Analysis of Risk Factors of Cord Blood Transplantation for Children

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Analysis of Risk Factors of Cord Blood Transplantation for Children"

Transcription

1 Pediatr Blood Cancer 2013;60: Analysis of Risk Factors of Cord Blood Transplantation for Children Gal Goldstein, MD, 1 * Bella Bielorai, MD, 1 Jerry Stein, MD, 2 Polina Stepensky, MD, 3 Ronit Elhasid, MD, 4 Irena Zaidman, MD, 4 Angela Chetrit, MSc, 5 Isaac Yaniv, MD, 2 Arnon Nagler, MD, 6,7 and Amos Toren, MD, PhD 1 Background. As cord blood (CB) is being used frequently as a source for heamtopoetic stem cell transplantation defining risk factors for transplantation outcome is an important issue. Procedure. The data of all single unit CB transplantation preformed in Israel from 1992 to 2011 were collected. The risk factors for myeloid engraftment, event free survival (EFS) and overall survival (OS) were studied in 87 children. Results. There were 49 children with hematological malignancies and 38 with non-malignant diseases. Cumulative rate of neutrophil recovery was 78.3%, while median time to myeloid recovery was 26 days. The incidence of platelet engraftment at 150 days was 53%, and the median time to platelet recovery was 36 days. ABO blood group matching between CB unit and recipient was associated with superior myeloid engraftment. Acute graft versus host disease of grades II IV occurred in 33% of the patients. Chronic graft versus host disease occurred in 16% of patients. Probabilities of EFS and OS at 1 year were 45% and 57%, respectively. Factors associated with inferior OS were Rh major mismatch versus matched Rh and transplantation from unrelated donor versus related donor. Conclusions. These results indicate that matching of ABO blood groups is an important factor that affects engraftment, and also that Rh matching seem to have an impact on OS, which was not previously described in the setting of CB transplantation. Pediatr Blood Cancer 2013;60: # 2013 Wiley Periodicals, Inc. Key words: blood; children; cord; transplantation INTRODUCTION In the last three decades, cord blood (CB) has become a viable option as a graft source for hematopoetic stem cell transplantation (HSCT). The fact that a less stringent human leukocyte antigen (HLA) matching is required for transplantations from CB made it possible to use it as an alternative graft source when a suitable matched donor could not be found [1]. Since each CB unit contains limited amount of stem cells, transplantation from a single unit is usually reserved for children [2]. Using CB as a graft source for HSCT in children is considered feasible and safe both in malignant and non-malignant diseases [3 7]. Its main setbacks are relatively high rates of graft failure and delayed myeloid engraftment [8]. Both contribute to considerable treatment related mortality rates. Since the usage of CB as a graft source for HSCT is expanding rapidly, defining risk factors for such transplantation is of paramount importance. As in other graft sources, blood group incompatibilities between CB and host, may affect transplantation outcome. There is conflicting evidence regarding the importance of these incompatibilities [1,4]. We performed a retrospective analysis of all the HSCTs from CB that were done in children in Israel. Our aim was to analyze the risk factors for myeloid engraftment, event free survival (EFS) and overall survival (OS). Specifically we wanted to assess the importance of ABO and Rh matching as prognostic factor for transplantation outcome. PATIENTS AND METHODS Data were collected retrospectively from the medical records of the patients. The study was approved by the IRB committees of the participating centers. We included all the patients under the age of 18 year who underwent CB transplantation in Israel from July 1994 to June CB from unrelated donors was used when neither sibling donor nor matched unrelated bone marrow donor could be found within a reasonable frame of time, in accordance with the clinical condition of the patient. Although in some cases additional alleles were analyzed, we regarded the degree of matching of HLA only in A and B (either serology in a minority of CB units, or DNA typing in most of them), and in DR (DNA typing). C 2013 Wiley Periodicals, Inc. DOI /pbc Published online 26 August 2013 in Wiley Online Library (wileyonlinelibrary.com). Analysis End Points and Definitions Primary end points for analysis in this study included myeloid engraftment, graft versus host disease (GVHD), OS, and EFS. To be evaluable for myeloid engraftment, patients had to survive to day 30. Myeloid engraftment was defined as the first of 3 days of a sustained absolute neutrophil count >500/ml, and the time to platelet engraftment as the first of the seven consecutive days of platelet counts of /L or higher without platelet transfusion. Acute and chronic GVHD were defined according to standard criteria [9]. We defined severe acute GVHD as grades II IV. Patients that had neutrophil engraftment and survived to day 30 after transplant were evaluable for acute GVHD and those surviving beyond day 100 after transplant were evaluable for chronic GVHD. Events were defined as graft failure/rejection, leukemic relapse after engraftment or death. Secondary endpoints were association between pre-transplant parameters of patients, CB units, degree and types of mismatching between them, and conditioning regimens, to myeloid engraftment, EFS and OS. Major mismatch of ABO or Rh blood groups was defined as the existence of an antigen on the donor red blood cells with its absence on the recipient s cells. Minor 1 Department of Pediatric Hemato-Oncology and Bone Marrow Transplantation, The Edmond and Lily Safra Children s Hospital, Ramat Gan, Israel; 2 Department of Pediatric Hematology Oncology and Stem Cell Transplantation, Schneider Children s Medical Center of Israel, Petach Tikva, Israel; 3 Department of Pediatric Hemato- Oncology, Hadassah Medical Center, Jerusalem, Israel; 4 Department of Pediatric Hemato-Oncology, Tel Aviv Medical Center, Tel Aviv, Israel; 5 Cancer and Radiation Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; 6 Hematology Division, Chaim Sheba Medical Center, Ramat Gan, Israel; 7 Cord Blood Bank, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel Conflict of interest: Nothing to declare. Correspondence to: Gal Goldstein, Department of Pediatric Hemato- Oncology and Bone Marrow Transplantation, The Edmond and Lily Safra Children s Hospital, Israel. Received 2 December 2012; Accepted 18 April 2013

