(200 mg/kg). Results. Seventeen patients were enrolled and underwent. 1 Department of Pediatrics, Weill Cornell Medical College, New York,

Size: px
Start display at page:

Download "(200 mg/kg). Results. Seventeen patients were enrolled and underwent. 1 Department of Pediatrics, Weill Cornell Medical College, New York,"

Transcription

1 Pediatr Blood Cancer 2014;61: Pilot Trial of Risk-Adapted Cyclophosphamide Intensity Based Conditioning and HLA Matched Sibling and Unrelated Cord Blood Stem Cell Transplantation in Newly Diagnosed Pediatric and Adolescent Recipients with Acquired Severe Aplastic Anemia Catherine McGuinn, MD, 1 Mark B. Geyer, MD, 2 Zhezhen Jin, PhD, 3 James H. Garvin, MD, PhD, 4 Prakash Satwani, MD, 4 M. Brigid Bradley, MD, 4 Monica Bhatia, MD, 4 Diane George, MD, 4 Deirdre Duffy, BS, 5 Erin Morris, RN, BSN, 5 Carmella van de Ven, MA, 5 Joseph Schwartz, MD, 6 Lee Ann Baxter-Lowe, PhD, 7 and Mitchell S. Cairo, MD 5,8,9,10,11 * Background. Cyclophosphamide-based conditioning regimens and allogeneic hematopoietic stem cell transplantation (AlloHSCT) from matched related donors (MRD) has resulted in the highest survival rates in children and adolescents with acquired severe aplastic anemia (SAA). Time to transplant has consistently been associated with decreased overall survival. Reduced toxicity conditioning and AlloHSCT has been used successfully in other pediatric non-malignant diseases. Procedure. We piloted a riskadapted AlloHSCT approach, using fludarabine and anti-thymocyte globulin based conditioning with high (200 mg/kg) and low (60 mg/ kg) dose cyclophosphamide as upfront treatment in newly diagnosed pediatric patients with acquired SAA incorporating alternative donor sources, including cord blood. Average risk for non-engraftment patients with <10 transfusions received low dose cyclophosphamide (60 mg/kg); High Risk, those with 10 transfusions received conditioning regimen with higher intensity cyclophosphamide (200 mg/kg). Results. Seventeen patients were enrolled and underwent AlloHSCT including 12 males and 5 females with mean age of 8 years (range 3 16), and median follow-up time of 39 months (range 1 135). Donor sources included MRD BM (6/6 [n ¼ 9], 5/6 [n ¼ 2]) and unrelated CB (5/6 [n ¼ 4], 4/6 [n ¼ 2]). Five year OS was 67.6% ( ). Three secondary graft failures (17.6%) occurred in the low dose cyclophosphamide arm. Conclusions. Upfront treatment with risk-adapted cyclophosphamide conditioning AlloSCT is well tolerated for the management of newly diagnosed pediatric and adolescent patients with acquired SAA. However, the increased risk of graft rejection in the lower dose arm warrants additional research regarding the optimal intensity of cyclophosphamide-based conditioning regimen to reduce toxicity without increasing graft failure. Pediatr Blood Cancer 2014;61: # 2014 Wiley Periodicals, Inc. Key words: acquired severe aplastic anemia; adolescent; matched donors; pediatric; risk-adapted conditioning; unrelated donors INTRODUCTION Acquired severe aplastic anemia (SAA) is a life-threatening pancytopenia with risk for serious infections and transfusion dependence. Curative upfront therapy in newly diagnosed children and adolescents with SAA is allogeneic hematopoietic stem cell transplantation (AlloHSCT) from a human leukocyte antigen (HLA) matched sibling donor (MSD) [1]. Patients lacking a wellmatched donor are often treated initially with immunosuppressive therapy (IST), anti-thymocyte globulin (ATG), and cyclosporine (CsA), despite a limited response and high failure rate (40 60%) [1]. IST has a cumulative increased risk of clonal transformation [2,3] and potential increased risk of graft rejection [4 6] and graft-versus-host disease (GVHD) [4,5] with increasing transfusion exposure if salvage AlloHSCT is needed. Improvements in donor selection through HLA high resolution typing, optimized conditioning regimens, and supportive care, have resulted in comparable overall survival (OS) using well-matched unrelated donors [7,8]. Given the negative impact of previous IST and risk of transfusional alloimmunization, there is an increasing interest in exploring utilizing AlloHSCT as upfront therapy with well-matched unrelated donors [9]. The challenges to this approach include timely identification of alternative donors, minimizing the risk of graft rejection and balancing the toxicity of transplantrelated mortality (TRM) and late effects. Unfortunately, greater than 70% of patients with SAA will not have a matched related donor (MRD), with decreasing likelihood in ethnically diverse populations. In these patients unrelated cord blood (UCB) presents the unique advantages of rapid availability, enhanced ability to cross donor-recipient mismatch and lower rates of GVHD [10 14]. UCB has been used successfully as a donor C 2014 Wiley Periodicals, Inc. DOI /pbc Published online 12 February 2014 in Wiley Online Library (wileyonlinelibrary.com). Additional Supporting Information may be found in the online version of this article. 1 Department of Pediatrics, Weill Cornell Medical College, New York, New York; 2 Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; 3 Department of Biostatistics, Columbia University, New York, New York; 4 Department of Pediatrics, Columbia University, New York, New York; 5 Department of Pediatrics, New York Medical College, Valhalla, New York; 6 Department of Pathology and Cell Biology, Columbia University, New York, New York; 7 Department of Surgery, University of California San Francisco, San Francisco, California; 8 Department of Medicine, New York Medical College, Valhalla, New York; 9 Department of Pathology, New York Medical College, Valhalla, New York; 10 Department of Microbiology and Immunology, New York Medical College, Valhalla, New York; 11 Department of Cell Biology and Anatomy, New York Medical College, Valhalla, New York Grant sponsor: Pediatric Cancer Research Foundation (PCRF); Grant sponsor: Brittany Barron Fund; Grant sponsor: Marisa Fund; Grant sponsor: Paul Luisi Foundation Conflict of interest: Nothing to declare. Correspondence to: Mitchell S. Cairo, Chief, Pediatric Hematology, Oncology and Stem Cell Transplantation, Director, Children and Adolescent Cancer and Blood Diseases Center, Medical and Scientific Director Cellular and Tissue Engineering Laboratory, Associate Chairman, Department of Pediatrics, Professor of Pediatrics, Medicine, Pathology, Microbiology & Immunology and Cell Biology & Anatomy, Maria Fareri Children s Hospital, Westchester Medical Center New York Medical College, Valhalla, NY Received 6 September 2013; Accepted 16 January 2014

