title: Cotransplantation of umbilical cord-derived mesenchymal stem cells promote hematopoietic engraftment in cord blood transplantation: a pilot study.
abstract: BACKGROUND
  Delayed hematopoietic reconstitution after cord blood transplantation (CBT) may lead to increased risk of complications and longer hospitalization. Bone marrow-derived mesenchymal stem cells (MSCs) have been found to promote engraftment after hematopoietic stem cell transplantation. However, harvesting MSCs from bone marrow involves an invasive procedure. Then again, MSCs can be easily obtained from umbilical cords without harm to the donors.
  
  
  METHODS
  Umbilical cord-derived MSCs (UCMSCs) were isolated from Wharton's jelly and then ex vivo cultured. After showing normal karyotype and negative for infectious contamination, culture-expanded UCMSCs were intravenously infused into the recipients on the day of CBT. The control patients were those receiving CBT alone. Adverse effects and efficacy of intravenous UCMSCs were evaluated.
  
  
  RESULTS
  A total of five patients received cotransplantation of UCMSCs at the time of CBT. No serious adverse events were observed. The time to achieve neutrophil engraftment ranged from 7 to 13 days (median, 11 days) and platelet engraftment ranged from 22 to 41 days (median, 32 days). Compared with the nine patients receiving CBT alone, patients receiving cotransplantation of UCMSCs had significantly faster hematopoietic recovery of neutrophils and platelets (P=0.02 and 0.01, respectively).
  
  
  CONCLUSIONS
  This pilot study is the first report of cotransplantation of UCMSCs in CBT. Intravenous infusion of UCMSCs appeared to be a feasible and safe modality to enhance hematopoietic engraftment in patients receiving CBT. Further studies were warranted.
authors.affiliation: Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Kang-Hsi
authors.initials: KH
authors.lastname: Wu
authors.forename: Ji-Nan
authors.initials: JN
authors.lastname: Sheu
authors.forename: Han-Ping
authors.initials: HP
authors.lastname: Wu
authors.forename: Chris
authors.initials: C
authors.lastname: Tsai
authors.forename: Martin
authors.initials: M
authors.lastname: Sieber
authors.forename: Ching-Tien
authors.initials: CT
authors.lastname: Peng
authors.forename: Yu-Hua
authors.initials: YH
authors.lastname: Chao
mesh_terms: D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D006410:Hematopoiesis; D006801:Humans; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation / Q000009:adverse effects; D010865:Pilot Projects; D014470:Umbilical Cord / Q000166:cytology*