2 2008 Goldstein et al. mismatch was defined as the absence of an antigen on the donor cells with its existence on the recipient s cells. Bidirectional ABO mismatch was defined as the existences of an antigen on the donor red blood cells with its absence on the recipient s cells but, at the same time existence of an antigen on the recipient red blood cells with its absence on the donor s cells. Statistical Analysis Associations of categorical study parameters with engraftment were tested using the Chi-square statistic test or Fisher s exact test (when needed), while the unpaired t-test was used for continuous variables. The risk for engraftment by cell dose and ABO-mismatch and for OS by Rh-mismatch was calculated using Kaplan Meier survival analysis, and the difference between the survival curves was tested using the log-rank test. The Cox proportional hazard model was used to study variables that were significantly and independently associated with the outcomes. Variables found to be associated with the outcomes studied in the univariate analysis at a level of P-value of 0.15 or less, were entered into the multivariate analysis. Age and gender were included in the models regardless of their association with the outcome. All of the statistical analyses were done with Statistical Analysis System software version 9.1 (SAS Institute, Inc., Cary, NC). Statistical significance was set at P < 0.05, using two-tailed tests. TABLE I. Patient and Disease Characteristics (N ¼ 87) Characteristics No. % Age at transplantation Median 4 years Range 6 weeks to 14.5 years Male Recipient CMV positive Diagnosis at transplantation Malignant disease Acute lymphoblastic leukemia Acute myeloid leukemia Acute biphenotypic leukemia 3 3 Non-Hodgkin lymphoma 2 2 Chronic myeloid leukemia 1 1 Chronic eosinophilic leukemia 1 1 Juvenile myelo-monocytic leukemia 8 9 Myelodysplastic syndrome 2 2 Disease status at transplant (for acute leukemia and lymphoma only) CR CR CR3 2 6 Refractory disease 3 8 No data 1 3 Prior transplant Autologous 2 6 Haploidentical donor 1 3 Non-malignant disease Bone marrow failure Metabolic diseases Immune deficiencies Histiocytic disorders 3 3 Hemoglobinopathies 2 2 CMV, cytomegalo virus; CR, complete remission. RESULTS Pre-Transplantation Patient Characteristics A total of 89 children underwent CB transplantations from a single unit in five tertiary health care centers in Israel. Two of these patients were excluded because their data were not available. Patient and disease characteristics are summarized in Table I. Conditioning and GVHD Prophylaxis Regimens Graft and conditioning regimens are summarized in Table II. Conditioning regimens varied according to the transplant center. GVHD prophylaxis regimens were diverse and consisted mainly of combinations of cyclosporine alone or with mycophenolate, or prednisolone. No metothrexate was given as a GVHD prophylaxis. Median follow-up was 52 months. Myeloid and Platelet Engraftment The cumulative rate of neutrophil recovery by day 60 was 78.3%. Neutrophil recovery occurred at a median of 26 days (range 12 57). Platelet engraftment occurred at a median of 36 days (range 2 90). The incidence of platelet engraftment at 150 days was 53%. Seven patients died before day 30 without achieving neutrophil engraftment. In three cases, data was missing. Primary graft failure occurred in 23 patients (29.9%). Of these, 15 died, three are alive TABLE II. Donor, Graft and Transplant Characteristics (N ¼ 87) Characteristics No. % Donor Matched sibling Unrelated donor No. of HLA disparities 6/6 match /6 match /6 match No data 7 12 Cell dose, nucleated cells 10 7 /kg Median 6.1 Range Blood groups compatibility ABO matched ABO major mismatch ABO minor mismatch ABO bidirectional mismatch 6 7 Rh matched Rh major mismatch 9 10 Rh minor mismatch 6 7 Conditioning regimens Busulfan based TBI based Fludarabine based No conditioning (SCID patient) 1 1 Use of ATG ATG, anti-thymocytic globulin; SCID, severe combined immune deficiency.