2 1290 McGuinn et al. source in patients with refractory SAA [14 16] with the hurdles of non-engraftment and rejection [17,18] improved by optimizing cell dose [18] and conditioning regimens [14,15]. Risk-adapted conditioning is an alternative strategy in nonmalignant diseases to minimize the long- and short-term morbidity and TRM [19,20]. Conditioning regimens for SAA have focused on reducing radiation exposure, while maintaining engraftment through the judicious use of T-cell targeted immunosuppression [21]. Based on these considerations, we piloted a risk-adapted cyclophosphamide-based conditioning intensity approach stratified according to prior transfusion history, as surrogate for risk of nonengraftment, in pediatric and adolescent patients with newly diagnosed acquired SAA. We compared cyclophosphamide standard dose 200 mg/kg with low dose 60 mg/kg, in combination with fludarabine and rabbit-atg in preparation for AlloHSCT. The objective of the study was to determine the feasibility, safety and efficacy of such a risk-adapted cyclophosphamide-based conditioning intensity approach, including timely identification of UCB units for alternative donor transplants. METHODS Seventeen patients underwent AlloHSCT after meeting diagnostic criteria for acquired SAA [22]. The minimally transfused patients, defined as patients receiving 10 previous transfusions received low dose cyclophosphamide (60 mg/kg) (30 mg/kg, days 3to 2), fludarabine 180 mg/m 2 (30 mg/m 2, days 7to 2) and rabbit-atg (ratg) (Thymoglobulin) 8 mg/kg (2 mg/kg, days 4to 1) (n ¼ 7) as we have previously described [23]. Patients with >10 transfusions, received higher dose cyclophosphamide (200 mg/kg) (50 mg/kg, days 5to 2), fludarabine 180 mg/m 2 (30 mg/m 2, days 7 to 2) and rabbit-atg (Thymoglobulin) 8 mg/kg (2 mg/kg, days 4 to 1) (n ¼ 10). Patients were eligible if they had a fully matched or one antigen-mismatched family donor (6/6 or 5/6) (MRD/mismatched related donor [MMRD]), or 6/6, 5/6 or 4/6 unrelated CB unit with a minimum cryopreserved cell dose of total nucleated cells (TNCs) per kg, washed and thawed [24 26]. All patients/parents signed informed consents and assents (when applicable). All protocols, informed consents and assents were approved by the Institutional Review Board in compliance with the Declaration of Helsinki. HLA-A and HLA-B typing was performed by intermediate resolution molecular testing, and HLA-DRB1 typing was determined by hybridization of PCR- amplified DNA with sequence specific oligonucleotide probes [27,28]. AGVHD prophylaxis consisted of tacrolimus and mycophenolate mofetil (MMF) [29,30]. Tacrolimus was tapered starting on day þ180 if patient had Grade I agvhd. AGVHD and cgvhd were graded according to Seattle criteria [31]. Isolation, transfusions, antibacterial, antifungal and antiviral prophylaxis and growth factor administration were performed according to institutional protocols as previously described [23,32 35]. Neutrophil recovery was defined as an ANC of >500/mm 3 for three consecutive days. Platelet recovery was defined as a platelet count of 20,000/mm 3 independent of transfusions for >7 days. Primary myeloid graft failure was defined as failure to achieve a donor-derived ANC 500/mm 3 by Day þ42 and/or 50% wholeblood donor chimerism by day þ60. Secondary graft failure was defined as achievement of neutrophil engraftment followed by 10 days of ANC 500/mm 3 and <50% whole-blood donor chimerism [23]. Donor chimerism was measured on days þ30, 60, 100, 180 and 365 and yearly after transplant using a PCR-based method involving amplification of genes containing short tandem repeats [34]. Opportunistic infections, viral and bacterial were defined as previously described [23,36,37]. Statistics Statistical analyses were performed in Prism 5.03 (GraphPad, La Jolla, CA). The cutoff date for analysis was December 5, Continuous variables were summarized as mean standard deviation (SD) and categorical variables as percentages. Continuous variables were compared between two groups using two-sample t-tests and categorical variables using chi-square tests. Probabilities of neutrophil and platelet engraftment, agvhd, cgvhd, post-transplantation lymphoproliferative disease (PTLD), day 100 TRM, and OS were estimated using the Kaplan Meier estimators, and comparisons between groups were carried out with log-rank tests. The Cox proportional hazards model was used to identify risk factors of agvhd and OS. A P-value less than 0.05 was considered significant. RESULTS Demographic data including age, prior treatments, time from diagnosis to transplant, donor source, cell source and dose, HLA concordance and period of transplantation are summarized in Tables I and II. Seven patients received 10 prior transfusions, classified as average risk for engraftment, received low dose cyclophosphamide (60 mg/kg) conditioning; 10 patients received >10 transfusion were classified as high risk and received a higher dose of cyclophosphamide (200 mg/kg) (Table I) with a median follow-up was 39 months (1 135). Recipients of higher dose compared with low dose cyclophosphamide did not differ significantly with respect to overall survival, time to neutrophil or platelet engraftment, whole-blood donor chimerism, probability of developing agvhd or cgvhd or incidence of bacterial and opportunistic infections (Fig. 1A C, Supplemental Figure 1A B, and Supplemental Tables I and II). Secondary graft failure occurred in three patients without a statistically significant difference based on donor type, cell source, prior IST, time to transplant, HLA match or conditioning regimen (Table III). However, all three secondary graft failures occurred in patients who received the low dose cyclophosphamide conditioning regimen with an HLA mismatched donor source. The OS in the study was 67.6% (CI 95 : ) (Fig. 2A and 2B). There was no statistically significant difference in OS according to donor type, cell source, conditioning intensity, sex or GVHD status (Table IV). There was a higher risk of overall mortality with a history of prior IST therapy (P ¼ ) and time >6 months from diagnosis to transplant (P ¼ 0.002) (Table IV). At the time of analysis, 12 patients remained alive with a median follow-up of 58 months for survivors. The causes of death in the remaining five patients were multi-organ failure (n ¼ 3), complications related to second AlloHSCT (n ¼ 1), and thrombotic microangiopathy (n ¼ 1). Three patients in our cohort developed PTLD following AlloHSCT. Two of three patients had an autoimmune hepatitis etiology of SAA. However, all three patients who developed PTLD occurred in the high risk group which received the higher dose cyclophosphamide conditioning regimen.

3 Risk-Adapted Upfront AlloHSCT in SAA 1291 TABLE I. Characteristics of Patients and AlloHSCT DISCUSSION All patients N ¼ 17 (%) Low dose Cy High dose Cy N ¼ 7 (41.2%) N ¼ 10 (58.8%) Age Mean 9.2 years 9.5 years 8.9 years Range 3 16 years 6 16 years 3 16 years Gender Male 12 (70.1%) 4 (57.1%) 8 (80%) Female 5 (29.4%) 3 (42.9%) 2 (20%) Prior treatment Immunosuppressive 2 (11.7%) 2 (20%) therapy (IST) No prior IST 15 (88.2%) 7 (100%) 8 (80%) Time from diagnosis to transplant Median 52 days 25 days 62.5 days Range 13 1,223 days days days <6 months 15 (83%) 7 (100%) 8 (80%) 6 months 2 (17%) 2 (20%) Donor source Related 11 (64.7%) 5 (71.4%) 6 (60%) Unrelated 6 (35.3%) 2 (28.6%) 4 (40%) Cell source Bone marrow 11 (64.7%) 5 (71.4%) 6 (60%) Unrelated cord blood 6 (35.3%) 2 (28.6%) 4 (40%) HLA match Related bone marrow Full Match (6/6) 9 (64.7%) 3 (42.8 %) 6 (60%) 1-antigen 2 (11.7%) 2 (28.5 %) mismatch (5/6) Unrelated cord blood 1-antigen 4 (23.5%) 2 (28.5%) 2 (20%) mismatch (5/6) 2-antigen 2 (11.7%) 2 (20%) mismatch (4/6) Date of transplant Before (47.1%) 4 (57.1%) 4 (40%) (52.9%) 3 (42.9 %) 6 (60%) AlloHSCT, allogeneic hematopoietic stem cell transplantation; Cy, cyclophosphamide; PBSC, peripheral blood stem cells; IST, immunosuppressive therapy; CsA, cyclosporine; ATG, anti-thymocyte globulin. Incorporating upfront use of alternative donor sources into the treatment of SAA, we extended the availability of potentially curative AlloHSCT in children and adolescents. The 5-year OS of 67.6% in this risk-adapted approach and AlloHSCT included patients with unrelated CB donor sources and HLA disparate grafts. The improvement in outcomes of alternative donor sources, reinforced by the increasing risk of poor outcomes with increasing time from diagnosis [8,38], pre-treatment with IST [6] and risk of clonal evolution to malignancy [3], support consideration for the role of AlloHSCT as first line therapy for all children diagnosed with acquired SAA. In our limited sample, a previous failed course of IST and prolonged disease duration prior to transplant (>6 months) was associated with a significant increase in mortality. In our series, 4/6 children with acquired SAA are alive following AlloHSCT from TABLE II. Outcomes of Transplantation HLA match Regimen agvhd cgvhd Graft failure Complications Disease status CD /kg TNC 10 8 /kg Donor source Related/ unrelated Time to transplant Prior IST Age/ sex Patient 1 4/M N 134 Unrelated Cord /6 Flu/Cy (200)/ATG N N Alive 2 12/F N 15 Related BM /6 Flu/Cy (60)/ATG N N Alive 3 8/F N 13 Related BM /6 Flu/Cy (60)/ATG N N Secondary Adenovirus/2nd AlloSCT Died 4 7/M Y 584 Related BM /6 Flu/Cy (200)/ATG Y N Multi-system organ failure Died 5 16/M Y 831 Unrelated Cord Flu/Cy (200)/ATG N N Multi-system organ failure Died 6 12/M N 45 Related BM /6 Flu/Cy (200)/ATG Y N Alive 7 11/M N 24 Unrelated Cord /6 Flu/Cy (60)/ATG Y N Secondary Autologous reconstitution Alive 8 6/M N 25 Related BM /6 Flu/Cy (60)/ATG Y N Alive 9 6/M N 52 Unrelated Cord /6 Flu/Cy (60)/ATG N N Alive 10 8/F N 43 Related BM /6 Flu/Cy (60)/ATG N N Secondary Pure RBC aplasia/2nd AlloSCT Alive 11 10/M N 53 Related BM /6 Flu/Cy (200)/ATG N N Thrombotic microangiopathy Died 12 15/F N 59 Related BM /6 Flu/Cy (200)/ATG N N Alive 13 16/F N 62 Related BM /6 Flu/Cy (60)/ATG N N Alive 14 8/M N 85 Unrelated Cord /6 Flu/Cy (200)/ATG N N Alive 15 3/M N 66 Unrelated Cord /6 Flu/Cy (200)/ATG Y Y PTLD/multi-system organ failure Died 16 5/F N 41 Related BM /6 Flu/Cy (200)/ATG N N PTLD Alive 17 9/M N 30 Related BM /6 Flu/Cy (200)/ATG N N PTLD Alive Age/sex indicates age in years; M, male; F, female; IST, immunosuppressive therapy; BM, bone marrow; Flu/Cy(60)/ATG, fludarabine (Flu) 180 mg/m 2 þ cyclophosphamide (Cy) 60mg/kg þ rabbit anti-thymocyte globulin (ratg) 8 mg/kg; Flu/Cy (200)/ATG, Cy 200 mg/kg þ Flu 180 mg/m 2 þ ratg 8 mg/kg.

4 1292 McGuinn et al. Fig. 1. A: Median time to neutrophil engraftment by Kaplan Meier method stratified by intensity of conditioning. B: Median time to platelet engraftment by Kaplan Meier method stratified by intensity of conditioning. C: Time to whole-blood donor chimerism stratified by intensity of conditioning compared using a students t-test. TABLE III. Predictors of Secondary Graft Failure Graft failure Engraftment Total P-value (2-tailed) N 3 18% 14 82% 17 Donor Related 2 18% 9 82% 11 Unrelated 1 17% 5 83% 6 Cell source Marrow 2 18% 9 82% 11 Cord blood 1 17% 5 83% 6 Conditioning intensity High dose cyclophosphamide 0 0% % 10 Low dose cyclophosphamide 3 43% 4 57% 7 Sex Male 1 8% 11 92% 12 Female 2 40% 3 60% 5 HLA match Fully matched 0 0% 9 100% 9 1-antigen mismatch 3 50% 3 50% 6 2-antigen mismatch (all 4/6 cords) 0 0% 2 100% 2 HLA match Fully matched 0 0% 9 100% 9 Not fully matched 3 38% 5 63% 9 Prior IST 1 No prior IST 3 20% 12 80% 15 Prior IST (CsA and/or ATG) 0 0% 2 100% 2 Time to transplant 1 <6 months from diagnosis 3 20% 12 80% 15 6 months from diagnosis 0 0% 2 100% 3 UCBT, umbilical cord blood transplantation; MRD, matched related donor; HLA, human leukocyte antigen; IST, immunosuppressive therapy; CsA, Cyclosporine; ATG, anti-thymocyte globulin.

