title: Complement fragment 3a priming of umbilical cord blood progenitors: safety profile.
abstract: Preclinical data showed that priming CD34(+) hematopoietic progenitor cells with complement fragment 3a (C3a) improved homing and engraftment. Thus, we hypothesized that priming of umbilical cord blood (UCB) hematopoietic progenitors with C3a would facilitate homing and could potentially be used to address the need for improved engraftment after UCB transplantation. We primed 1 of 2 UCB units for double UCB transplantation after nonmyeloablative conditioning. This design provided adequate safety and the potential to observe skewed long-term chimerism in favor of the C3a-primed unit as a surrogate measure of efficacy. C3a priming of 1 UCB unit did not result in infusional toxicity. Increased grades 1 to 3 hypertension were the only infusional adverse events observed in 9 (30%) patients. We observed no activation of inflammatory or coagulation pathways downstream of C3a. As tested, C3a priming did not impair engraftment, but did not skew chimerism toward the treated unit. As compared with historical controls, mortality and survival were not adversely affected. Thus, before any additional clinical studies, C3a priming to promote engraftment will require further preclinical optimization.
authors.affiliation: Blood and Marrow Transplantation Program, University of Minnesota, Minneapolis, Minnesota. Electronic address: bruns072@umn.edu.
authors.forename: Claudio G
authors.initials: CG
authors.lastname: Brunstein
authors.forename: David H
authors.initials: DH
authors.lastname: McKenna
authors.forename: Todd E
authors.initials: TE
authors.lastname: DeFor
authors.forename: Darin
authors.initials: D
authors.lastname: Sumstad
authors.forename: Philip
authors.initials: P
authors.lastname: Paul
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Weisdorf
authors.forename: Mariusz
authors.initials: M
authors.lastname: Ratajczak
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Laughlin
authors.forename: John E
authors.initials: JE
authors.lastname: Wagner
mesh_terms: D000328:Adult; D000368:Aged; D015926:Complement C3a / Q000008:administration & dosage* / Q000276:immunology; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005312:Fetal Blood / Q000166:cytology* / Q000187:drug effects / Q000276:immunology; D006412:Hematopoietic Stem Cells / Q000166:cytology* / Q000187:drug effects / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D015926:Complement C3a
keywords: Chimerism; Engraftment; Priming; Umbilical cord blood
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