3 Risk Factors in Cord Blood Transplantation 2009 TABLE III. Distribution of Study Characteristics by Myeloid Engraftment After Cord Blood Transplantation for Children Not engrafted Engrafted Variable # % # % Age (mean SD, years) Recepient gender Male Female Diagnosis Non-malignant Malignant Conditioning Non-myeloabltive Busulfan based TBI ATG Yes No Donor Sibling Unrelated Male Female No data HLA MM Full match MM MM No data Cell dose, 10 7 nucleated cell/kg > No data ABO mismatch Matched Major and minor MM Bidirectional 1 5 P-value after a second transplant, three are alive after their disease recurred (Chronic Granulomatous Disease, Gaucher, and Thalassemia), and two were lost to follow-up. Secondary graft failure occurred in one patient with Hurler syndrome and in eight patients with malignant diseases. Table III presents the univariate analysis of the study characteristics on myeloid engraftment. In a multivariate analysis an association between major ABO mismatch versus matched (Table IV) and lower incidence of myeloid engraftment (Fig. 1) was found. There was also an association of borderline statistical significance between cell dose of more than /kg compared to cell dose less than /kg (Table IV) and myeloid engraftment. In a multivariate analysis, no association was found between HLA matching and myeloid engraftment. Mortality Forty-one patients died. Fifteen of these died after primary graft failure, among them five after a second transplant. The main cause of death was graft failure. It occurred in the non-malignant diseases setting in seven cases. Twelve cases relapsed. The principal causes of treatment related mortality were infections (bacterial n ¼ 4, and fungal n ¼ 1) and GVHD (n ¼ 5). GVHD Seventeen (32.6%) and 14 (26.9%) of the 52 patients assessable had acute GVHD of grades II IVand III IV, respectively. Fifteen of the 43 patients assessable had chronic GVHD (34.8.6%). Seven had limited disease (16.2%) and eight had extensive chronic GVHD TABLE IV. Multivariate Analysis for Myeloid Engraftment After Cord Blood Transplantation for Children OR 95% CI P-value Recepient gender (male vs. female) Age (continuous) Cell dose (>3.5 vs NC/kg) ABO incompatibility Major MM vs. matched Minor MM vs. matched Bidirectional vs. matched

