplantation. https://doi.org/10.1038/s41409-020-0959-5
Gomez-Arteaga A, et al. Cord Blood Transplants Supported By Unrelated Donor CD34+ Progenitor Cells. Bone Marrow Transplant. 2020 Jun 9; PubMed PMID: 32518291.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cord blood transplants supported by unrelated donor CD34+ progenitor cells. AU - Gomez-Arteaga,Alexandra, AU - Orfali,Nina, AU - Guarneri,Danielle, AU - Cushing,Melissa M, AU - Gergis,Usama, AU - Hsu,Jingmei, AU - Hsu,Yen-Michael S, AU - Mayer,Sebastian A, AU - Phillips,Adrienne A, AU - Chase,Stacy A, AU - Mokhtar,Asmaa E, AU - Shore,Tsiporah B, AU - Van Besien,Koen, Y1 - 2020/06/09/ PY - 2020/03/25/received PY - 2020/05/27/accepted PY - 2020/05/15/revised PY - 2020/6/11/entrez JF - Bone marrow transplantation JO - Bone Marrow Transplant. N2 - Alternative donor transplantation with the haplo-cord platform allows the use of a lower-dose single umbilical cord blood unit (CBU) by co-infusion of third-party CD34+-selected cells from a haploidentical relative, which provides early transient engraftment while awaiting durable CBU engraftment. In our experience, ~15% of patients lack a suitable haploidentical donor. Here we report 26 patients who underwent haplo-cord transplant using CD34+-selected partially matched unrelated donor grafts. Twenty-four were conditioned with fludarabine/melphalan +/- low-dose TBI (n = 16). Twenty-five received ATG and all received posttransplant tacrolimus and mycophenolate mofetil. Median time to neutrophil and platelet recovery was 11 and 18 days. CBU engraftment, with CD33 and CD3 >5% cord chimerism in the myeloid/lymphoid compartment by day +60, occurred in 20 of 24 patients (83%). Incidence of grade 2-4 acute graft-versus-host disease (GVHD) was 27% at day +100, and chronic GVHD was 4% at 1 year. Overall survival at 1 year was 54%. For patients in need of an alternative transplant who lack a haploidentical donor, haplo-cord transplantation using CD34+-selected partially matched unrelated donor grafts results in rapid engraftment with no increased rate of cord graft failure or GVHD. SN - 1476-5365 UR - https://www.unboundmedicine.com/medline/citation/32518291/Cord_blood_transplants_supported_by_unrelated_donor_CD34+_progenitor_cells L2 - http://dx.doi.org/10.1038/s41409-020-0959-5 DB - PRIME DP - Unbound Medicine ER -
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