title: Effect of cord blood processing on transplantation outcomes after single myeloablative umbilical cord blood transplantation.
abstract: Variations in cord blood manufacturing and administration are common, and the optimal practice is not known. We compared processing and banking practices at 16 public cord blood banks (CBB) in the United States and assessed transplantation outcomes on 530 single umbilical cord blood (UCB) myeloablative transplantations for hematologic malignancies facilitated by these banks. UCB banking practices were separated into 3 mutually exclusive groups based on whether processing was automated or manual, units were plasma and red blood cell reduced, or buffy coat production method or plasma reduced. Compared with the automated processing system for units, the day 28 neutrophil recovery was significantly lower after transplantation of units that were manually processed and plasma reduced (red cell replete) (odds ratio, .19; P = .001) or plasma and red cell reduced (odds ratio, .54; P = .05). Day 100 survival did not differ by CBB. However, day 100 survival was better with units that were thawed with the dextran-albumin wash method compared with the "no wash" or "dilution only" techniques (odds ratio, 1.82; P = .04). In conclusion, CBB processing has no significant effect on early (day 100) survival despite differences in kinetics of neutrophil recovery.
authors.affiliation: Department of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Karen K
authors.initials: KK
authors.lastname: Ballen
authors.affiliation: Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Brent R
authors.initials: BR
authors.lastname: Logan
authors.affiliation: Cleveland Cord Blood Center, Cleveland, Ohio.
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Laughlin
authors.affiliation: Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Wensheng
authors.initials: W
authors.lastname: He
authors.affiliation: Center for Cancer and Blood Disorders, Children's Hospital Colorado, Aurora, Colorado.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Ambruso
authors.affiliation: MD Anderson Cord Blood Bank, Houston, Texas.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Armitage
authors.affiliation: South Texas Blood and Tissue Center, San Antonio, Texas.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Beddard
authors.affiliation: St.Louis Cord Blood Bank, St. Louis, Missouri.
authors.forename: Deepika
authors.initials: D
authors.lastname: Bhatla
authors.affiliation: Singapore Cord Blood Bank, Ltd., Singapore.
authors.forename: William Y K
authors.initials: WY
authors.lastname: Hwang
authors.affiliation: The Institute for Transfusion Medicine, Pittsburgh, Pennsylvania.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Kiss
authors.affiliation: Dusseldorf Cord Blood Bank, Dusseldorf, Germany.
authors.forename: Gesine
authors.initials: G
authors.lastname: Koegler
authors.affiliation: Division of Pediatric Blood and Marrow Transplantation, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina; Carolinas Cord Blood Bank, Durham, North Carolina.
authors.forename: Joanne
authors.initials: J
authors.lastname: Kurtzberg
authors.affiliation: Division of Internal Medicine, The Bone Marrow Transplantation Department, Sheba Medical Center, Tel-Hashomer, Israel; Sheba Cord Blood Bank, Ramat Gan, Israel.
authors.forename: Arnon
authors.initials: A
authors.lastname: Nagler
authors.affiliation: San Diego Blood Bank, San Diego, California.
authors.forename: David
authors.initials: D
authors.lastname: Oh
authors.affiliation: StemCyte, Covina, California.
authors.forename: Lawrence D
authors.initials: LD
authors.lastname: Petz
authors.affiliation: Puget Sound Blood Center, Seattle, Washington.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Price
authors.affiliation: University of Colorado Cord Blood Bank, Aurora, Colorado.
authors.forename: Ralph R
authors.initials: RR
authors.lastname: Quinones
authors.affiliation: Department of Clinical Arrangements, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan; J.P. McCarthy Cord Stem Cell Bank, Detroit, Michigan.
authors.forename: Voravit
authors.initials: V
authors.lastname: Ratanatharathorn
authors.affiliation: Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Rizzo
authors.affiliation: LifeSouth Community Blood Centers, Gainesville, Florida.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Sazama
authors.affiliation: New York Blood Center, National Cord Blood Program, Long Island City, New York.
authors.forename: Andromachi
authors.initials: A
authors.lastname: Scaradavou
authors.affiliation: Department of Medicine, Stony Brook University Medical Center, Stony Brook, New York; Gift of Life Bone Marrow Foundation, Boca Raton, Florida.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Schuster
authors.affiliation: Children's Hospital of Orange County Cord Blood Bank, Orange, California.
authors.forename: Leonard S
authors.initials: LS
authors.lastname: Sender
authors.affiliation: MD Anderson Cord Blood Bank, Houston, Texas.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Shpall
authors.affiliation: Center for International Blood and Marrow Transplant Research, National Marrow Donor Program, Minneapolis, Minnesota.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Spellman
authors.affiliation: Community Blood Services, Camden, New Jersey.
authors.forename: Millicent
authors.initials: M
authors.lastname: Sutton
authors.affiliation: Michigan Blood Cord Blood Bank, Grand Rapids, Michigan.
authors.forename: Lee Ann
authors.initials: LA
authors.lastname: Weitekamp
authors.affiliation: LifeSouth Community Blood Centers, Gainesville, Florida; Divison of Hematology and Oncology, Department of Medicine, Shands HealthCare and University of Florida, Gainesville, Florida.
authors.forename: John R
authors.initials: JR
authors.lastname: Wingard
authors.affiliation: Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: meapen@mcw.edu.
authors.forename: Mary
authors.initials: M
authors.lastname: Eapen
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D005260:Female; D006412:Hematopoietic Stem Cells / Q000166:cytology*; D006801:Humans; D008297:Male; D019172:Transplantation Conditioning
keywords: Cord blood bank; Processing methods; Survival