5 Risk-Adapted Upfront AlloHSCT in SAA 1293 TABLE IV. Predictors of Overall Mortality HR 95% CI P-value Fig. 2. A: Probability of overall survival by Kaplan Meier method. B: Probability of overall survival by Kaplan Meier method stratified by intensity of conditioning. unrelated CB and there was no significant difference in OS based on donor stem cell source. Well-matched CB should be investigated as a potential donor source with acknowledgment of the importance of TNC dose and degree of HLA disparity in CB selection. In our series, the patients treated with two antigen-mismatched CB (4/6) had a trend towards decreased OS, consistent with reports highlighting the increased risk of TRM [39,40], GVHD [39] and infections [39] contributing to inferior outcomes with two antigenmismatched UCBT [39]. Small prospective trials with UCBT in patients with acquired SAA have begun to show potentially encouraging results [15,20,41]. The largest series of UCBT for refractory SAA in 71 adults and pediatric patients from 23 EBMT centers showed a 51% engraftment rate and 38% 3-year OS, with a clear association of outcome with TNC dose [18]. Moving from refractory disease to upfront treatment, a series of eighteen adult patients with newly diagnosed SAA treated with UCBT had an encouraging 2-year survival of 88.9% [17]. This OS included an extremely high incidence of graft failure (16/18 patients) with the hypothesis that the immunosuppressive effect of the combination of T cell-directed conditioning regimen with autologous reconstitution mitigated the impact of graft failure on OS [17]. We did not observe the same magnitude of effect in our pediatric population, but this represents an important concept in envisioning the potential roles for UCBT in management of SAA. OS was comparative between the low dose and higher dose cyclophosphamide groups with 6/7 and 6/10 patients surviving in each group. Importantly, there was a suggestion of increased rates of secondary graft failure with low dose cyclophosphamide conditioning, especially in the setting of mismatched donor sources. While these are small numbers, there is a suggestion that low doses Donor Related 1 Referent Unrelated Cell source Marrow 1 Referent Cord blood Conditioning intensity High dose 1 Referent cyclophosphamide Low dose cyclophosphamide Sex Male 1 Referent Female HLA match Fully matched 1 Referent 1-antigen mismatch antigen mismatch HLA match Fully matched 1 Referent Not fully matched GVHD status agvhd Grades 0 I 1 Referent agvhd Grades II IV Prior IST No prior IST 1 Referent Prior IST 2, (CsA and/or ATG) Time to transplant <6 months from diagnosis 6 months from diagnosis 1 Referent 2, MRD, matched related donor; UCBT, umbilical cord blood transplantation; GVHD, graft-versus-host disease; agvhd, acute graft-versushost disease; cgvhd, chronic graft-versus-host disease; IST, immunosuppressive therapy; CsA, cyclosporine; ATG, anti-thymocyte globulin. of cyclophosphamide may not be adequate for sustained engraftment. The optimal conditioning dose of cyclophosphamide for acquired SAA remains unclear. Preliminary analysis from BMT CTN 0301 (NCT ) identified that omitting cyclophosphamide potentially was associated with increased graft failures, but toxicity at escalating doses met safety stopping criteria; reinforcing the need for additional information to determine the optimal conditioning regimen in SAA AlloHSCT [42]. Limitations of our study include small sample size, heterogeneous donor sources and surrogate, rather than biologic basis, for non-engraftment risk. Patient risk stratification was assigned solely on the number of preceding transfusions. Unfortunately, we did not measure anti-hla antibodies; therefore, exposure to 10 transfusions was a dichotomous categorical point chosen based on historical research regarding a continuously higher risk of nonengraftment and alloimmunization with increasing transfusion exposure [4,5,43,44]. While these historical data straddle the adoption of universal blood product leukoreduction, concerns persist for the risk of rejection in multiply transfused patients [45]. While we acknowledge this as a limitation of our study, increasing

