title: Analysis of hematopoietic cell transplants using plasma-depleted cord blood products that are not red blood cell reduced.
abstract: Limited cell dose hampers wider use of cord blood transplantation (CBT). By depleting plasma but not RBC during processing, nucleated cell (NC) loss is reduced to <0.1% which increases significantly the proportion of high cell dose products-3-fold for products with NC >or=200 x 10(7). Clinical outcome for plasma depleted (PD) CBT was previously unavailable. A retrospective audited analysis was performed on 118 PD CBT, with mean and median NC doses of 7.6 x 10(7)/kg and 5.6 x 10(7)/kg, respectively, for this mostly pediatric population. The median times to engraftment and engraftment rates for ANC 500 and platelet 20K were 22 and 50 days, respectively, and 90% +/- 3% and 77% +/- 5%, respectively. The incidences of grade III-IV acute graft-versus-host disease (aGVHD) and extensive chronic GVHD (cGVHD) were 13% +/- 4% and 17% +/- 6%, respectively. Relapse rate for malignancies was 25% +/- 6% and 100-day treatment-related mortality (TRM) was 16% +/- 3%. With a median follow-up of 557 days, the 1-year overall survival and relapse-free survival are 65% +/- 5% and 51% +/- 6%, respectively. These results demonstrate that PD CBT is safe and effective, and that eliminating RBC reduction or depletion improves cell recovery during CB processing, resulting in a larger proportion of the inventory with high NC number.
authors.affiliation: StemCyte International Cord Blood Center, Arcadia, California 91722, USA. rchow@stemcyte.com
authors.forename: Robert
authors.initials: R
authors.lastname: Chow
authors.forename: Auayporn
authors.initials: A
authors.lastname: Nademanee
authors.forename: Joseph
authors.initials: J
authors.lastname: Rosenthal
authors.forename: Chatchada
authors.initials: C
authors.lastname: Karanes
authors.forename: Tang-Her
authors.initials: TH
authors.lastname: Jaing
authors.forename: Michael L
authors.initials: ML
authors.lastname: Graham
authors.forename: Elsa
authors.initials: E
authors.lastname: Tsukahara
authors.forename: Brian
authors.initials: B
authors.lastname: Wang
authors.forename: David
authors.initials: D
authors.lastname: Gjertson
authors.forename: Patrick
authors.initials: P
authors.lastname: Tan
authors.forename: Stephen
authors.initials: S
authors.lastname: Forman
authors.forename: Lawrence D
authors.initials: LD
authors.lastname: Petz
mesh_terms: D000293:Adolescent; D000328:Adult; D001771:Blood Banks; D001781:Blood Component Removal; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D015925:Cryopreservation / Q000379:methods*; D005260:Female; D005312:Fetal Blood / Q000166:cytology*; D006085:Graft Survival; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D044469:Racial Groups; D012189:Retrospective Studies; D013624:Taiwan; D014184:Transplantation, Homologous / Q000379:methods; D014481:United States