PMID- 19896084
OWN - NLM
STAT- MEDLINE
DCOM- 20100303
LR  - 20211020
IS  - 1523-6536 (Electronic)
IS  - 1083-8791 (Print)
IS  - 1083-8791 (Linking)
VI  - 15
IP  - 12
DP  - 2009 Dec
TI  - A "no-wash" albumin-dextran dilution strategy for cord blood unit thaw: high rate 
      of engraftment and a low incidence of serious infusion reactions.
PG  - 1596-602
LID - 10.1016/j.bbmt.2009.08.009 [doi]
AB  - Preparation of cord blood (CB) units for infusion by albumin-dextran dilution 
      without centrifugation may be advantageous for adult patients to minimize cell 
      loss and, unlike a bedside thaw, is still conducted in the controlled laboratory 
      environment. Therefore, we studied CB transplantation (CBT) using this technique 
      in 54 consecutive CBT recipients >20 kg. Patients (median age=42 years [range: 
      7-66 years]; median weight=71 kg [range: 24-109]) were transplanted for high-risk 
      hematologic malignancies with myeloablative (n=35) or nonmyeloablative (n=19) 
      conditioning and 4-6/6 human leukocyte antigen (HLA)-matched double-unit grafts. 
      One hundred seven units were thawed with dilution, whereas 1 red blood cell 
      (RBC)-replete unit was washed. A 5:1 dextran 40%/25% albumin solution was used. 
      RBC-depleted units (n=104) were diluted >or=5.5-fold (median final volume 200 mL 
      [range: 200-500]), whereas RBC-replete units (n=3) were diluted >or=4-fold 
      (median final volume 400 mL [range: 400-535]). Total nucleated cell (TNC) 
      recovery was 86%; the median infused TNC dose was 2.17x10(7)/kg/unit. Although 35 
      patients (65%) had a total of 45 infusion reactions (6 nausea, 31 hypertension, 3 
      pain, 1 rigors/fever, 2 transient hypoxia, 2 renal impairment) requiring 
      additional therapy, there were no infusion-related serious adverse events, and 
      reactions were not related to dimethyl sulfoxide (DMSO) dose/kg. Cumulative 
      incidence of sustained donor engraftment was 94% (95% cumulative incidence [CI]: 
      87-100) with neutrophil recovery occurring at a median of 25 days (range: 13-43) 
      in myeloablative and 10 days (range: 7-36) in nonmyeloablative recipients. CB 
      thaw with albumin-dextran dilution reduces unit manipulation, and minimizes cell 
      loss, speeds time to infusion, is associated with a tolerable infusion reaction 
      profile, and a high rate of sustained engraftment in CBT recipients >or=20 kg.
FAU - Barker, Juliet N
AU  - Barker JN
AD  - Department of Medicine, Allogeneic Bone Marrow Transplantation Service, Memorial 
      Sloan-Kettering Cancer Center, New York, New York 10021, USA. barkerj@mskcc.org
FAU - Abboud, Michelle
AU  - Abboud M
FAU - Rice, Robert D
AU  - Rice RD
FAU - Hawke, Rebecca
AU  - Hawke R
FAU - Schaible, Allison
AU  - Schaible A
FAU - Heller, Glenn
AU  - Heller G
FAU - La Russa, Vincent
AU  - La Russa V
FAU - Scaradavou, Andromachi
AU  - Scaradavou A
LA  - eng
GR  - P01 CA023766/CA/NCI NIH HHS/United States
GR  - P01 CA023766-32/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20090925
PL  - United States
TA  - Biol Blood Marrow Transplant
JT  - Biology of blood and marrow transplantation : journal of the American Society for 
      Blood and Marrow Transplantation
JID - 9600628
RN  - 0 (Albumins)
RN  - 0 (Dextrans)
RN  - YOW8V9698H (Dimethyl Sulfoxide)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Albumins
MH  - Blood Preservation/*methods
MH  - Child
MH  - Cord Blood Stem Cell Transplantation/adverse effects/*methods
MH  - Cryopreservation/*methods
MH  - Dextrans
MH  - Dimethyl Sulfoxide
MH  - Female
MH  - *Fetal Blood
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Young Adult
PMC - PMC3105472
MID - NIHMS285745
EDAT- 2009/11/10 06:00
MHDA- 2010/03/04 06:00
PMCR- 2011/06/01
CRDT- 2009/11/10 06:00
PHST- 2009/07/02 00:00 [received]
PHST- 2009/08/08 00:00 [accepted]
PHST- 2009/11/10 06:00 [entrez]
PHST- 2009/11/10 06:00 [pubmed]
PHST- 2010/03/04 06:00 [medline]
PHST- 2011/06/01 00:00 [pmc-release]
AID - S1083-8791(09)00371-1 [pii]
AID - 10.1016/j.bbmt.2009.08.009 [doi]
PST - ppublish
SO  - Biol Blood Marrow Transplant. 2009 Dec;15(12):1596-602. doi: 
      10.1016/j.bbmt.2009.08.009. Epub 2009 Sep 25.