PMID- 27788764
OWN - NLM
STAT- MEDLINE
DCOM- 20170302
LR  - 20181202
IS  - 1532-8686 (Electronic)
IS  - 0037-1963 (Linking)
VI  - 53
IP  - 4
DP  - 2016 Oct
TI  - Haploidentical cord transplantation-The best of both worlds.
PG  - 257-266
LID - S0037-1963(16)30066-X [pii]
LID - 10.1053/j.seminhematol.2016.07.004 [doi]
AB  - Haploidentical (haplo)-cord transplantation combines infusion of an umbilical 
      cord blood (UCB) unit with CD34-selected cells usually from human leukocyte 
      antigen (HLA) mismatched donors. Initial rapid count recovery from the 
      haplo-hematopoietic progenitors, is gradually replaced by durable engraftment 
      from UCB progenitors. UCB grafts used for haplo-cord are smaller, but better 
      matched than those required for single or double UCB stem cell transplant (SCT). 
      More than 200 patients with hematological malignancies have been transplanted. 
      Median age was 54 years (range 17-74) and 77 were over age 60. One-year survival 
      was 64% for patients with intermediate- and low-risk disease, with no deaths 
      beyond 2 years. In high-risk disease, 1-year survival was 44%. In a comparison 
      with patients undergoing double UCB SCT, haplo-cord transplant resulted in faster 
      hematopoietic recovery, lower rates of acute and chronic graft-versus-host 
      disease (GVHD), lower rates of disease recurrence, and improved GVHD- and 
      relapse-free survival (GRFS). Excellent results were also reported for patients 
      with aplastic anemia where 18 of 21 patients had sustained cord blood 
      engraftment. Rates of GVHD and of disease recurrence after haplo-cord are 
      encouraging. However, in the approximately 10% of patients with failure of the 
      UCB graft disease recurrence is high, supporting the important role of 
      UCB-mediated graft-versus-leukemia (GVL). Ongoing efforts are aimed at 
      identifying determinants of UCB engraftment, at reducing rates of disease 
      recurrence in high risk patients and at optimizing dose and schedule of ATG 
      -necessary to avoid early haplo-graft rejection, but also contributing to early 
      post-transplant immunocompromise. For those lacking haploidentical donors, 
      unrelated donors have been successfully utilized.
CI  - Copyright (c) 2016 Elsevier Inc. All rights reserved.
FAU - van Besien, Koen
AU  - van Besien K
AD  - Division of Hematology/Oncology, Weill Cornell Medicine, New York, NY. Electronic 
      address: kov9001@med.cornell.edu.
FAU - Childs, Richard
AU  - Childs R
AD  - National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, 
      MD.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20160725
PL  - United States
TA  - Semin Hematol
JT  - Seminars in hematology
JID - 0404514
SB  - IM
MH  - *Cord Blood Stem Cell Transplantation
MH  - Fetal Blood
MH  - Graft vs Host Disease/immunology
MH  - *Haploidy
MH  - Hematologic Neoplasms/immunology/therapy
MH  - Hematopoietic Stem Cell Transplantation/adverse effects
MH  - Humans
MH  - Transplantation Conditioning
OTO - NOTNLM
OT  - Alternative donor transplant
OT  - Third-party progenitors
OT  - Umbilical cord blood
EDAT- 2016/10/30 06:00
MHDA- 2017/03/03 06:00
CRDT- 2016/10/30 06:00
PHST- 2016/06/02 00:00 [received]
PHST- 2016/07/20 00:00 [accepted]
PHST- 2016/10/30 06:00 [pubmed]
PHST- 2017/03/03 06:00 [medline]
PHST- 2016/10/30 06:00 [entrez]
AID - S0037-1963(16)30066-X [pii]
AID - 10.1053/j.seminhematol.2016.07.004 [doi]
PST - ppublish
SO  - Semin Hematol. 2016 Oct;53(4):257-266. doi: 10.1053/j.seminhematol.2016.07.004. 
      Epub 2016 Jul 25.