4 2010 Goldstein et al. Fig. 1. Myeloid engraftment according to ABO matching. Fig. 2. Overall survival according to Rh matching. (18.6%). Cumulative incidence of acute and chronic GVHD could not be evaluated due to absence of data. Survival The probability of EFS was 45% at 1 year and 40.5% at 2 years. No factor had a significant impact on EFS, but some showed a trend towards superior EFS. These were cell dose above nucleated cells (NC)/kg versus less than NC/ kg (HR 0.57, 95% CI ; P ¼ 0.09), and matched Rh versus major Rh mismatch (HR % CI ; P ¼ 0.1; Fig. 2). OS at 1 year was 56.1% and 54.6% at 2 years. Factors associated with inferior OS included: Rh major mismatch versus matched Rh (HR 2.89, 95% CI , P ¼ 0.01) and transplantation from unrelated donor versus related donor (HR 2.81, 95% CI , P ¼ 0.03). In a multivariate analysis, no associations were found between HLA matching and OS or EFS. DISCUSSION Our main findings in this retrospective multicenter study was that there was a better OS in CB transplantation of matched versus major Rh blood groups incompatibility. This is the first report of the impact that such blood group incompatibility has on CB transplantation outcomes. We have also found that matching of ABO was associated with improved myeloid engraftment and that there was a better OS in transplantation from related versus unrelated donor. There is evidence that major ABO incompatibility increases the risk for hemolytic events and red blood cell transfusion requirements post transplantation [10 11]. Although controversial, some studies have shown that ABO incompatibility also affects GVHD occurrence, myeloid engraftment, EFS, and OS [12 27]. ABO incompatibility is a significant negative factor for myeloid engraftment in unrelated CB transplantation and also in related donor CB transplantation for children [22]. This negative effect could be explained, as suggested by other authors, by the binding of anti A or B antibodies to the A or B antigens that were either adsorbed or expressed on myeloid precursors of the CB [23,27]. ABO major incompatibility has been described to be associated with decreased OS and DFS in CB transplantation for adults and children [12,4]. Such incompatibility was also found to be associated with higher treatment related mortality after reduced intensity conditioning-cb transplantation in adults with hematological malignancies [28]. The impact that ABO incompatibility may have on myeloid recovery in BM transplantation setting is a matter of debate. While there are several studies that did not find a correlation between ABO incompatibility and myeloid engraftment [11,14,29,30], others showed that major mismatch correlates with longer time to engraftment [16,31]. These were performed mostly on malignant, but also on non-malignant, diseases. The conditioning regimens were myeloablative, non-myeloablative and reduced intensity, and graft source was peripheral blood, bone marrow, and small numbers of CB. With regard to CB transplantation several studies did not show any effect of ABO incompatibility on transplantation outcome [1,32]. We can postulate that major ABO incompatibility may affect myeloid engraftment by stimulating cytokine production, as a consequence of a hemolytic event occurring shortly after graft transplantation. This may activate the remnants of the immune system of the host against myeloid precursors of the graft. Another interesting finding was the impact of major Rh incompatibility on transplantation outcome. Except for a single report of Erker et al. [33] this type of incompatibility usually is not considered to be a risk factor in HSCT. This finding was later challenged by Wirk et al. [34] that published a contradictory work. Although our work supports Erker et al. data, we could not find an explanation for it. In spite of the fact that there were only nine cases of major Rh incompatibility we believe that this question is relevant and should be studied further in larger cohorts of CB transplantation. As has been widely recognized in previous work, we found that low cell dose correlated to a trend of poor EFS [5,12,35 37]. In the group of the non-malignant diseases engraftment was achieved in 58% of the cases compared to 72% in the malignant diseases; however, survival was worse in latter group. We also found a statistically insignificant difference (P ¼ 0.3) in engraftment rate between the related group (79%) versus the unrelated CB group (60%). All the patients with the malignant diseases who received a graft from a sibling engrafted (n ¼ 8), with two cases of relapse, comparable to the unrelated group in which six relapses occurred. A graft from related CB was associated with better OS compared to unrelated CB. This is not surprising with respect to the HLA and minor antigens mismatch that every unrelated transplantation bears. These may interfere with

