PMID- 15466923
OWN - NLM
STAT- MEDLINE
DCOM- 20050421
LR  - 20210206
IS  - 0006-4971 (Print)
IS  - 0006-4971 (Linking)
VI  - 105
IP  - 3
DP  - 2005 Feb 1
TI  - Transplantation of 2 partially HLA-matched umbilical cord blood units to enhance 
      engraftment in adults with hematologic malignancy.
PG  - 1343-7
AB  - Limited umbilical cord blood (UCB) cell dose compromises the outcome of adult UCB 
      transplantation. Therefore, to augment graft cell dose, we evaluated the safety 
      of the combined transplantation of 2 partially human leukocyte antigen 
      (HLA)-matched UCB units. Twenty-three patients with high-risk hematologic 
      malignancy (median age, 24 years; range, 13-53 years) received 2 UCB units 
      (median infused dose, 3.5 x 10(7) nucleated cell [NC]/kg; range, 1.1-6.3 x 10(7) 
      NC/kg) after myeloablative conditioning. All evaluable patients (n = 21) 
      engrafted at a median of 23 days (range, 15-41 days). At day 21, engraftment was 
      derived from both donors in 24% of patients and a single donor in 76% of 
      patients, with 1 unit predominating in all patients by day 100. Although neither 
      nucleated or CD34(+) cell doses nor HLA-match predicted which unit would 
      predominate, the predominating unit had a significantly higher CD3(+) dose (P < 
      .01). Incidences of grades II-IV and III-IV acute GVHD were 65% (95% confidence 
      interval [CI], 42%-88%) and 13% (95% CI, 0%-26%), respectively. Disease-free 
      survival was 57% (95% CI, 35%-79%) at 1 year, with 72% (95% CI, 49%-95%) of 
      patients alive if they received transplants while in remission. Therefore, 
      transplantation of 2 partially HLA-matched UCB units is safe, and may overcome 
      the cell-dose barrier that limits the use of UCB in many adults and adolescents.
FAU - Barker, Juliet N
AU  - Barker JN
AD  - Blood and Marrow Transplant Program, Division of Medical and Pediatric Oncology, 
      University of Minnesota, Box 480, 420 Delaware St SE, Minneapolis, MN 55455, USA. 
      barke014@umn.edu.
FAU - Weisdorf, Daniel J
AU  - Weisdorf DJ
FAU - DeFor, Todd E
AU  - DeFor TE
FAU - Blazar, Bruce R
AU  - Blazar BR
FAU - McGlave, Philip B
AU  - McGlave PB
FAU - Miller, Jeffrey S
AU  - Miller JS
FAU - Verfaillie, Catherine M
AU  - Verfaillie CM
FAU - Wagner, John E
AU  - Wagner JE
LA  - eng
GR  - P30 CA008748/CA/NCI NIH HHS/United States
GR  - P01-CA65493/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20041005
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (Antigens, CD34)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Antigens, CD34/blood
MH  - *Blood Transfusion
MH  - *Fetal Blood
MH  - Hematologic Neoplasms/immunology/*therapy
MH  - Histocompatibility Testing
MH  - Humans
MH  - Infant, Newborn
MH  - Middle Aged
MH  - Stem Cell Transplantation
MH  - Transplantation Chimera
MH  - Treatment Outcome
EDAT- 2004/10/07 09:00
MHDA- 2005/04/22 09:00
CRDT- 2004/10/07 09:00
PHST- 2004/10/07 09:00 [pubmed]
PHST- 2005/04/22 09:00 [medline]
PHST- 2004/10/07 09:00 [entrez]
AID - S0006-4971(20)46830-2 [pii]
AID - 10.1182/blood-2004-07-2717 [doi]
PST - ppublish
SO  - Blood. 2005 Feb 1;105(3):1343-7. doi: 10.1182/blood-2004-07-2717. Epub 2004 Oct 
      5.