Analysis of outcomes of single-unit cord blood transplantation with umbilical cord blood units processed with two different red blood cell sedimentation reagents.
Adolescent
Antigens, CD34
/ analysis
Blood Specimen Collection
/ methods
Child
Cord Blood Stem Cell Transplantation
/ methods
Erythrocyte Count
Erythrocytes
/ cytology
Female
Fetal Blood
/ transplantation
Hematopoietic Stem Cell Transplantation
/ methods
Humans
Hydroxyethyl Starch Derivatives
Indicators and Reagents
Male
Retrospective Studies
Hetastarch
PrepaCyte
transplantation
umbilical cord blood
Journal
Transfusion
ISSN: 1537-2995
Titre abrégé: Transfusion
Pays: United States
ID NLM: 0417360
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
revised:
12
03
2021
received:
17
07
2020
pubmed:
22
5
2021
medline:
23
7
2021
entrez:
21
5
2021
Statut:
ppublish
Résumé
Various processing methodologies are routinely used to reduce volume and red blood cell content of umbilical cord blood (UCB) units collected for hematopoietic stem cell transplantation. There is limited information regarding effects of UCB processing techniques on clinical outcomes. Retrospective data analysis compared laboratory and clinical outcomes following single-unit UCB transplantation performed between 1999 and 2015. All UCB units were from St. Louis Cord Blood Bank and all were manually processed with either Hetastarch processed cord blood units (HCB) (n = 661) or PrepaCyte processed cord blood units (PCB) (n = 84). Additional sensitivity analysis focused on units transplanted from 2010 to 2015 and included 105 HCB and 84 PCB. There were no significant differences in patient characteristics between the two groups. Pre-freeze total nucleated and CD34+ cell counts, cell doses/kg of recipient weight, and total colony-forming units (CFUs) were higher in PCB compared with HCB. Post-thaw, the PCB group had a significantly better total nucleated cell recovery, while there were no significant differences in cell viability, CFU recovery, or CD34+ cell recovery. Primary analysis demonstrated faster neutrophil and platelet engraftment for PCB but no differences in overall survival (OS), whereas sensitivity analysis found no effect of processing method on engraftment, but better OS in the HCB group compared with PCB group. The UCB processing method had no significant impact on engraftment. However, we cannot completely exclude the effect of processing method on OS. Additional studies may be warranted to investigate the potential impact of the PCB processing method on clinical outcomes.
Sections du résumé
BACKGROUND
Various processing methodologies are routinely used to reduce volume and red blood cell content of umbilical cord blood (UCB) units collected for hematopoietic stem cell transplantation. There is limited information regarding effects of UCB processing techniques on clinical outcomes.
STUDY DESIGN AND METHODS
Retrospective data analysis compared laboratory and clinical outcomes following single-unit UCB transplantation performed between 1999 and 2015. All UCB units were from St. Louis Cord Blood Bank and all were manually processed with either Hetastarch processed cord blood units (HCB) (n = 661) or PrepaCyte processed cord blood units (PCB) (n = 84). Additional sensitivity analysis focused on units transplanted from 2010 to 2015 and included 105 HCB and 84 PCB.
RESULTS
There were no significant differences in patient characteristics between the two groups. Pre-freeze total nucleated and CD34+ cell counts, cell doses/kg of recipient weight, and total colony-forming units (CFUs) were higher in PCB compared with HCB. Post-thaw, the PCB group had a significantly better total nucleated cell recovery, while there were no significant differences in cell viability, CFU recovery, or CD34+ cell recovery. Primary analysis demonstrated faster neutrophil and platelet engraftment for PCB but no differences in overall survival (OS), whereas sensitivity analysis found no effect of processing method on engraftment, but better OS in the HCB group compared with PCB group.
CONCLUSION
The UCB processing method had no significant impact on engraftment. However, we cannot completely exclude the effect of processing method on OS. Additional studies may be warranted to investigate the potential impact of the PCB processing method on clinical outcomes.
Substances chimiques
Antigens, CD34
0
Hydroxyethyl Starch Derivatives
0
Indicators and Reagents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1856-1866Informations de copyright
© 2021 AABB.
Références
Gluckman E, Broxmeyer HA, Auerbach AD, Friedman HS, Douglas GW, Devergie A, et al. Hematopoietic reconstitution in a patient with Fanconi's anemia by means of umbilical-cord blood from an HLA-identical sibling. N Engl J Med. 1989;321:1174-8.
Gragert L, Eapen M, Williams E, Freeman J, Spellman S, Baitty R, et al. HLA match likelihoods for hematopoietic stem-cell grafts in the U.S. registry. N Engl J Med. 2014;371:339-48.
Bart T, Boo M, Balabanova S, Fischer Y, Nicoloso G, Foeken L, et al. Impact of selection of cord blood units from the United States and swiss registries on the cost of banking operations. Transfus Med Hemother. 2013;40:14-20.
Harris DT, Schumacher MJ, Rychlik S, Booth A, Acevedo A, Rubinstein P, et al. Collection, separation and cryopreservation of umbilical cord blood for use in transplantation. Bone Marrow Transplant. 1994;13:135-43.
Rubinstein P, Dobrila L, Rosenfield RE, Adamson JW, Migliaccio G, Migliaccio AR, et al. Processing and cryopreservation of placental/umbilical cord blood for unrelated bone marrow reconstitution. Proc Natl Acad Sci U S A. 1995;92:10119-22.