5 Risk Factors in Cord Blood Transplantation 2011 engraftment, pose a greater risk due to immune suppression and increase the likelihood of severe GVHD. Although not statistically significant in univariate analysis we have noticed a higher engraftment rate in the malignant disease group compared to the non-malignant group (P-0.1). There was a relatively high rate of graft failure in the non-malignant group (40%). This could be explained by the fact that 16 of 30 (44%) evaluable CB units in that group had a cell dose below the threshold recommended by Eurocord for CB transplantation in the nonmalignant disease setting NC/kg [8]. In comparison in only 12% of the transplantations in the malignant diseases group cell dose was below a dose of NC/kg. Although most patients of the unrelated group were mismatched with their CB donors at one or two HLA loci (45% and 20%, respectively), the incidence of acute GVHD II was comparable with that reported in several other studies on children [1,22,35]. The occurrence of chronic GVHD was slightly higher than reported in some of the studies of CB transplantation. Of note is the fact that some of these studies included only patients with extensive GVHD while others did not state if limited disease was also included. In 25 of the transplantations in this study, the conditioning regimens used were not myeloablative. We noted a similar engraftment, GVHD, EFS, and OS in this group of patients. The different conditioning regimens limited our ability to identify a preferable preparative regimen. Our study has some limitations, mostly related to the fact that it is retrospective. The wide variety of diseases, different conditioning, and GVHD prophylaxis regimens, limit the ability to draw precise conclusions. Our study reiterates the importance of a minimum cell dose in CB transplantation. The superior results of related versus unrelated CB transplantation in our study may stress the importance of CB collection from a sibling in families in which an offspring has a disease that is potentially treatable by HSCT. Our results indicate that matching of Rh blood groups is important in CB transplants. This observation will need to be studied in a larger cohort of patients. REFERENCES 1. Gluckman E, Rocha V. Donor selection for unrelated cord blood transplants. Curr Opin Immunol 2006;5: Davey S, Armitage S, Rocha V, et al. The London Cord Blood Bank: Analysis of banking and transplantation outcome. Br J Haematol 2004;125: Michel G, Rocha V, Chevret S, et al. Unrelated cord blood transplantation for childhood acute myeloid leukemia: A Eurocord Group analysis. Blood 2003;102: Locatelli F, Rocha V, Chastang C, et al. Factors associated with outcome after cord blood transplantation in children with acute leukemia. Eurocord Cord Blood Transplant Group. Blood 1999;93: Prasad VK, Mendizabal A, Parikh SH, et al. Unrelated donor umbilical cord blood transplantation for inherited metabolic disorders in 159 pediatric patients from a single center: Influence of cellular composition of the graft on transplantation outcomes. Blood 2008;112: Rocha V, Gluckman E. Eurocord-Netcord registry and European Blood and Marrow Transplant group. Improving outcomes of cord blood transplantation: HLA matching, cell dose and other graft- and transplantation-related factors. Br J Haematol 2009;147: Ruggeri A, Eapen M, Scaravadou A, et al. Umbilical cord blood transplantation for children with thalassemia and sickle cell disease. Biol Blood Marrow Transplant 2011;9: Gluckman E, Rocha V, Ionescu I, et al. Results of unrelated cord blood transplant in fanconi anemia patients: Risk factor analysis for engraftment and survival. Biol Blood Marrow Transplant 2007;9: Przepioka D, Weisdorf D, Martin P, et al Consensus conference on acute GVHD grading. Bone Marrow Transplant 1995;15: Toren A, Dacosta Y, Manny N, et al. Passenger B-lymphocyte-induced severe hemolytic disease after allogeneic peripheral blood stem cell transplantation. Blood 1996;87: Kanda J, Ichinohe T, Matsuo K, et al. Impact of ABO mismatching on the outcomes of allogeneic related and unrelated blood and marrow stem cell transplantations for hematologic malignancies: IPD-based meta-analysis of cohort studies. Transfusion 2009;49: Arcese W, Rocha V, Labopin M, et al. Unrelated cord blood transplants in adults with hematologic malignancies. Haematologica 2006;91: Benjamin RJ, McGurk S, Ralston MS, et al. ABO incompatibility as an adverse risk factor for survival after allogeneic bone marrow transplantation. Transfusion 1999;39: Blin N, Traineau R, Houssin S, et al. Impact of donor-recipient major ABO mismatch on allogeneic transplantation outcome according to stem