Safety of allogeneic umbilical cord blood infusions for the treatment of neurological conditions: a systematic review of clinical studies.


Journal

Cytotherapy
ISSN: 1477-2566
Titre abrégé: Cytotherapy
Pays: England
ID NLM: 100895309

Informations de publication

Date de publication:
01 2022
Historique:
received: 12 05 2021
revised: 30 06 2021
accepted: 02 07 2021
pubmed: 14 8 2021
medline: 2 2 2022
entrez: 13 8 2021
Statut: ppublish

Résumé

Umbilical cord blood (UCB) infusion is being investigated as a treatment for a range of neurological conditions, primarily because of its potent immunomodulatory effects mediated via paracrine signaling. Although initial research mainly utilized autologous UCB, allogeneic samples from a sibling or unrelated donor have now become more common. With the use of allogeneic UCB, questions have arisen surrounding the necessity for human leukocyte antigen (HLA) matching, preparative regimens and immunosuppressant drugs. To investigate the safety of allogeneic UCB for the treatment of neurological conditions and the impact of HLA mismatching and immunosuppresion, the authors conducted a systematic review of the safety of allogeneic UCB infusion for neurological conditions. A systematic review of published and gray literature was conducted to investigate the safety of allogeneic UCB infusions for neurological conditions. Authors identified 10 studies using allogeneic UCB to treat autism spectrum disorder, cerebral palsy, stroke, traumatic brain injury and various other conditions. A total of 361 participants (with at least 442 UCB infusions) received a range of HLA-matched/untyped allogeneic units and cell doses, with the majority not administered post-infusion immunosuppression. There were no reported serious adverse events definitely or probably related to the allogeneic UCB infusion, nor later potential complications such as graft-versus-host disease or teratoma formation. Although variability between studies is high, the available data do not identify safety concerns with allogeneic UCB infusion for the treatment of neurological conditions, even with variable HLA matching or no immunosuppression.

Sections du résumé

BACKGROUND AIMS
Umbilical cord blood (UCB) infusion is being investigated as a treatment for a range of neurological conditions, primarily because of its potent immunomodulatory effects mediated via paracrine signaling. Although initial research mainly utilized autologous UCB, allogeneic samples from a sibling or unrelated donor have now become more common. With the use of allogeneic UCB, questions have arisen surrounding the necessity for human leukocyte antigen (HLA) matching, preparative regimens and immunosuppressant drugs. To investigate the safety of allogeneic UCB for the treatment of neurological conditions and the impact of HLA mismatching and immunosuppresion, the authors conducted a systematic review of the safety of allogeneic UCB infusion for neurological conditions.
METHODS
A systematic review of published and gray literature was conducted to investigate the safety of allogeneic UCB infusions for neurological conditions.
RESULTS
Authors identified 10 studies using allogeneic UCB to treat autism spectrum disorder, cerebral palsy, stroke, traumatic brain injury and various other conditions. A total of 361 participants (with at least 442 UCB infusions) received a range of HLA-matched/untyped allogeneic units and cell doses, with the majority not administered post-infusion immunosuppression. There were no reported serious adverse events definitely or probably related to the allogeneic UCB infusion, nor later potential complications such as graft-versus-host disease or teratoma formation.
CONCLUSIONS
Although variability between studies is high, the available data do not identify safety concerns with allogeneic UCB infusion for the treatment of neurological conditions, even with variable HLA matching or no immunosuppression.

Identifiants

pubmed: 34384698
pii: S1465-3249(21)00715-5
doi: 10.1016/j.jcyt.2021.07.001
pii:
doi:

Substances chimiques

Pharmaceutical Preparations 0

Types de publication

Journal Article Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

2-9

Informations de copyright

Copyright © 2021 International Society for Cell & Gene Therapy. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors have no commercial, proprietary or financial interest in the products or companies described in this article.

Auteurs

Madison C B Paton (MCB)

Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia. Electronic address: madison.paton@cerebralpalsy.org.au.

Donna A Wall (DA)

Bone Marrow Transplant/Cellular Therapy, Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children/University of Toronto, Toronto, Canada; Department of Pediatrics, University of Toronto, Toronto, Canada.

Ngaire Elwood (N)

BMDI Cord Blood Bank, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia.

Kuang-Yueh Chiang (KY)

Bone Marrow Transplant/Cellular Therapy, Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children/University of Toronto, Toronto, Canada; Department of Pediatrics, University of Toronto, Toronto, Canada.

Genevieve Cowie (G)

Cerebral Palsy Alliance, Sydney, Australia.

Iona Novak (I)

Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.

Megan Finch-Edmondson (M)

Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH