title: Use of recombinant human deoxyribonuclease (DNase) for processing of a thawed umbilical cord blood transplant in a patient with relapsed acute lymphoblastic leukemia.
abstract: This case report describes for the first time the use of a recombinant human enzyme deoxyribonuclease (rhDNase) containing solution for the processing of a thawed umbilical cord blood (UCB) unit prior to successful transplantation to avoid cell losses by clotting phenomena. A 6-year-old boy received an unrelated 2/6 HLA antigen mismatched UCB transplant for high-risk Burkitt type acute lymphoblastic leukemia. The UCB unit was provided as a volume-reduced sample after buffy coat separation with a final volume of 36 ml. To avoid the loss of nucleated cells due to cell clumping during thawing procedure cells were washed with a solution containing the rhDNase. No visible clotting of the resuspended unit occurred, and the patient was transplanted with 2.9x10(7) nucleated cells/kg body weight without any acute or chronic side effects due to rhDNase. On day +35, PCR analysis of bone marrow aspirate showed complete chimerism, and the child engrafted with an absolute neutrophil count greater than 0.5x10(9)/l on day +47. Platelet transfusion independence was achieved on day +120. In conclusion, the supplementation of rhDNase to the washing and resuspension solutions of a thawed UCB unit is effective to prevent cell losses prior to transplantation. However, further investigations must be performed to confirm the safety of this procedure.
authors.affiliation: Institute of Transfusion Medicine and Immunology, Red Cross Blood Service of Baden-Württemberg-Hessen, College of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany. h.eichler@blutspende.de
authors.forename: H
authors.initials: H
authors.lastname: Eichler
authors.forename: C
authors.initials: C
authors.lastname: Beck
authors.forename: F
authors.initials: F
authors.lastname: Bernard
authors.forename: P
authors.initials: P
authors.lastname: Bugert
authors.forename: H
authors.initials: H
authors.lastname: Klüter
mesh_terms: D001803:Blood Transfusion; D002648:Child; D003850:Deoxyribonuclease I / Q000627:therapeutic use*; D005312:Fetal Blood / Q000187:drug effects*; D005615:Freezing; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D011994:Recombinant Proteins / Q000627:therapeutic use*
chemical_list: D011994:Recombinant Proteins; C085693:DNASE1 protein, human; D003850:Deoxyribonuclease I