title: Post-Thaw Viable CD45+ Cells and Clonogenic Efficiency are Associated with Better Engraftment and Outcomes after Single Cord Blood Transplantation in Adult Patients with Malignant Diseases.
abstract: The quantity of cells is widely accepted as the main factor influencing the outcome after umbilical cord blood transplantation (UCBT) however, the quality of the cord blood units (CBUs) has been less studied. In order to determine the impact of qualitative variables in UCBT outcomes, we conducted a multicenter retrospective study in adult patients with hematological malignancies who underwent single UCBT after a common myeloablative conditioning regimen. One hundred and ten patients from 3 institutions [median age, 35 years (range 18-55)] were included. Quantitative (TNC and total CD34+cells) and qualitative variables [viable CD45+ (vCD45+), vCD34+ and clonogenic efficiency [(CLONE), quotient of post-thaw colony-forming units (CFU)] and pre-freeze CD34+ cells predicted engraftment in univariate analysis however, only 2 qualitative variables remained significant in the multivariate analysis. Infusion of more than 2 × 10(7) post-thaw vCD45+ cells per kilogram was significantly associated with faster neutrophil (P = .01), platelet engraftment (P = .01), higher disease-free (P = .01) and overall survival (0.02). In addition, CLONE ≥ 20% predicted a faster neutrophil (P = .005), platelet engraftment (P = .01) and contributed to decrease the non-relapse mortality (P = .02). Our study suggests that the vCD45+ cells dose and CLONE are powerful surrogate markers of graft quality and can potentially help on CBUs selection if tested with representative reference samples.
authors: Adult Hematology Department, Hospital Vall d'Hebron, Barcelona, Spain; Cell Therapy Laboratory, Banc de Sang i Teixits, Barcelona, Spain. Electronic address: nercastillo@vhebron.net.
authors: Nerea
authors: N
authors: Castillo
authors: Adult Hematology Department, Hospital Universitari de la Santa Creu i Sant Pau.
authors: Irene
authors: I
authors: García-Cadenas
authors: Adult Hematology Department, Hospital Vall d'Hebron, Barcelona, Spain.
authors: Pere
authors: P
authors: Barba
authors: Adult Hematology Department, Hospital Universitari de la Santa Creu i Sant Pau.
authors: Rodrigo
authors: R
authors: Martino
authors: Cell Therapy Laboratory, Banc de Sang i Teixits, Barcelona, Spain.
authors: Carmen
authors: C
authors: Azqueta
authors: Adult Hematology Department, Institut Català d'Oncologia-Badalona, Barcelona, Spain.
authors: Christelle
authors: C
authors: Ferrà
authors: Cell Therapy Laboratory, Banc de Sang i Teixits, Barcelona, Spain.
authors: Carme
authors: C
authors: Canals
authors: Adult Hematology Department, Hospital Universitari de la Santa Creu i Sant Pau; IIB Sant Pau and Jose Carreras Research Institutes, Barcelona, Spain.
authors: Jorge
authors: J
authors: Sierra
authors: Adult Hematology Department, Hospital Vall d'Hebron, Barcelona, Spain.
authors: David
authors: D
authors: Valcárcel
authors: Cell Therapy Laboratory, Banc de Sang i Teixits, Barcelona, Spain.
authors: Sergio
authors: S
authors: Querol
mesh_terms: D000293:Adolescent; D000328:Adult; D002999:Clone Cells; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D015925:Cryopreservation; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000517:prevention & control; D019337:Hematologic Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000627:therapeutic use*; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D019653:Myeloablative Agonists
keywords: Quality; Transplantation; Umbilical cord blood