title: Ex Vivo Expansion or Manipulation of Stem Cells to Improve Outcome of Umbilical Cord Blood Transplantation.
abstract: The outcome of umbilical cord blood transplantation for adult patients with hematologic malignancies now rivals that of matched unrelated donor transplantation. However, delayed hematopoietic and immunologic recovery remains a source of significant morbidity and mortality. Multiple strategies are now being studied to overcome these limitations. One strategy involves ex vivo expansion of the umbilical cord blood unit prior to transplantation. A second strategy involves exposure of the umbilical cord blood graft to compounds aimed at improving homing and engraftment following transplantation. Such a strategy may also address the problem of slow hematopoietic recovery as well as the increased risk of graft failure. Many of these strategies are now being tested in late phase multi-center clinical trials. If proven cost-effective and efficacious, they may alter the landscape of donor options for allogeneic stem cell transplantation.
authors.affiliation: Adult Blood and Marrow Transplant Program, Duke University School of Medicine, 2400 Pratt St. DUMC 3961, Durham, NC, 27710, USA. Mitchell.Horwitz@duke.edu.
authors.forename: Mitchell E
authors.initials: ME
authors.lastname: Horwitz
mesh_terms: D018929:Cell Culture Techniques / Q000295:instrumentation / Q000379:methods*; D018920:Coculture Techniques; D015926:Complement C3a / Q000378:metabolism; D015232:Dinoprostone / Q000378:metabolism; D005312:Fetal Blood / Q000166:cytology*; D006031:Glycosylation; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000166:cytology / Q000378:metabolism; D006801:Humans; D009504:Neutrophils / Q000166:cytology / Q000276:immunology; D051880:Receptors, Notch / Q000235:genetics / Q000378:metabolism; D014184:Transplantation, Homologous
chemical_list: D051880:Receptors, Notch; D015926:Complement C3a; D015232:Dinoprostone
keywords: Expansion; Hematopoietic progenitor cell; Hematopoietic recovery; Manipulation; Stem cell transplantation; Umbilical cord blood