cell source. Biol Blood Marrow Transplant 2010;16: Bolan CD, Leitman SF, Griffith LM, et al. Delayed donor red cell aplasia following major ABOincompatible nonmyeloablative hematopoietic stem cell transplantation. Blood 2001;98: Kimura F, Sato K, Kobayashi S, et al. Impact of ABO-blood group incompatibility on the outcome of recipients of bone marrow transplants from unrelated donors in the Japan Marrow Donor Program. Haematologica 2008;93: Ludajic K, Balavarca Y, Bickeböller H, et al. Minor ABO-mismatches are risk factors for acute graftversus-host disease in hematopoietic stem cell transplant patients. Biol Blood Marrow Transplant 2009;15: Mehta J, PowlesR, SirohiB, etal. Doesdonor-recipient ABOincompatibility protectagainstrelapseafter allogeneic bone marrow transplantation in first remission acute myeloid leukemia? Bone Marrow Transplant 2002;29: Michallet M, Le QH, Mohty M, et al. Predictive factors for outcomes after reduced intensity conditioning hematopoietic stem cell transplantation for hematological malignancies: A 10-year retrospective analysis from the Société Française de Greffe de Moelle et de Thérapie Cellulaire. Exp Hematol 2008;36: Ozkurt ZN, Yegin ZA, Yenicesu I, et al. Impact of ABO-incompatible donor on early and late outcome of hematopoietic stem cell transplantation. Transplant Proc 2009;41: Resnick IB, Tsirigotis PD, Shapira MY, et al. ABO incompatibility is associated with increased nonrelapse and GVHD related mortality in patients with malignancies treated with a reduced intensity regimen: A single center experience of 221 patients. Biol Blood Marrow Transplant 2008;14: Rocha V, Wagner JE, Sobocinski KA, et al. Graft versushost disease in children who have received a cord blood or bone marrow transplant from HLA identical sibling. New Engl J Med 2000;342: Seebach JD, Stussi G, Passweg JR, et al. GVHD Working Committee of Center for International Blood and Marrow Transplant Research. ABO blood group barrier in allogeneic bone marrow transplantation revisited. Biol Blood Marrow Transplant 2005;11: Stussi G, Seebach L, Muntwyler J, et al. Graft-versus-host disease and survival after ABO-incompatible allogeneic bone marrow transplantation: A single-centre experience. Br J Haematol 2001;113: Stussi G, Muntwyler J, Passweg JR, et al. Consequences of ABO incompatibility in allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2002;30: Worel N, Kahls P, Keil F, et al. ABO mismatch increases transplant related morbidity and mortality in patients given non-myeloablative allogeneic HPC transplantation. Transfusion 2003;43: Remberger M, Watz E, Ringdén O, et al. Major ABO blood group mismatch increases the risk for graft failure after unrelated donor hematopoetic stem cell transplantation. Biol Blood Marrow Transplant 2007;13: RioB, Furst S, Renaud M, et al. Encouraging resultsofunrelated cordblood transplantation (UCBT) after homogenous reduced intensity conditioning (RIC) in adults with hematological malignancy: Impact of HLA disparities on outcomes A French multicentre study on behalf of the SFGM-TC andeurocord. Bone Marrow Transplant 2009;43(Suppl 1):Abstract Goldman J, Liesveld J, Nichols D, et al. ABO incompatibility between donor and recipient and clinical outcomes in allogeneic stem cell transplantation. Leuk Res 2003;27: Mielcarek M, Leisenring W, Torok-Storb B, et al. Graft-versus-host disease and donor-directed hemagglutinin titers after ABO-mismatched related and unrelated marrow allografts: Evidence for a graft-versus-plasma cell effect. Blood 2000;96: Kim JG, Sohn SK, Kim DH, et al. Impact of ABO incompatibility on outcome after allogeneic peripheral blood stem cell transplantation. Bone Marrow Transplant 2005;35: Bacigalupo A, Vanlint MT, Occhini D, et al. ABO compatibility and acute graft-versus-host disease following allogeneic bone marrow transplantation. Transplantation 1988;45: Erker CG, Steins MB, Fischer RJ, et al. The influence of blood group differences in allogeneic hematopoietic peripheral blood progenitor cell transplantation. Transfusion 2005;45: Wirk B, Klumpp TR, Ulicny J, et al. Lack of effect of donor-recipient Rh mismatch on outcomes after allogeneic hematopoietic stem cell transplantation. Transfusion 2008;48: Wagner JE, Barker JN, DeFor TE, 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: 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: Rubinstein P, Carrier C, Scaradavou A, et al. Outcomes among 562 recipients of placental-blood transplants from unrelated donors. N Engl J Med 1998;339:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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 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

