title: Posttransplantation engraftment and safety of cord blood transplantation with grafts containing relatively low cell doses in adults.
abstract: The cell dose of a graft is a critical determinant of hematopoietic recovery and survival following unrelated cord blood transplantation. Most studies have found that the minimum acceptable nucleated cell dose should be between 1.5 X 10(7) and 2.0 X 10(7) nucleated cells per kilogram of body weight to reduce the time to myeloid recovery and increase the probability of engraftment. For some patients who have indications for hematopoietic cell transplants and for whom no other graft source except cord blood is available, it is difficult to decide whether they can receive cord blood grafts containing lower cell doses. In our study, patients who received cord blood grafts containing 1.0 X 10(7) to 2.0 X 10(7) cells/kg (n = 7) exhibited slower neutrophil and platelet recoveries compared with patients who received grafts containing total nucleated cell doses of 2.0 X 10(7) cells/kg and above (n = 93); however, 4 of those low-cell-dose recipients survived with a longer follow-up. Based on these preliminary results, cord blood grafts containing less than 2.0 X 10(7) cells/kg may be useful for cases where no grafts with higher cell doses or other stem cell sources are available.
authors.affiliation: Division of Molecular Therapy, Advanced Clinical Research Center, School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan. radius@ims.u-tokyo.ac.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Jun
authors.initials: J
authors.lastname: Ooi
authors.forename: Akira
authors.initials: A
authors.lastname: Tomonari
authors.forename: Takaaki
authors.initials: T
authors.lastname: Konuma
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tsukada
authors.forename: Arinobu
authors.initials: A
authors.lastname: Tojo
authors.forename: Takuhiro
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Asano
mesh_terms: D000293:Adolescent; D000328:Adult; D001772:Blood Cell Count; D036101:Cord Blood Stem Cell Transplantation / Q000401:mortality / Q000592:standards*; D006085:Graft Survival; D006410:Hematopoiesis; D006801:Humans; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology; D010976:Platelet Count; D015996:Survival Rate