title: Cellular engineering and therapy in combination with cord blood allografting in pediatric recipients.
abstract: Cord blood (CB) transplantation is an alternate source of human hematopoietic progenitor cells for allogeneic stem cell transplantation in children and adolescents with both malignant and nonmalignant diseases. Current limitations included delay in hematopoietic reconstitution, increased incidence of primary graft failure and slow cellular immunoreconstitution. These limitations lead to a significant increase in primary graft failure, infectious complications and increased transplant-related mortality. There is a number of experimental approaches currently under investigation including cellular engineering to circumvent these limitations. In this review, we summarize the recent findings of utilizing ex vivo CB expansion with Notch1 ligand Delta 1, mesenchymal progenitor cells, the use of human placenta-derived stem cells and CB-derived natural killer cells. Early and preliminary results suggest some of these experimental cellular strategies may in part ameliorate the incidence of primary graft failure, delays in hematopoietic reconstitution and/or slowness in cellular immune reconstitution following unrelated CB transplantation.
authors.affiliation: Department of Pediatrics, Maria Fareri Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, NY, USA.|Department of Medicine, Maria Fareri Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, NY, USA.|Department of Pathology, Maria Fareri Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, NY, USA.|Department of Microbiology and Immunology, Maria Fareri Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, NY, USA.|Department of Cell Biology and Anatomy, Maria Fareri Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Cairo
authors.affiliation: Department of Pediatrics, Cell Therapy Section, MD Anderson Cancer Center, University of Texas, Houston, TX, USA.
authors.forename: N
authors.initials: N
authors.lastname: Tarek
authors.affiliation: Department of Pediatrics, Cell Therapy Section, MD Anderson Cancer Center, University of Texas, Houston, TX, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA.
authors.forename: C
authors.initials: C
authors.lastname: Delaney
mesh_terms: D000293:Adolescent; D064591:Allografts; D060846:Cell Engineering / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation; D005260:Female; D006084:Graft Rejection / Q000378:metabolism / Q000628:therapy*; D006801:Humans; D007223:Infant; D007694:Killer Cells, Natural / Q000378:metabolism / Q000637:transplantation; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation; D059630:Mesenchymal Stem Cells / Q000378:metabolism; D010920:Placenta / Q000378:metabolism; D011247:Pregnancy; D020127:Recovery of Function