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

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

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

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

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

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

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

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

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

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

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

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

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

UMBILICAL CORD BLOOD STATISTICS

UMBILICAL CORD BLOOD STATISTICS UMBILICAL CORD BLOOD STATISTICS INTRODUCTION Stem cells are the next frontier in medicine. Stem cells are thought to have great therapeutic and biotechnological potential. This will not only to replace

More information

Cord blood Banking Transplant List for One USA Bank - StemCyte www.stemcyte.com/cordblood-banking-transplant-list

Cord blood Banking Transplant List for One USA Bank - StemCyte www.stemcyte.com/cordblood-banking-transplant-list Cells4Life is the oldest and largest cord blood storage company in the UK. We are governed by some of the world's most stringent medical laws, and are currently the only stem cell storage company in the

More information

Selecting Appropriate Blood Products for Recipients of ABO/Rh Mismatched Stem Cell Transplants. Summary of Significant Changes. Purpose.

Selecting Appropriate Blood Products for Recipients of ABO/Rh Mismatched Stem Cell Transplants. Summary of Significant Changes. Purpose. This Specification replaces SPN/DDR/RC/023/05 (SPN215/1) Copy Number Summary of Significant Changes Change to new document reference numbers. Effective 18/10/11 Removal of ABO titres from sections 3.1

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

Artemisa. Hematopoietic stem-cell transplantation using umbilical-cord blood cells. medigraphic. pdf elaborado por medigraphic.

Artemisa. Hematopoietic stem-cell transplantation using umbilical-cord blood cells. medigraphic. pdf elaborado por medigraphic. medigraphic Artemisa en línea ARTÍCULO ESPECIAL Hematopoietic stem-cell transplantation using umbilical-cord blood cells Vanderson Rocha,* Federico Garnier,* Irina Ionescu,* Eliane Gluckman* * FRCP on

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

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

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

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

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

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

UMBILICAL CORD BLOOD, STEM CELL BANKING

UMBILICAL CORD BLOOD, STEM CELL BANKING UMBILICAL CORD BLOOD, STEM CELL BANKING Dr.Sharad Jain MD Blood Transfusion officer, & I/C Transfusion Medicine NSCB Medical College. Jabalpur.MP. Introduction: Every parent during childbirth DREAMS the

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 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

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

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

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

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

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

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

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

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

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

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

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

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

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

PT CordLife Indonesia Premium Cordblood Bank. PT CordLife Indonesia Premium Cordblood Bank

PT CordLife Indonesia Premium Cordblood Bank. PT CordLife Indonesia Premium Cordblood Bank Cordblood Stem Cells and The Role of Cordblood Bank in Supporting Stem Cells Research Presentation Overview Company profile Haematopoietic stem cells in cordblood What we can do to help 1 2 PT CordLife

More information

In a number of genetic, hematologic, and oncologic

In a number of genetic, hematologic, and oncologic AMERICAN ACADEMY OF PEDIATRICS Cord Blood Banking for Potential Future Transplantation: Subject Review ABSTRACT. In recent years, umbilical cord blood, which contains a large number of hematopoietic stem

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

Reference: NHS England B04/P/a

Reference: NHS England B04/P/a Clinical Commissioning Policy: Haematopoietic Stem Cell Transplantation (HSCT) (All Ages): Revised Reference: NHS England B04/P/a 1 NHS England Clinical Commissioning Policy: Haematopoietic Stem Cell Transplantation

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

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

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

MEDICAL COVERAGE POLICY

MEDICAL COVERAGE POLICY Important note Even though this policy may indicate that a particular service or supply is considered covered, this conclusion is not necessarily based upon the terms of your particular benefit plan. Each

More information

What we will discuss today

What we will discuss today Umbilical cord blood banking It s Utility? Dr. Nita Radhakrishnan Pediatric Hematology Oncology Unit, Sir Ganga Ram Hospital, New Delhi What we will discuss today What are stem cells? What are the sources

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

Telephone: 414 805 0700; Fax: 414 805 0714; E mail: meapen@mcw.edu

Telephone: 414 805 0700; Fax: 414 805 0714; E mail: meapen@mcw.edu Not for publication or presentation A G E N D A CIBMTR WORKING COMMITTEE FOR GRAFT SOURCES & MANIPULATION Grapevine, TX Thursday, February 27, 2014, 2:45 4:45 pm Co Chair: Co Chair: Co Chair: Statisticians:

