PMID- 17348813
OWN - NLM
STAT- MEDLINE
DCOM- 20070726
LR  - 20071115
IS  - 1547-3287 (Print)
IS  - 1547-3287 (Linking)
VI  - 16
IP  - 1
DP  - 2007 Feb
TI  - Multiple unit HLA-unmatched sex-mismatched umbilical cord blood transplantation 
      for advanced hematological malignancy.
PG  - 177-86
AB  - We investigated the effect of multiple-unit umbilical cord blood (UCB) 
      transplantation on engraftment in the setting of severe human leukocyte antigen 
      (HLA) mismatch. Ten poor-risk adult patients with hematological malignancy 
      received multiple unit, HLA-unmatched, sex-mismatched, unrelated UCB 
      transplantation after a reduced intensity-conditioning regimen (RICR) with 
      engraftment as the primary endpoint. The median age of the patients was 55 years 
      with a range of 28-67. Patients received one unit of UCB per 10 kg of recipient 
      body weight (5-7 units). The median number of nucleated cells and CD34(+) cells 
      per kilogram of recipient body weight infused was 6.3 x 10(7) (range 3.8-10.0) 
      (NC/kg) and 5.7 x 10(5) (range 1.1-11.9) (CD34/kg), respectively. Three patients 
      expired before day 28 and were not evaluable for engraftment. Five of the 
      remaining 7 patients showed increasing neutrophil counts. Fluorescent in situ 
      hybridization (FISH) for the Y chromosome or HLA-typing showed only donor cells 
      in the peripheral blood. After engraftment, HLA typing was done on 3 patients and 
      their infused UCB units. All revealed the presence of a single HLA type 
      concordant with one of the infused units. Moreover, the order of infusion did not 
      influence which UCB unit engrafted. The engrafting UCB units were infused first 
      or second in one case and fourth in the other two. One patient transplanted for 
      refractory acute lymphoblastic leukemia (ALL) survives in continuous complete 
      remission 4 years after transplant. He engrafted with one UCB unit, is fully 
      hematologically reconstituted, has no evidence of graft-versus-host disease 
      (GVHD), and takes no immunosuppressive medication. HLA typing reveals that the 
      recipient and the engrafted cord blood match at only one HLA-B locus using 
      conventional 6 antigen typing (A, B, and DR). Although engraftment was not 
      accelerated, it did occur in the majority of evaluable patients. Long-term 
      disease-free survivorship without debilitating GVHD is possible in patients with 
      refractory hematological malignancy who receive unmatched multiple unit UCB.
FAU - Lister, John
AU  - Lister J
AD  - Division of Hematology/Oncology, The Western Pennsylvania Hospital and Western 
      Pennsylvania Cancer Institute, Pittsburgh, PA 15224, USA.
FAU - Gryn, Jeffrey F
AU  - Gryn JF
FAU - McQueen, Karina L
AU  - McQueen KL
FAU - Harris, David T
AU  - Harris DT
FAU - Rossetti, James M
AU  - Rossetti JM
FAU - Shadduck, Richard K
AU  - Shadduck RK
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Stem Cells Dev
JT  - Stem cells and development
JID - 101197107
RN  - 0 (HLA Antigens)
RN  - 0 (Receptors, Immunologic)
RN  - 0 (Receptors, KIR)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cord Blood Stem Cell Transplantation/*methods
MH  - Female
MH  - Genotype
MH  - Graft vs Host Disease
MH  - Graft vs Leukemia Effect
MH  - HLA Antigens/genetics/*immunology
MH  - Hematologic Neoplasms/immunology/*therapy
MH  - Histocompatibility Testing
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neutrophils/metabolism
MH  - Receptors, Immunologic/genetics
MH  - Receptors, KIR
MH  - Transplantation Conditioning
EDAT- 2007/03/14 09:00
MHDA- 2007/07/27 09:00
CRDT- 2007/03/14 09:00
PHST- 2007/03/14 09:00 [pubmed]
PHST- 2007/07/27 09:00 [medline]
PHST- 2007/03/14 09:00 [entrez]
AID - 10.1089/scd.2006.06500-HB [doi]
PST - ppublish
SO  - Stem Cells Dev. 2007 Feb;16(1):177-86. doi: 10.1089/scd.2006.06500-HB.