6 1294 McGuinn et al. exposure to transfusions may encompass additional high risk factors such as prolonged time to transplantation, increased risk of infection or even potentially iron load, which was not determined in our study. As our medical center is an ethnically diverse referral center, the interval between diagnosis and HLA results allowing for identification and mobilization of well-matched donor may account for the limited prior IST therapy, despite the majority of patients with >10 transfusion in our series. This highlights the importance of incorporating CB stem cell sources balancing the competing risks of time to transplantation against challenges suitable donor identification [46]. In summary, our data suggest that an upfront risk-adapted cyclophosphamide intensity approach to AlloHSCT from related and alternative unrelated CB donor sources is a feasible strategy for treatment of pediatric and adolescent patients newly diagnosed with SAA. However, the increased risk of graft rejection in the lower dose arm warrants additional research regarding the optimal intensity of cyclophosphamide-based conditioning regimen to reduce toxicity without increasing graft failure. Given the increased risk of prior IST therapy and prolonged duration from diagnosis to transplant, additional prospective trials incorporating unrelated CB donor sources into the upfront treatment of acquired SAA should be explored in patients lacking an HLA matched related donor. ACKNOWLEDGMENTS We would like to thank the patients and their families for participating in this clinical research and the nurses for their assistance in the excellent care of these patients. We would also like to thank Kristen Petrillo, RN, for her assistance with data collection. M.B.B. is Director of Oncology Global Clinical Research, Research and Development, Bristol-Myers Squibb. Presented in part at The American Society for Pediatric Hematology Oncology (ASPHO) Annual Meeting 2011, Baltimore, MD, May, Supported in part by grants from the Pediatric Cancer Research Foundation (PCRF), Brittany Barron Fund, Marisa Fund and the Paul Luisi Foundation. REFERENCES 1. Kojima S, Horibe K, Inaba J, et al. Long-term outcome of acquired aplastic anaemia in children: Comparison between immunosuppressive therapy and bone marrow transplantation. Br J Haematol 2000;111: Bekassy AN, Locasciulli A, MarshJC, etal. ImmunosuppressionwithALGandCsAisfirstlinetreatment in children with SAA lacking an HLA identical sibling. Pediatr Blood Cancer 2005;45: ; author reply Kojima S, Ohara A, Tsuchida M, et al. Risk factors for evolution of acquired aplastic anemia into myelodysplastic syndrome and acute myeloid leukemia after immunosuppressive therapy in children. Blood 2002;100: Anasetti C, Doney KC, Storb R, et al. Marrow transplantation for severe aplastic anemia. Long-term outcome in fifty untransfused patients. Ann Intern Med 1986;104: Deeg HJ, Self S, Storb R, et al. Decreased incidence of marrow graft rejection in patients with severe aplastic anemia: Changing impact of risk factors. Blood 1986;68: Kobayashi R, Yabe H, Hara J, et al. Preceding immunosuppressive therapy with antithymocyte globulin and ciclosporin increases the incidence of graft rejection in children with aplastic anaemia who underwent allogeneic bone marrow transplantation from HLA-identical siblings. Br J Haematol 2006;135: Kennedy-Nasser AA, Leung KS, Mahajan A, et al. Comparable outcomes of matched-related and alternative donor stem cell transplantation for pediatric severe aplastic anemia. Biol Blood Marrow Transplant 2006;12: Yagasaki H, Takahashi Y, Hama A, et al. Comparison of matched-sibling donor BMTand unrelateddonor BMT in children and adolescent with acquired severe aplastic anemia. Bone Marrow Transplant 2010;45: Samarasinghe S, Webb DK. How I manage aplastic anaemia in children. Br J Haematol 2012;157: Cairo MS, Rocha V, Gluckman E, et al. Alternative allogeneic donor sources for transplantation for childhood diseases: Unrelated cord blood and haploidentical family donors. Biol Blood Marrow Transplant 2008;14: CairoMS, WagnerJE. Placental and/orumbilicalcordblood: Analternativesourceofhematopoieticstem cells for transplantation. Blood 1997;90: Liao Y, Geyer MB, Yang AJ, et al. Cord blood transplantation and stem cell regenerative potential. Exp Hematol 2011;39: Wagner JE, Rosenthal J, Sweetman R, et al. Successful transplantation of HLA-matched and HLAmismatched umbilical cord blood from unrelated donors: Analysis of engraftment and acutegraft-versushost disease. Blood 1996;88: Jaing TH, Huang IA, Chen SH, et al. Cord blood transplantation in children with relapsed or refractory severe aplastic anemia. J Pediatr Hematol Oncol 2011;33: Chan KW, McDonald L, Lim D, et al. Unrelated cord blood transplantation in children with idiopathic severe aplastic anemia. Bone Marrow Transplant 2008;42: Geyer MB, Jacobson JS, Freedman J, et al. A comparison of immune reconstitution and graft-versus-host disease following myeloablative conditioning versus reduced toxicity conditioning and umbilical cord blood transplantation in paediatric recipients. Br J Haematol 2011;155: Liu HL, Sun ZM, Geng LQ, et al. Unrelated cord blood transplantation for newly diagnosed patients with severe acquired aplastic anemia using a reduced-intensity conditioning: high graft rejection, but good survival. Bone Marrow Transplant 2012;47: Peffault delatour R, Purtill D, Ruggeri A, et al. Influence of nucleated cell dose on overall survival of unrelated cord blood transplantation for patients with severe acquired aplastic anemia: A study by eurocord and the aplastic anemia working party of the European group for blood and marrow transplantation. Biol Blood Marrow Transplant 2011;17: Satwani P, Morris E, Bradley MB, et al. Reduced intensity and non-myeloablative allogeneic stem cell transplantation in children and adolescents with malignant and non-malignant diseases. Pediatr Blood Cancer 2008;50: Yamamoto H, Kato D, Uchida N, et al. Successful sustained engraftment after reduced-intensity umbilical cord blood transplantation for adult patients with severe aplastic anemia. Blood 2011;117: Chan KW, Li CK, Worth LL, et al. A fludarabine-based conditioning regimen for severe aplastic anemia. Bone Marrow Transplant 2001;27: Alter BP, Young NS. The bone marrow failure syndromes. In: Nathan DG, Orkin SH, editors. Nathan and Oski s hematology of infancy and childhood, 5th edition, volume 1. Philadelphia: W.B. Saunders; pp Geyer MB, Ricci AM, Jacobson JS, et al. T cell depletion utilizing CD34(þ) stem cell selection and CD3 (þ) addback from unrelated adult donorsin paediatric allogeneic stem cell transplantation recipients. Br J Haematol 2012;157: Fraser JK, Cairo MS, Wagner EL, et al. Cord blood transplantation study (COBLT): Cord blood bank standard operating procedures. J Hematother 1998;7: Kurtzberg J, Cairo MS, Fraser JK, et al. Results of the cord blood transplantation (COBLT) study unrelated donor banking program. Transfusion 2005;45: RubinsteinP, DobrilaL, RosenfieldRE, etal. Processingandcryopreservationofplacental/umbilical cord blood for unrelated bone marrow reconstitution. Proc Natl Acad Sci U S A 1995;92: Bradley MB, Satwani P, Baldinger L, et al. Reduced intensity allogeneic umbilical cord blood transplantation in children and adolescent recipients with malignant and non-malignant diseases. Bone Marrow Transplant 2007;40: Petersdorf EW, Smith AG, Haase AM, et al. Polymorphism of HLA-DRw52-associated DRB1 genes as defined by sequence-specific oligonucleotide probe hybridization and sequencing. Tissue Antigens 1991;38: Bhatia M, Militano O, Jin Z, et al. An age-dependent pharmacokinetic study of intravenous and oral mycophenolate mofetil in combination with tacrolimus for GVHD prophylaxis in pediatric allogeneic stem cell transplantation recipients. Biol Blood Marrow Transplant 2010;16: OsunkwoI, BessmertnyO, Harrison L, etal. Apilotstudyof tacrolimusandmycophenolatemofetilgraftversus-host disease prophylaxis in childhood and adolescent allogeneic stem cell transplant recipients. Biol Blood Marrow Transplant 2004;10: Glucksberg H, Storb R, Fefer A, et al. Clinical manifestations of graft-versus-host disease in human recipients of marrow from HL-A-matched sibling donors. Transplantation 1974;18: Roman E, Osunkwo I, Militano O, et al. Liposomal amphotericin B prophylaxis of invasive mold infections in children post allogeneic stem cell transplantation. Pediatr Blood Cancer 2008;50: Shereck EB, Cooney E, van de Ven C, et al. A pilot phase II study of alternate day ganciclovir and foscarnet in preventing cytomegalovirus (CMV) infections in at-risk pediatric and adolescent allogeneic stem cell transplant recipients. Pediatr Blood Cancer 2007;49: Styczynski J, Tallamy B, Waxman I, et al. A pilot study of reduced toxicity conditioning with BU, fludarabine and alemtuzumab before the allogeneic hematopoietic SCTin children and adolescents. Bone Marrow Transplant 2011;46: Waxman IM, Militano O, Baldinger L, et al. Sequential administration of sargramostim and filgrastim in pediatric allogeneic stem cell transplantation recipients undergoing myeloablative conditioning. Pediatr Transplant 2009;13: George D, El-Mallawany NK, Jin Z, et al. Adenovirus infection in paediatric allogeneic stem cell transplantation recipients is a major independent factor for significantly increasing the risk of treatment related mortality. Br J Haematol 2012;156: Ljungman P, Ward KN, Crooks BN, et al. Respiratory virus infections after stem cell transplantation: a prospective study from the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant 2001;28: Perez-Albuerne ED, Eapen M, Klein J, et al. Outcome of unrelated donor stem cell transplantation for children with severe aplastic anemia. Br J Haematol 2008;141: 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: Eapen M, Rubinstein P, Zhang MJ, et al. Outcomes of transplantation of unrelated donor umbilical cord blood and bone marrow in children with acute leukaemia: a comparison study. Lancet 2007;369: Scheinberg P, Young NS. How I treat acquired aplastic anemia. Blood 2012;120: Tolar J, Deeg HJ, Arai S, et al. Fludarabine-based conditioning for marrow transplantation from unrelated donors in severe aplastic anemia: Early results of a cyclophosphamide dose deescalation study show lifethreatening adverse events at predefined cyclophosphamide dose levels. Biol Blood Marrow Transplant 2012;18: Storb R, Prentice RL, Thomas ED, et al. Factors associated with graft rejection after HLA-identical marrow transplantation for aplastic anaemia. Br J Haematol 1983;55: Champlin RE, Horowitz MM, van Bekkum DW, et al. Graft failure following bone marrow transplantation for severe aplastic anemia: Risk factors and treatment results. Blood 1989;73: Desmarets M, Cadwell CM, Peterson KR, et al. Minor histocompatibility antigens on transfused leukoreduced units of red blood cells induce bone marrow transplant rejection in a mouse model. Blood 2009;114: Meyers G, Maziarz RT. Is it time for a change? The case for early application of unrelated allo-sct for severe aplastic anemia. Bone Marrow Transplant 2010;45:

Stem Cell Transplantation In Patients with Fanconi Anemia

Stem Cell Transplantation In Patients with Fanconi Anemia Stem Cell Transplantation In Patients with Fanconi Anemia FARF Annual Family Meeting 6/28/15 Casco, ME Parinda A. Mehta, M.D. Cincinnati Children s Hospital Medical Center Improvements in Unrelated Donor

More information

Stem Cell Transplantation in Severe Aplastic Anemia

Stem Cell Transplantation in Severe Aplastic Anemia Stem Cell Transplantation in Severe Aplastic Anemia Dr. D. Goodyear MD, FRCPC Division of Hematology and Hematological Malignancies, University of Calgary 1 of 11 Introduction Most cases of aplastic anemia

More information

Pr Eliane Gluckman, MD, FRCP, Disclosure of Interest: Nothing to Disclose

Pr Eliane Gluckman, MD, FRCP, Disclosure of Interest: Nothing to Disclose Pr Eliane Gluckman, MD, FRCP, Hospital Saint Louis, University Paris- Diderot, France Should Haplo-identical transplantation be preferred to cord blood in patients without a matched donor? Disclosure of

More information

Selecting an appropriately matched donor for hematopoietic

Selecting an appropriately matched donor for hematopoietic Transplant Outcomes in Acute Leukemia (I) Mary Eapen a and John E. Wagner b Umbilical cord blood (UCB) has gradually emerged over the last decade as an alternative source of hematopoietic cells for transplantation

More information

Fetal Maternal Immunity and Antileukemia Activity in Cord Blood Transplant. Recipients

Fetal Maternal Immunity and Antileukemia Activity in Cord Blood Transplant. Recipients Fetal Maternal Immunity and Antileukemia Activity in Cord Blood Transplant Recipients Filippo Milano, 1 J. Lee Nelson, 1, 2 Colleen Delaney 1,3 1 Clinical Research Division, Fred Hutchinson Cancer Research

More information

In contrast to the very high transplant-related

In contrast to the very high transplant-related Cord Blood: an Alternative Stem Cell Source or a New Standard? Juliet N. BARKER Memorial Sloan-Kettering Cancer Center, NY, ABD In contrast to the very high transplant-related mortality (TRM) associated

More information

UMBILICAL CORD BLOOD TRANSPLANTATION: KFSH EXPERIENCE

UMBILICAL CORD BLOOD TRANSPLANTATION: KFSH EXPERIENCE UMBILICAL CORD BLOOD TRANSPLANTATION: KFSH EXPERIENCE HIND AL HUMAIDAN, MD,FRCPA Director, Blood Bank (Donor & Transfusion Services) and Stem Cell Cord Blood Bank Consultant Hematopathologist INTRODUCTION

More information

The donor search: the best donor or cord blood unit

The donor search: the best donor or cord blood unit The donor search: the best donor or cord blood unit Dr Bronwen Shaw Consultant in haematopoietic cell transplantation Royal Marsden Hospital /Anthony Nolan Overview Where do we find donors/units for transplantation

More information

Bone Marrow, Peripheral Blood Stem Cells or Umbilical Cord Blood transplantation? Federica Giannotti, MD Eurocord-Hôpital Saint Louis, Paris

Bone Marrow, Peripheral Blood Stem Cells or Umbilical Cord Blood transplantation? Federica Giannotti, MD Eurocord-Hôpital Saint Louis, Paris Bone Marrow, Peripheral Blood Stem Cells or Umbilical Cord Blood transplantation? Federica Giannotti, MD Eurocord-Hôpital Saint Louis, Paris Background Hematopoietic stem cell transplantation (HSCT) is

