Erythrocyte-depleted allogeneic human umbilical cord blood transplantation.
Cord blood is a recently recognized source of hematopoietic stem cells. It can be employed successfully to reconstitute hematopoiesis following allogeneic transplantation. One current drawback of cord blood as a treatment has been a risk of transfusion reactions attributable to ABO blood group mismatch. Removal of red cells from the cord blood has led to reduction of the stem cells by 30-50%. In this paper we report red cell depletion by a method that employs 3% gelatin to effectively sediment the erythrocytes and selectively deplete red cells but permits 94% recovery of nucleated cells and enrichment of colony-forming cells by granulocyte-macrophage colony-forming units, erythrocyte burst-forming units, and granulocyte-macrophage-megakaryocyte colony-forming units in the cord blood preparation. This technique has been employed in our study to remove red cells from the cord blood of a male infant delivered by cesarean section, which has permitted treatment of a female sibling suffering from leukemia. The recipient was 8 years old and weighted 36.7/kg. Complete HLA identity between the two siblings was established. A cord blood cell transplant of cryopreserved and later thawed cells (4 x 10(7) nucleated cells per kilogram) was administered to the patient after intensive myeloablative chemotherapy. The patient exhibited a prompt hematologic recovery (absolute neutrophil count > 500 by day 31, 100% male cells in bone marrow and peripheral blood by day 25) and has experienced a 13-month disease-free survival to date.(ABSTRACT TRUNCATED AT 250 WORDS)
Pahwa
R N
RN
Department of Pediatrics, Schneider Children's Hospital of Long Island Jewish Medical Center, New Hyde Park, New York 11042, USA.
Fleischer
A
A
Shih
S
S
Uckan
D
D
Durham
S
S
Garofalo
P
P
Karayalcin
G
G
Shende
A
A
Redner
A
A
Paley
C
C
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002469:Cell Separation; D002648:Child; D003131:Combined Modality Therapy; D004912:Erythrocytes; D005260:Female; D005312:Fetal Blood / Q000166:cytology*; D005780:Gelatin; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007231:Infant, Newborn; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D012074:Remission Induction
D005780:Gelatin