Kaur I, Zulovich JM, Gonzalez M, McGee KM, Ponweera N, Thandi D, et al. Comparison of two methodologies for the enrichment of mononuclear cells from thawed cord blood products: the automated Sepax system versus the manual Ficoll method. Cytotherapy. 2017;19:433-9.
Schwandt S, Korschgen L, Peters S, Kogler G. Cord blood collection and processing with hydroxyethyl starch or non-hydroxyethyl starch. Cytotherapy. 2016;18:642-52.
Solves P, Planelles D, Mirabet V, Blanquer A, Carbonell-Uberos F. Qualitative and quantitative cell recovery in umbilical cord blood processed by two automated devices in routine cord blood banking: a comparative study. Blood Transfus. 2013;11:405-11.
Souri M, Nikougoftar Zarif M, Rasouli M, Golzadeh K, Nakhlestani Hagh M, Ezzati N, et al. Comparison of human umbilical cord blood processing with or without hydroxyethyl starch. Transfusion. 2017;57:2758-66.
Lapierre V, Pellegrini N, Bardey I, Malugani C, Saas P, Garnache F, et al. Cord blood volume reduction using an automated system (Sepax) vs. a semi-automated system (Optipress II) and a manual method (hydroxyethyl starch sedimentation) for routine cord blood banking: a comparative study. Cytotherapy. 2007;9:165-9.
Basford C, Forraz N, Habibollah S, Hanger K, McGuckin C. The cord blood separation league table: a comparison of the major clinical grade harvesting techniques for cord blood stem cells. Int J Stem Cells. 2010;3:32-45.
Eapen M, Klein JP, Ruggeri A, Spellman S, Lee SJ, Anasetti C, et al. Impact of allele-level HLA matching on outcomes after myeloablative single unit umbilical cord blood transplantation for hematologic malignancy. Blood. 2014;123:133-40.
Wagner JE, Barker JN, DeFor TE, Baker KS, Blazar BR, Eide C, et al. Transplantation of unrelated donor umbilical cord blood in 102 patients with malignant and nonmalignant diseases: influence of CD34 cell dose and HLA disparity on treatment-related mortality and survival. Blood. 2002;100:1611-8.
Barker JN, Scaradavou A, Stevens CE. Combined effect of total nucleated cell dose and HLA match on transplantation outcome in 1061 cord blood recipients with hematologic malignancies. Blood. 2010;115:1843-9.
Barker JN, Kurtzberg J, Ballen K, Boo M, Brunstein C, Cutler C, et al. Optimal practices in unrelated donor cord blood transplantation for hematologic malignancies. Biol Blood Marrow Transplant. 2017;23:882-96.
Nikiforow S, Li S, Snow K, Liney D, Kao GS, Haspel R, et al. Lack of impact of umbilical cord blood unit processing techniques on clinical outcomes in adult double cord blood transplant recipients. Cytotherapy. 2017;19:272-84.
Ballen KK, Logan BR, Laughlin MJ, He W, Ambruso DR, Armitage SE, et al. Effect of cord blood processing on transplantation outcomes after single myeloablative umbilical cord blood transplantation. Biol Blood Marrow Transplant. 2015;21:688-95.
Regan D, Wofford J, Fortune K, Henderson C, Akel S. Clinical evaluation of an alternative cord blood processing method. 2011 AABB Annual Meeting and CTTXPO. San Diego, CA: Wiley Online; 2011. 227A.
Naing MW, Gibson DA, Hourd P, Gomez SG, Horton RB, Segal J, et al. Improving umbilical cord blood processing to increase total nucleated cell count yield and reduce cord input wastage by managing the consequences of input variation. Cytotherapy. 2015;17:58-67.
CMDG. PrepaCyte®-WBC PWBC1000 Red Blood Cell Depletion Reagent 2015.
Akel S, Murray C, Ferguson W, Babic A. Outcomes of processing of bone marrow harvests for hematopoietic stem cell transplantation in pediatric patients utilizing a novel red blood cell sedimentation kit. Transfusion. 2019;59:2375-81.
Akel S, Regan D, Wall D, Petz L, McCullough J. Current thawing and infusion practice of cryopreserved cord blood: the impact on graft quality, recipient safety, and transplantation outcomes. Transfusion. 2014;54:2997-3009.
Rocha V, Gluckman E, Eurocord-Netcord r, European B, Marrow Transplant g. Improving outcomes of cord blood transplantation: HLA matching, cell dose and other graft- and transplantation-related factors. Br J Haematol. 2009;147:262-74.
Regan DM, Wofford JD, Wall DA. Comparison of cord blood thawing methods on cell recovery, potency, and infusion. Transfusion. 2010;50:2670-5.
Kim KM, Huh JY, Kim JJ, Kang MS. Quality comparison of umbilical cord blood cryopreserved with conventional versus automated systems. Cryobiology. 2017;78:65-9.
Brunstein CG, Barker JN, Weisdorf DJ, DeFor TE, Miller JS, Blazar BR, et al. Umbilical cord blood transplantation after nonmyeloablative conditioning: impact on transplantation outcomes in 110 adults with hematologic disease. Blood. 2007;110:3064-70.
Mielcarek M, Martin PJ, Heimfeld S, Storb R, Torok-Storb B. CD34 cell dose and chronic graft-versus-host disease after human leukocyte antigen-matched sibling hematopoietic stem cell transplantation. Leuk Lymphoma. 2004;45:27-34.