More information

CHAPTER 1 BACKGROUND AND CORD BLOOD BANK (CBB) ORGANIZATION

CHAPTER 1 BACKGROUND AND CORD BLOOD BANK (CBB) ORGANIZATION CHAPTER 1 BACKGROUND AND CORD BLOOD BANK (CBB) ORGANIZATION Chapter 1 BACKGROUND AND CORD BLOOD BANK (CBB) ORGANIZATION 1.1 OVERVIEW OF THE CORD BLOOD TRANSPLANTATION STUDY Bone marrow transplantation

More information

Hematopoietic Stem Cell Transplantation. Imad A. Tabbara, M.D. Professor of Medicine

Hematopoietic Stem Cell Transplantation. Imad A. Tabbara, M.D. Professor of Medicine Hematopoietic Stem Cell Transplantation Imad A. Tabbara, M.D. Professor of Medicine Hematopoietic Stem Cells Harvested from blood, bone marrow, umbilical cord blood Positive selection of CD34 (+) cells

More information

Beyond Cell Dose: Selection of the Optimal Umbilical Cord Blood Unit. Karen Ballen, MD Massachusetts General Hospital June, 2012

Beyond Cell Dose: Selection of the Optimal Umbilical Cord Blood Unit. Karen Ballen, MD Massachusetts General Hospital June, 2012 Beyond Cell Dose: Selection of the Optimal Umbilical Cord Blood Unit Karen Ballen, MD Massachusetts General Hospital June, 2012 OUTLINE Cell Dose HLA Typing HLA C and KIR HLA Antibodies ABO and Racial/Ethnic

More information

Challenges of Hematopoietic Stem Cell Transplantation. Robert J. Soiffer, MD Dana Farber Cancer Institute

Challenges of Hematopoietic Stem Cell Transplantation. Robert J. Soiffer, MD Dana Farber Cancer Institute Challenges of Hematopoietic Stem Cell Transplantation Robert J. Soiffer, MD Dana Farber Cancer Institute Hematopoietic Stem Cell Transplantation Objectives Deliver sufficient chemo-radio therapy to destroy

More information

Myeloablative versus Reduced Intensity Conditioning Regimen Cord Blood Transplants

Myeloablative versus Reduced Intensity Conditioning Regimen Cord Blood Transplants Educational 2 Cord Blood Transplantation Myeloablative versus Reduced Intensity Conditioning Regimen Cord Blood Transplants William Arcese University of Rome Tor Vergata Rome Transplant Network 4th April

More information

Selection of the Optimal Umbilical Cord Blood Unit

Selection of the Optimal Umbilical Cord Blood Unit Karen Ballen, MD Selection of the Optimal Umbilical Cord Blood Unit Massachusetts General Hospital September, 2013 OUTLINE Cell Dose HLA Match Allele Level HLA C KIR Directional Mismatch NIMA HLA Antibodies

More information

Placental/Umbilical Cord Blood as a Source of Stem Cells. Original Policy Date

Placental/Umbilical Cord Blood as a Source of Stem Cells. Original Policy Date MP 7.01.38 Placental/Umbilical Cord Blood as a Source of Stem Cells Medical Policy Section Surgery Issue 12:2013 Original Policy Date 12:2013 Last Review Status/Date Reviewed with literature search/12:2013

More information

Sibling Donor Cord Blood Transplantation for Thalassemia Major: Experience of the Sibling Donor Cord Blood Program

Sibling Donor Cord Blood Transplantation for Thalassemia Major: Experience of the Sibling Donor Cord Blood Program Sibling Donor Cord Blood Transplantation for Thalassemia Major: Experience of the Sibling Donor Cord Blood Program MARK C. WALTERS, LYNN QUIROLO, ELIZABETH T. TRACHTENBERG, SANDIE EDWARDS, LISA HALE, JOANNA

More information

Placental and Umbilical Cord Blood as a Source of Stem Cells

Placental and Umbilical Cord Blood as a Source of Stem Cells Placental and Umbilical Cord Blood as a Source of Stem Cells Policy Number: 7.01.50 Last Review: 12/2015 Origination: 12/2001 Next Review: 12/2016 Policy Blue Cross and Blue Shield of Kansas City (Blue

More information

Cord Blood: that other stem cell source. Donna Wall, MD Director, Manitoba Blood and Marrow Transplant Program

Cord Blood: that other stem cell source. Donna Wall, MD Director, Manitoba Blood and Marrow Transplant Program Cord Blood: that other stem cell source Donna Wall, MD Director, Manitoba Blood and Marrow Transplant Program CBMTG April 2012 The problem: In order to perform a BMT from one person to another one needs

More information

Navelstrengbloed tegen kanker

Navelstrengbloed tegen kanker Navelstrengbloed tegen kanker THERAPIEDAG 2008: "Zorgtrajecten in kanker" Zaterdag 27 september 2008 Gasthuisberg, Leuven. Hélène Schoemans, MD KUL, Stem Cell Institute Leuven Cord blood Collection and

More information

A Cure for Sickle Cell Anemia and Thalassemia

A Cure for Sickle Cell Anemia and Thalassemia IV Simpósio Internacional de Hemoglobinopatias A Cure for Sickle Cell Anemia and Thalassemia Bertram Lubin, MD and Mark Walters, MD 4 September 2007 Topics to be covered Cord blood: Importance and biology

More information

Placental and Umbilical Cord Blood as a Source of Stem Cells

Placental and Umbilical Cord Blood as a Source of Stem Cells Placental and Umbilical Cord Blood as a Source of Stem Cells Policy Number: 7.01.50 Last Review: 12/2013 Origination: 12/2001 Next Review: 12/2014 Policy Blue Cross and Blue Shield of Kansas City (Blue

More information

One-Unit versus Two-Unit Cord-Blood Transplantation for Hematologic Cancers

One-Unit versus Two-Unit Cord-Blood Transplantation for Hematologic Cancers The new england journal of medicine Original Article One-Unit versus Two-Unit Cord-Blood Transplantation for Hematologic Cancers John E. Wagner, Jr., M.D., Mary Eapen, M.B., B.S., Shelly Carter, D.Sc.,

More information

Umbilical Cord Blood Transplantation

Umbilical Cord Blood Transplantation Umbilical Cord Blood Transplantation V Rocha MD, PhD Hopital Saint Louis, Paris University 7 CIBMTR Milwaukee Umbilical Cord blood transplantation Background History Clinical results in children and adults

More information

Placental and Umbilical Cord Blood as a Source of Stem Cells

Placental and Umbilical Cord Blood as a Source of Stem Cells Placental and Umbilical Cord Blood as a Source of Stem Cells Policy Number: 7.01.50 Last Review: 12/2014 Origination: 12/2001 Next Review: 12/2015 Policy Blue Cross and Blue Shield of Kansas City (Blue

More information

Pros and Cons of Stem Cell Sources and their availability in Africa. Dr Jaimendra Singh Inkosi Albert Luthuli Central Hospital Durban, South Africa

Pros and Cons of Stem Cell Sources and their availability in Africa. Dr Jaimendra Singh Inkosi Albert Luthuli Central Hospital Durban, South Africa Pros and Cons of Stem Cell Sources and their availability in Africa Dr Jaimendra Singh Inkosi Albert Luthuli Central Hospital Durban, South Africa Introduction The ability to perform a haematopoietic stem

More information

UMBILICAL-CORD BLOOD TRANSPLANTATION FOR THE TREATMENT OF CANCER

UMBILICAL-CORD BLOOD TRANSPLANTATION FOR THE TREATMENT OF CANCER UMBILICAL-CORD BLOOD TRANSPLANTATION FOR THE TREATMENT OF CANCER Juliet N. Barker* and John E. Wagner Haematopoietic stem-cell transplantation is used to treat many haematological cancers, but is limited

More information

Program Co-Chairmen: Dr. John Wagner, University of Minnesota Dr. Richard Champlin, M.D. Anderson Cancer Center

Program Co-Chairmen: Dr. John Wagner, University of Minnesota Dr. Richard Champlin, M.D. Anderson Cancer Center (last updated May 13, 2004) This is an activity offered by CBBS, a CMA accredited provider. Physicians attending this course may report up to 13.25 hours of Category 1 credits toward the California Medical

More information

Name of Policy: Placental/Umbilical Cord Blood as a Source of Stem Cells

Name of Policy: Placental/Umbilical Cord Blood as a Source of Stem Cells Name of Policy: Placental/Umbilical Cord Blood as a Source of Stem Cells Policy #: 439 Latest Review Date: September 2014 Category: Medical Policy Grade: A Background/Definitions: As a general rule, benefits

More information

Unrelated donor umbilical cord blood transplantation for the treatment of hematologic malignancies Craig Sauter and Juliet N.

