title: Intrabone transplant of cord blood stem cells establishes a local engraftment store: a functional PET/FDG study.
abstract: BACKGROUND
  Despite advancements in comprehension of molecular mechanisms governing bone marrow (BM) homing of hematopoietic stem cells, cord blood transplant (CBT) suffers from a slow rate of hematopoietic recovery. Intrabone (i.b.) injection has been proposed as a method able to improve speed of BM engraftment with respect to conventional i.v. protocols. However, the mechanisms underlying this benefit are largely unknown.
  
  
  OBJECTIVE
  To verify whether i.b.-CBT determines a local engraftment able to predict the reconstitution of recipient hematopoiesis.
  
  
  METHODS
  Twenty-one patients with hematologic malignancies received i.b. injection into both iliac crests of 3.2 ± 0.68 ∗ 107/kg cord blood cells. One month following i.b.-CBT, PET-CT imaging was performed. Maximal standardized uptake values (SUVs) were assessed in BM of both iliac crests and in all lumbar vertebrae.
  
  
  RESULTS
  Maximal SUV within iliac crests was higher than in lumbar vertebrae (4.1 ± 1.7 versus 3.2 ± 0.7, resp., P = 0.01). However, metabolic activity in these two different BM districts was significantly correlated (r = 0.7, P < 0.001). Moreover, FDG uptake values within the injection site closely predicted platelet recovery 100 days after i.b.-CBT (r = 0.72, P < 0.01).
  
  
  CONCLUSIONS
  The metabolic activity of injected BM predicts the subsequent rate of hematopoietic recovery after i.b.-CBT, suggesting a pivotal role of the local engraftment in the reconstitution of recipient hematopoiesis.
authors.affiliation: CNR Institute of Bioimages and Molecular Physiology, Section of Genoa, Via De Marini 6, 16149 Genoa, Italy.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Marini
authors.forename: Marina
authors.initials: M
authors.lastname: Podestà
authors.forename: Michela
authors.initials: M
authors.lastname: Massollo
authors.forename: Selene
authors.initials: S
authors.lastname: Capitanio
authors.forename: Francesco
authors.initials: F
authors.lastname: Fiz
authors.forename: Silvia
authors.initials: S
authors.lastname: Morbelli
authors.forename: Massimo
authors.initials: M
authors.lastname: Brignone
authors.forename: Andrea
authors.initials: A
authors.lastname: Bacigalupo
authors.forename: Michele
authors.initials: M
authors.lastname: Piana
authors.forename: Francesco
authors.initials: F
authors.lastname: Frassoni
authors.forename: Gianmario
authors.initials: G
authors.lastname: Sambuceti
mesh_terms: D000328:Adult; D000368:Aged; D001842:Bone and Bones / Q000601:surgery*; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D005260:Female; D019788:Fluorodeoxyglucose F18; D019337:Hematologic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18