title: Expanded umbilical cord blood T cells used as donor lymphocyte infusions after umbilical cord blood transplantation.
abstract: BACKGROUND
  Umbilical cord blood (UCB) is an alternative graft source for hematopoietic stem cell transplantation and has been shown to give results comparable to transplantation with other stem cell sources. Donor lymphocyte infusion (DLI) is an effective treatment for relapsed malignancies after hematopoietic stem cell transplantation. However, DLI is not available after UCB transplantation.
  
  
  METHODS
  In this study, in vitro-cultured T cells from the UCB graft were explored as an alternative to conventional DLI. The main aim was to study the safety of the cultured UCB T cells used as DLI because such cell preparations have not been used in this context previously. We also assessed potential benefits of the treatment.
  
  
  RESULTS
  The cultured UCB T cells (UCB DLI) were given to 4 patients with mixed chimerism (n = 2), minimal residual disease (n = 1) and graft failure (n = 1). No adverse reactions were seen at transfusion. Three of the patients did not show any signs of graft-versus-host disease (GVHD) after UCB DLI, but GVHD could not be excluded in the last patient. In the patient with minimal residual disease treated with UCB DLI, the malignant cell clone was detectable shortly before infusion but undetectable at treatment and for 3 months after infusion. In 1 patient with mixed chimerism, the percentage of recipient cells decreased in temporal association with UCB DLI treatment.
  
  
  CONCLUSIONS
  We saw no certain adverse effects of treatment with UCB DLI. Events that could indicate possible benefits were seen but with no certain causal association with the treatment.
authors.affiliation: Center for Allogeneic Stem Cell Transplantation, Karolinska University Hospital, Stockholm, Sweden; Department of Laboratory Medicine, Division of Therapeutic Immunology, Karolinska Institutet, Stockholm, Sweden. Electronic address: sofia.berglund@ki.se.
authors.forename: Sofia
authors.initials: S
authors.lastname: Berglund
authors.affiliation: Department of Laboratory Medicine, Division of Therapeutic Immunology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Jens
authors.initials: J
authors.lastname: Gertow
authors.affiliation: Center for Allogeneic Stem Cell Transplantation, Karolinska University Hospital, Stockholm, Sweden; Department of Laboratory Medicine, Division of Therapeutic Immunology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Michael
authors.initials: M
authors.lastname: Uhlin
authors.affiliation: Center for Allogeneic Stem Cell Transplantation, Karolinska University Hospital, Stockholm, Sweden; Department of Laboratory Medicine, Division of Therapeutic Immunology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Jonas
authors.initials: J
authors.lastname: Mattsson
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005312:Fetal Blood / Q000166:cytology / Q000637:transplantation*; D006086:Graft vs Host Disease / Q000473:pathology / Q000628:therapy; D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013601:T-Lymphocytes
keywords: DLI; T-cell expansion; cell culture; umbilical cord blood