Unrelated donor umbilical cord blood transplantation for the treatment of hematologic malignancies Craig Sauter and Juliet N. Unrelated donor umbilical cord blood transplantation for the treatment of hematologic malignancies Craig Sauter and Juliet N. Barker Adult Allogeneic Bone Marrow Transplantation Service, Memorial Sloan-Kettering

More information

Section: Transplant Last Reviewed Date: January 2015. Policy No: 45.16 Effective Date: April 1, 2015

Section: Transplant Last Reviewed Date: January 2015. Policy No: 45.16 Effective Date: April 1, 2015 Medical Policy Manual Topic: Placental and Umbilical Cord Blood as a Source of Stem Cells Date of Origin: December 2009 Section: Transplant Last Reviewed Date: January 2015 Policy No: 45.16 Effective Date:

More information

Corporate Medical Policy

Corporate Medical Policy Corporate Medical Policy Hematopoietic Stem-Cell Transplantation for CLL and SLL File Name: Origination: Last CAP Review: Next CAP Review: Last Review: hematopoietic_stem-cell_transplantation_for_cll_and_sll

More information

Cord Blood Transplant. E. Gluckman Eurocord ESH-EBMT training course Vienna 2014

Cord Blood Transplant. E. Gluckman Eurocord ESH-EBMT training course Vienna 2014 Cord Blood Transplant E. Gluckman Eurocord ESH-EBMT training course Vienna 2014 Background Since 1988, umbilical cord blood (CB) has been successfully used to treat children and adults needing stem cell

More information

POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT VARIATIONS DISCLAIMER CODING INFORMATION REFERENCES POLICY HISTORY

POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT VARIATIONS DISCLAIMER CODING INFORMATION REFERENCES POLICY HISTORY Original Issue Date (Created): 4/1/2011 Most Recent Review Date (Revised): 3/24/2015 Effective Date: 6/1/2015 POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT VARIATIONS DISCLAIMER

More information

HAPLO-CORD HEMATOPOIETIC STEM CELL TRANSPLANTATION

HAPLO-CORD HEMATOPOIETIC STEM CELL TRANSPLANTATION HAPLO-CORD HEMATOPOIETIC STEM CELL TRANSPLANTATION Frequency, Risk Factors and Outcomes of Cord Graft Failure (CGF) After Haplo-Cord Transplantation Stephanie B. Tsai, MD Fellow in Hematology-Oncology

More information

Umbilical Cord Blood: An Alternative Allogeneic Stem Cell Source for Transplantation

Umbilical Cord Blood: An Alternative Allogeneic Stem Cell Source for Transplantation Umbilical Cord Blood: An Alternative Allogeneic Stem Cell Source for Transplantation Mary J. Laughlin, MD Associate Professor of Medicine and Pathology Dr. Donald and Ruth Weber Goodman Professor of Innovative

More information

Graft Failure After HSCT

Graft Failure After HSCT Graft Failure After HSCT Vanderson Rocha, MD, PhD Professor of Haematology- Oxford University Bone Marrow Transplant Unit- Sirio Libanes Hospital- Sao Paulo Scientific Director of Eurocord-Paris Clinical

More information

Disclosures. I have no disclosures.

Disclosures. I have no disclosures. Not Your Own Marrow Jenni Krajewski, MD Clinical Assistant Professor, Rutgers New Jersey Medical School Attending Physician, Pediatric Blood and Marrow Transplantation The Institute for Pediatric Cancer

More information

Cord Blood for Cellular Therapy: A Snapshot of this Evolving Market Landscape

Cord Blood for Cellular Therapy: A Snapshot of this Evolving Market Landscape GENReports: Market & Tech Analysis Cord Blood for Cellular Therapy: A Snapshot of this Evolving Market Landscape > Enal Razvi, Ph.D. Biotechnology Analyst, Managing Director SELECTBIO US enal@selectbio.us

More information

The Value of Cord Blood Stem Cells. Mona Shafey, MD, FRCPC Medical Grand Rounds October 25 th, 2011

The Value of Cord Blood Stem Cells. Mona Shafey, MD, FRCPC Medical Grand Rounds October 25 th, 2011 The Value of Cord Blood Stem Cells Mona Shafey, MD, FRCPC Medical Grand Rounds October 25 th, 2011 Objectives To discuss umbilical cord blood as a stem cell source and the role of umbilical cord blood

More information

2011 Update on the ECIL-3 guidelines for EBV management in patients with leukemia and other hematological disorders

2011 Update on the ECIL-3 guidelines for EBV management in patients with leukemia and other hematological disorders UPDATE ECIL-4 2011 2011 Update on the ECIL-3 guidelines for EBV management in patients with leukemia and other hematological disorders Jan Styczynski, Hermann Einsele, Rafael de la Camara, Catherine Cordonnier,

More information

Hematology, National Research Cancer Center - Istituto Tumori Giovanni Paolo II, Bari, Italy;

Hematology, National Research Cancer Center - Istituto Tumori Giovanni Paolo II, Bari, Italy; DCTH - 3 2014-125-131 CASE REPORT An alternative strategy for cord blood stem cells transplant to reduce time of neutrophils engraftment: case report of co-infusion of haploidentical and cord blood stem

More information

INFORMATION ON STEM CELLS/BONE MARROW AND REINFUSION/TRANSPLANTATION SUR703.002

INFORMATION ON STEM CELLS/BONE MARROW AND REINFUSION/TRANSPLANTATION SUR703.002 INFORMATION ON STEM CELLS/BONE MARROW AND REINFUSION/TRANSPLANTATION SUR703.002 COVERAGE: SPECIAL COMMENT ON POLICY REVIEW: Due to the complexity of the Peripheral and Bone Marrow Stem Cell Transplantation

More information

Transplantation of cord blood stem cells from related or unrelated donors is considered investigational in all other situations.

Transplantation of cord blood stem cells from related or unrelated donors is considered investigational in all other situations. MEDICAL POLICY POLICY RELATED POLICIES POLICY GUIDELINES DESCRIPTION SCOPE BENEFIT APPLICATION RATIONALE REFERENCES CODING APPENDIX HISTORY Placental and Umbilical Cord Blood as a Source of Stem Cells

More information

Corporate Medical Policy Cord Blood as a Source of Stem Cells

Corporate Medical Policy Cord Blood as a Source of Stem Cells Corporate Medical Policy Cord Blood as a Source of Stem Cells File Name: Origination: Last CAP Review: Next CAP Review: Last Review cord_blood_as_a_source_of_stem_cells 2/2001 3/2015 3/2016 3/2015 Description

More information

Umbilical Cord Blood Stem Cells Current Status & Future Potential

Umbilical Cord Blood Stem Cells Current Status & Future Potential Umbilical Cord Blood Stem Cells Current Status & Future Potential Natasha Ali Assistant Professor Haematology Department of Pathology & Laboratory Medicine/Oncology The Aga Khan University Email: natasha.ali@aku.edu

More information

Cord Blood Biology and Transplantation

Cord Blood Biology and Transplantation Cord Blood Biology and Transplantation Yossi Cohen MD MSc and Arnon Nagler MD Institute of Hematology, Department of Bone Marrow Transplantation and Cord Blood Bank, Sheba Medical Center, Tel Hashomer,

More information

Clinical Outcomes of Unrelated Donor Umbilical Cord Blood Transplantation for 30 Adults with Hematological Malignancies

Clinical Outcomes of Unrelated Donor Umbilical Cord Blood Transplantation for 30 Adults with Hematological Malignancies Clinical Outcomes of Unrelated Donor Umbilical Cord Blood Transplantation for 30 Adults with Hematological Malignancies KOICHIRO KOBAYASHI 1, YOSHINOBU MAEDA 1, YOSHITAKA HARA 1, MIYUKI NISHIE-KATAOKA

More information

* CHAPTER 6. Choice of the donor according to HLA typing and stem cell source. Eliane Gluckman

* CHAPTER 6. Choice of the donor according to HLA typing and stem cell source. Eliane Gluckman * CHAPTER 6 Choice of the donor according to HLA typing and stem cell source Eliane Gluckman CHAPTER 6 Choice of the donor according to HLA typing and stem cell source 1. Introduction Allogeneic haematopoietic

More information

Corporate Medical Policy Hematopoietic Stem-Cell Transplantation for Breast Cancer

Corporate Medical Policy Hematopoietic Stem-Cell Transplantation for Breast Cancer Corporate Medical Policy Hematopoietic Stem-Cell Transplantation for Breast Cancer File Name: Origination: Last CAP Review: Next CAP Review: Last Review: hematopoietic_stem_cell_transplantation_for_breast_cancer

More information

Double cord blood transplantation

Double cord blood transplantation DCTH - 2 2013-113-121 REVIEW Double cord blood transplantation R. Angarano, I. Donnini, B. Bartolozzi, A. Bosi Ematologia, Azienda Ospedaliera Universitaria Careggi, Università di Firenze, Italy SUMMARY

More information

Outcome of Unrelated HSCT in Patients Lacking HLA Matched Related Donors: Iranian Stem Cell Donor Program (ISCDP)

Outcome of Unrelated HSCT in Patients Lacking HLA Matched Related Donors: Iranian Stem Cell Donor Program (ISCDP) Outcome of Unrelated HSCT in Patients Lacking HLA Matched Related Donors: Iranian Stem Cell Donor Program (ISCDP) October 18, 2014 19th Congress of APBMT, Hangzhou, China AMIR ALI HAMIDIEH, MD Iranian

More information

Bone Marrow, Peripheral Blood Stem Cells or Umbilical Cord Blood transplantation? E. Gluckman WBMT meeting Cape Town November 14-16, 2014

Bone Marrow, Peripheral Blood Stem Cells or Umbilical Cord Blood transplantation? E. Gluckman WBMT meeting Cape Town November 14-16, 2014 Bone Marrow, Peripheral Blood Stem Cells or Umbilical Cord Blood transplantation? E. Gluckman WBMT meeting Cape Town November 14-16, 2014 The ideal HSCs source Immediate availability Few HLA restrictions

More information

EUROCORD. in 49 countries and 484 transplant centres* 264 EBMT 4847 (73%) cases 220 Non-EBMT 1797 (27%) cases