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

New insights into cord blood stem cell transplantation William Tse a,c, Kevin D. Bunting b,c and Mary J. Laughlin b,c,d

New insights into cord blood stem cell transplantation William Tse a,c, Kevin D. Bunting b,c and Mary J. Laughlin b,c,d New insights into cord blood stem cell transplantation William Tse a,c, Kevin D. Bunting b,c and Mary J. Laughlin b,c,d a Division of Medical Oncology, Department of Medicine, University of Colorado Health

More information

BL-8040: BEST-IN-CLASS CXCR4 ANTAGONIST FOR TREATMENT OF ONCOLOGICAL MALIGNANCIES

BL-8040: BEST-IN-CLASS CXCR4 ANTAGONIST FOR TREATMENT OF ONCOLOGICAL MALIGNANCIES BL-8040: BEST-IN-CLASS CXCR4 ANTAGONIST FOR TREATMENT OF ONCOLOGICAL MALIGNANCIES Clinical Development Program Prof. Moshe Phillip, MD VP Clinical & Medical Affairs 1 Rationale for BL-8040 Development

More information

Stem Cell Transplantation: Umbilical Cord

Stem Cell Transplantation: Umbilical Cord Stem Cell Transplantation: Umbilical Cord Maneesha Sasidharan, Ranju M, Sreedurga T.S, *Saritha A. Surendran Review Article Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham University, AIMS Healthcare

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

Rationale for cord blood banking from hematopoietic stem cell transplant to regenerative medicine. Milan November 2008

Rationale for cord blood banking from hematopoietic stem cell transplant to regenerative medicine. Milan November 2008 Rationale for cord blood banking from hematopoietic stem cell transplant to regenerative medicine Milan November 2008 Hematopoietic reconstitution in a patient with Fanconi's anemia by means of umbilical

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

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

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

4. All cord blood banks should be subject to the same standards, regulations and accreditation requirements.

4. All cord blood banks should be subject to the same standards, regulations and accreditation requirements. WMDA Policy Statement on the Utility of Autologous or Family Cord Blood Unit Storage The WMDA Board adopted this policy on 25 th of May 2006. Policy updated _April 2011 The Cord Blood Working Group and

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

ARTICLE IN PRESS. Blood Reviews xxx (2009) xxx xxx. Contents lists available at ScienceDirect. Blood Reviews

ARTICLE IN PRESS. Blood Reviews xxx (2009) xxx xxx. Contents lists available at ScienceDirect. Blood Reviews Blood Reviews xxx (2009) xxx xxx Contents lists available at ScienceDirect Blood Reviews journal homepage: www.elsevier.com/locate/blre Review Umbilical cord blood transplantation: Pros, cons and beyond

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

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

GRANIX (tbo-filgrastim)

GRANIX (tbo-filgrastim) RATIONALE FOR INCLUSION IN PA PROGRAM Background Neutropenia is a hematological disorder characterized by an abnormally low number of neutrophils. A person with severe neutropenia has an absolute neutrophil

More information

Stem Cell Transplantation and the Canadian First Nations Community. Becky Luk (PTLS) Tanya Petraszko, MD

Stem Cell Transplantation and the Canadian First Nations Community. Becky Luk (PTLS) Tanya Petraszko, MD Stem Cell Transplantation and the Canadian First Nations Community Becky Luk (PTLS) Tanya Petraszko, MD Why is there a need for stem cells? Our Story Why are we engaging the First Nations, Metis and Inuit

More information

Public Cord Blood Banking at the National Cord Blood Program (NCBP)

Public Cord Blood Banking at the National Cord Blood Program (NCBP) Public Cord Blood Banking at the National Cord Blood Program (NCBP) A. Scaradavou, MD Medical Director, National Cord Blood Program, New York Blood Center Associate Attending, Pediatric BMT Memorial Sloan-Kettering

More information

5. All cord blood banks should be subject to the same standards, regulations and accreditation requirements.

5. All cord blood banks should be subject to the same standards, regulations and accreditation requirements. WMDA Policy Statement for the Utility of Autologous or Family Cord Blood Unit Storage (This policy statement has been approved and adopted by the WMDA board on the 25 th of May 2006) The Cord Blood Registries

More information