EUROCORD. in 49 countries and 484 transplant centres* 264 EBMT 4847 (73%) cases 220 Non-EBMT 1797 (27%) cases ! 21%! EUROCORD 6756 cord blood transplantations performed from 1988 to March 2010 in 49 countries and 484 transplant centres* 264 EBMT 4847 (73%) cases 220 Non-EBMT 1797 (27%) cases * missing center

More information

Corporate Medical Policy Cord Blood as a Source of Stem Cells

Corporate Medical Policy Cord Blood as a Source of Stem Cells Corporate Medical Policy Cord Blood as a Source of Stem Cells File Name: Origination: Last CAP Review: Next CAP Review: Last Review cord_blood_as_a_source_of_stem_cells 2/2001 3/2015 3/2016 3/2015 Description

More information

Cord Blood Market Trends, circa 2014

Cord Blood Market Trends, circa 2014 GENReports: Market & Tech Analysis Cord Blood Market Trends, circa 2014 > Enal Razvi, Ph.D. Managing Director Select Biosciences, Inc. enal@selectbio.us Topic Introduction and Scope The focus of this GEN

More information

ANTHONY NOLAN SEARCH ALGORITHM FOR A BASIC CORD BLOOD UNIT SELECTION BY SERGIO QUEROL AND IRINA EVSEEVA FEBRUARY 2012

ANTHONY NOLAN SEARCH ALGORITHM FOR A BASIC CORD BLOOD UNIT SELECTION BY SERGIO QUEROL AND IRINA EVSEEVA FEBRUARY 2012 ANTHONY NOLAN SEARCH ALGORITHM FOR A BASIC CORD BLOOD UNIT SELECTION BY SERGIO QUEROL AND IRINA EVSEEVA FEBRUARY 2012 PAGE 1 OF 7 PRINCIPLES FOR A NEW ALGORITHM Once cord blood transplantation (CBT) is

More information

Narrator: Transplants using stem cells from the blood, bone marrow or umbilical cord blood

Narrator: Transplants using stem cells from the blood, bone marrow or umbilical cord blood [Track 2: What Is a Transplant?] Narrator: Transplants using stem cells from the blood, bone marrow or umbilical cord blood can be an effective treatment for people with blood cancers such as leukemia,

More information

Bone Marrow Transplantation and Peripheral Blood Stem Cell Transplantation: Questions and Answers. Key Points

Bone Marrow Transplantation and Peripheral Blood Stem Cell Transplantation: Questions and Answers. Key Points CANCER FACTS N a t i o n a l C a n c e r I n s t i t u t e N a t i o n a l I n s t i t u t e s o f H e a l t h D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s Bone Marrow Transplantation

More information

Advances in HSC Transplantation for Myelodysplasia: Cord Blood Transplantation & RIC

Advances in HSC Transplantation for Myelodysplasia: Cord Blood Transplantation & RIC Advances in HSC Transplantation for Myelodysplasia: Cord Blood Transplantation & RIC -7-6 -5-4 -3-2 -1 0 30 100 CSA/ MMF Juliet N. Barker, MBBS (Hons), FRACP Associate Attending Director Cord Blood Transplant

More information

Cord Blood Transplant Past and Future. E. Gluckman Eurocord ISCT Paris 24/04/2014

Cord Blood Transplant Past and Future. E. Gluckman Eurocord ISCT Paris 24/04/2014 Cord Blood Transplant Past and Future E. Gluckman Eurocord ISCT Paris 24/04/2014 Background Since 1988, umbilical cord blood (CB) has been successfully used to treat children and adults needing stem cell

More information

Hematologic Malignancies/Stem Cell Transplantation Program Clinical Section UCLA Health System Los Angeles, CA 90095

Hematologic Malignancies/Stem Cell Transplantation Program Clinical Section UCLA Health System Los Angeles, CA 90095 Hematologic Malignancies/Stem Cell Transplantation Program Clinical Section UCLA Health System Los Angeles, CA 90095 CS 6.4 DIAGNOSIS AND MANAGEMENT OF CYTOMEGALOVIRUS (CMV) INFECTION AND DISEASE Location:

More information

Umbilical Cord Blood (UCB) Transplantation: An Alternative to the Use of Unrelated Volunteer Donors?

Umbilical Cord Blood (UCB) Transplantation: An Alternative to the Use of Unrelated Volunteer Donors? Umbilical Cord Blood (UCB) Transplantation: An Alternative to the Use of Unrelated Volunteer Donors? Juliet N. Barker Memorial Sloan-Kettering Cancer Center, New York, NY Cryopreserved umbilical cord blood

More information

Umbilical cord blood transplantation

Umbilical cord blood transplantation Review article http://dx.doi.org/10.3345/kjp.2012.55.7.219 Korean J Pediatr 2012;55(7):219-223 eissn 1738-1061 pissn 2092-7258 Umbilical cord blood transplantation Hong Hoe Koo, MD 1, Hyo Seop Ahn, MD

More information

Blood-Forming Stem Cell Transplants

Blood-Forming Stem Cell Transplants Blood-Forming Stem Cell Transplants What are bone marrow and hematopoietic stem cells? Bone marrow is the soft, sponge-like material found inside bones. It contains immature cells known as hematopoietic

More information

10 th Annual International Cord Blood Transplantation Symposium June 7-9, 2012 Preliminary Scientific Program. Thursday, June 7

10 th Annual International Cord Blood Transplantation Symposium June 7-9, 2012 Preliminary Scientific Program. Thursday, June 7 10 th Annual International Cord Blood Transplantation Symposium June 7-9, 2012 Preliminary Scientific Program Thursday, June 7 7:00 8:00 AM Breakfast in Exhibit Hall Session IA 8:00 10:00 AM Advances in

More information

Comparison of Unrelated Cord Blood Transplantation and HLA-Mismatched Unrelated Bone Marrow Transplantation for Adults with Leukemia

Comparison of Unrelated Cord Blood Transplantation and HLA-Mismatched Unrelated Bone Marrow Transplantation for Adults with Leukemia Comparison of Unrelated Cord Blood Transplantation and HLA-Mismatched Unrelated Bone Marrow Transplantation for Adults with Leukemia Yoshiko Atsuta, 1 Yasuo Morishima, 2, * Ritsuro Suzuki, 1 Tokiko Nagamura-Inoue,

More information

Cord Cor Blood Banking Scott N. Furlan, MD Ellen S. Plummer, Plummer MD

Cord Cor Blood Banking Scott N. Furlan, MD Ellen S. Plummer, Plummer MD Cord Blood Banking Scott N. Furlan, MD Ellen S.Plummer, MD Overview Background Biology of Stem Cell Transplant Opportunities i at Parkland Logistics of Banking Potential Barriers Indications for HCT Cancer

More information

THE INFLUENCE OF TISSUE (IN)COMPATIBILITY IN UMBILICAL CORD BLOOD TRANSPLANTATION

THE INFLUENCE OF TISSUE (IN)COMPATIBILITY IN UMBILICAL CORD BLOOD TRANSPLANTATION THE INFLUENCE OF TISSUE (IN)COMPATIBILITY IN UMBILICAL CORD BLOOD TRANSPLANTATION Matjaž Jeras Blood Transfusion Centre of Slovenia Tissue Typing Center Šlajmerjeva 6, 1000 Ljubljana, Slovenia matjaz.jeras@ztm.si

More information

Therapeutic Treatment Options: Chronic Blood Transfusions Bone Marrow Transplantation. Marianne E. McPherson Yee, MD, MSc

Therapeutic Treatment Options: Chronic Blood Transfusions Bone Marrow Transplantation. Marianne E. McPherson Yee, MD, MSc Therapeutic Treatment Options: Chronic Blood Transfusions Bone Marrow Transplantation Marianne E. McPherson Yee, MD, MSc Sickle Cell Treatment Options Supportive Care Newborn Screen PCN Immunizations Education

More information

Hematologic Malignancies/Stem Cell Transplantation Program Clinical Section UCLA Health System Los Angeles, CA 90095

Hematologic Malignancies/Stem Cell Transplantation Program Clinical Section UCLA Health System Los Angeles, CA 90095 Clinical Section UCLA Health System Los Angeles, CA 90095 CS 6.2 DIAGNOSIS AND MANAGEMENT OF INTERSTITIAL PNEUMONIA Location: Clinical Section Supersedes/Replaces: B3.421g Document drive\path\name Effective

More information

Allogeneic stem cell transplant in HIV-1-infected individuals

Allogeneic stem cell transplant in HIV-1-infected individuals Allogeneic stem cell transplant in HIV-1-infected individuals Javier Martinez-Picado UNIVERSITAT DE VIC Barriers to cure HIV infection Residual Replication Immune activation Inflammation Latent Infection

More information

How to select a donor and product for allogeneic HCT

How to select a donor and product for allogeneic HCT How to select a donor and product for allogeneic HCT Dr Bronwen Shaw 10 February 2015 Overview Who (and where) are the donors What factors determine how we choose between them Acquisition Clinical Donor

More information

Stem cells from Cord Blood: Myths, reality and potential. Elisabeth Semple, PhD Scientific Director Cells for Life Cord Blood Institute

Stem cells from Cord Blood: Myths, reality and potential. Elisabeth Semple, PhD Scientific Director Cells for Life Cord Blood Institute Stem cells from Cord Blood: Myths, reality and potential Elisabeth Semple, PhD Scientific Director Cells for Life Cord Blood Institute Learning objectives Understand the current usage of stem cells from

More information

NIH Public Access Author Manuscript Biol Blood Marrow Transplant. Author manuscript; available in PMC 2012 September 01.

NIH Public Access Author Manuscript Biol Blood Marrow Transplant. Author manuscript; available in PMC 2012 September 01. NIH Public Access Author Manuscript Published in final edited form as: Biol Blood Marrow Transplant. 2011 September ; 17(9): 1375 1382. doi:10.1016/j.bbmt.2011.01.012. Umbilical Cord Blood Transplantation

More information

Corporate Medical Policy Hematopoietic Stem-Cell Transplantation for Breast Cancer

Corporate Medical Policy Hematopoietic Stem-Cell Transplantation for Breast Cancer Corporate Medical Policy Hematopoietic Stem-Cell Transplantation for Breast Cancer File Name: Origination: Last CAP Review: Next CAP Review: Last Review: hematopoietic_stem_cell_transplantation_for_breast_cancer

More information

BIOSTATISTICS FOR TRANSLATIONAL & CLINICAL RESEARCH. Blood-&-Marrow Transplants & CANCERS

BIOSTATISTICS FOR TRANSLATIONAL & CLINICAL RESEARCH. Blood-&-Marrow Transplants & CANCERS BIOSTATISTICS FOR TRANSLATIONAL & CLINICAL RESEARCH Blood-&-Marrow Transplants & CANCERS Stem Cells Stem cells are immature body cells that act like "starter dough" because they can make identical copies

More information

CORD BLOOD TRANSPLANTATION STUDY EXPANDED ACCESS PROTOCOL APPENDIX A SAMPLE CONSENT FORM

CORD BLOOD TRANSPLANTATION STUDY EXPANDED ACCESS PROTOCOL APPENDIX A SAMPLE CONSENT FORM APPENDIX A SAMPLE CONSENT FORM CORD BLOOD TRANSPLANTATION (COBLT) STUDY SAMPLE CONSENT FORM FOR THE EXPANDED ACCESS PROTOCOL You (your child) are being asked to take part in a clinical research study.

More information

On April 4, a group of physicians at the 37th annual

On April 4, a group of physicians at the 37th annual By Ronale Tucker Rhodes, MS Better gene sampling and newer transplant regimens are making stem cell transplantation possible for a host of disease states that previously were rarely considered for this

More information

Hematopoietic Stem Cell Transplantation: Evolving Strategies That Have Resulted in Improved Outcomes

Hematopoietic Stem Cell Transplantation: Evolving Strategies That Have Resulted in Improved Outcomes Hematopoietic Stem Cell Transplantation: Evolving Strategies That Have Resulted in Improved Outcomes Asad Bashey, MD, PhD Blood and Marrow Transplantation Program at Northside Hospital Atlanta, Georgia

More information

Detroit, MI 48202. PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012

Detroit, MI 48202. PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 AD AWARD NUMBER: W81XWH-05-1-0266 TITLE: Cord Blood Stem Cell Procurement in Minority Donors PRINCIPAL INVESTIGATOR: Voravit Ratanatharathorn, M.D. CONTRACTING ORGANIZATION: Wayne State University Detroit,

More information

Hematopoietic Stem Cell Transplantation: Current Status and Future Directions RICHARD W. CHILDS M.D. NIH, BETHESDA MD

Hematopoietic Stem Cell Transplantation: Current Status and Future Directions RICHARD W. CHILDS M.D. NIH, BETHESDA MD Hematopoietic Stem Cell Transplantation: Current Status and Future Directions RICHARD W. CHILDS M.D. NIH, BETHESDA MD Stem cell transplantation Autologous Autologous stem cell collection Freeze Stem Cells

More information

The availability of haematopoietic stem or progenitor

The availability of haematopoietic stem or progenitor Update Article Umbilical Cord Blood Transplantation: Newer Trends MB Agarwal Abstract During last ten years, over 4000 umbilical cord blood transplantations have been performed worldwide. The interest

More information

Cord Blood: Research Progress and Future Promise

Cord Blood: Research Progress and Future Promise Cord Blood: Research Progress and Future Promise By Al Staropoli, AABB Contributing Writer Sue Fister found out she had leukemia when she was 50 years old. Doctors suggested a bone marrow transplant as

More information

A fact sheet UNRELATED BONE MARROW AND CORD BLOOD STEM CELL TRANSPLANTS

A fact sheet UNRELATED BONE MARROW AND CORD BLOOD STEM CELL TRANSPLANTS A fact sheet UNRELATED BONE MARROW AND CORD BLOOD STEM CELL TRANSPLANTS Each year, thousands of patients are diagnosed with diseases treatable by a blood stem cell transplant. These blood stem cells can

More information

CPT Codes for Bone Marrow Transplant January 2015 James L. Gajewski, MD

CPT Codes for Bone Marrow Transplant January 2015 James L. Gajewski, MD The blood and marrow transplant field has 15 dedicated CPT codes. These CPT codes can be categorized into three groups: 1. Collection Codes 2. Cell Processing Codes 3. Cell Infusion Codes Collection Codes

More information

DEPARTMENT OF BONE MARROW AND STEM CELL TRANSPLANT

DEPARTMENT OF BONE MARROW AND STEM CELL TRANSPLANT www.narayanahealth.org DEPARTMENT OF BONE MARROW AND STEM CELL TRANSPLANT About Narayana Health City Narayana Health, one of India's largest and the world's most economical healthcare service providers

More information

THE NEW ZEALAND MEDICAL JOURNAL

THE NEW ZEALAND MEDICAL JOURNAL THE NEW ZEALAND MEDICAL JOURNAL Vol 118 No 1208 ISSN 1175 8716 Private umbilical cord blood banking: a biological insurance of dubious future benefit! Michael Sullivan, Peter Browett, Nigel Patton In its

More information

Not for publication or presentation

Not for publication or presentation MINUTES CIBMTR WORKING COMMITTEE FOR GVHD Orlando, Florida Thursday, February 25, 2010, 2:45 pm 4:45 pm Statisticians: Scientific Directors: Steven Pavletic MD, National Cancer Institute Telephone: 301-402-4899;

More information

Umbilical Cord Blood Transplantation in Adults: Results of the Prospective Cord Blood Transplantation (COBLT)

Umbilical Cord Blood Transplantation in Adults: Results of the Prospective Cord Blood Transplantation (COBLT) Biology of Blood and Marrow Transplantation 11:149-160 (2005) 2005 American Society for Blood and Marrow Transplantation 1083-8791/05/1102-0010$30.00/0 doi:10.1016/j.bbmt.2004.11.020 Umbilical Cord Blood

More information

Unrelated Umbilical Cord Blood Transplantation in Children and Adults

Unrelated Umbilical Cord Blood Transplantation in Children and Adults Review Article 559 Unrelated Umbilical Cord Blood Transplantation in Children and Adults LP Koh, 1 MBBS, MRCP (UK), FAMS Abstract Umbilical cord blood (UCB) has recently been explored as an alternative

More information

Umbilical Cord Blood Transplantation for the Treatment of Hematologic Malignancies

Umbilical Cord Blood Transplantation for the Treatment of Hematologic Malignancies Umbilical cord blood transplantation is a useful treatment in several types of hematologic malignancies. Gene Elling. St. Lucia. Photograph. Umbilical Cord Blood Transplantation for the Treatment of Hematologic

More information

Natasha Kekre, 1 Jennifer Philippe, 2 Ranjeeta Mallick, 3 Susan Smith, 2 and David Allan 1,2,4. 1. Introduction

Natasha Kekre, 1 Jennifer Philippe, 2 Ranjeeta Mallick, 3 Susan Smith, 2 and David Allan 1,2,4. 1. Introduction Hindawi Publishing Corporation Stem Cells International Volume 2013, Article ID 124834, 6 pages http://dx.doi.org/10.1155/2013/124834 Research Article Modelling Improvements in Cell Yield of Banked Umbilical

More information

Corporate Medical Policy

Corporate Medical Policy Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: hematopoietic_stem-cell_transplantation_for_epithelial_ovarian_cancer 2/2001 11/2015 11/2016 11/2015 Description

More information

Determinants of Engraftment after Double-Unit Cord Blood Transplantation

Determinants of Engraftment after Double-Unit Cord Blood Transplantation In: Broxmeyer HE, ed. Cord Blood: Biology, Transplantation, Banking, and Regulation Bethesda, MD: AABB Press, 2011 26 Determinants of Engraftment after Double-Unit Cord Blood Transplantation Doris M. Ponce,

More information

Cord Blood Stem Cell Transplantation

Cord Blood Stem Cell Transplantation LEUKEMIA LYMPHOMA MYELOMA FACTS Cord Blood Stem Cell Transplantation No. 2 in a series providing the latest information on blood cancers Highlights Umbilical cord blood, like bone marrow and peripheral

More information

SEARCHING FOR A BONE MARROW DONOR

SEARCHING FOR A BONE MARROW DONOR SEARCHING FOR A BONE MARROW DONOR Angela received a bone marrow transplant from an unrelated donor to treat her non-hodgkin s lymphoma. INFORMATION FOR PATIENTS AND THEIR FAMILIES For patients who need

More information

Not All Stem Cells are the Same

Not All Stem Cells are the Same Cord Blood Banking and Transplantation Jennifer Willert, M.D. Hematology/Oncology Blood and Marrow Transplant Rady Children s Hospital San Diego Clinical Professor UCSD Not All Stem Cells are the Same

More information

Preparation of cord blood for infusion: bedside thaw, dilute and wash, or somewhere in between

Preparation of cord blood for infusion: bedside thaw, dilute and wash, or somewhere in between Preparation of cord blood for infusion: bedside thaw, dilute and wash, or somewhere in between Donna Wall, MD Director, Manitoba Blood and Marrow Transplant Program ISCT 2012 Disclosures: none The problem:

More information