TY - JOUR
T1 - Post-Thaw Viable CD45+ Cells and Clonogenic Efficiency are Associated with Better Engraftment and Outcomes after Single Cord Blood Transplantation in Adult Patients with Malignant Diseases
AU - Castillo, Nerea
AU - Garcia Cadenas, Irene
AU - Barba, Pere
AU - Martino Bofarull, Rodrigo
AU - Azqueta, Carmen
AU - Ferrá, Christelle
AU - Canals, Carme
AU - Sierra, Jorge
AU - Valcárcel, David
AU - Querol, Sergi
PY - 2015
Y1 - 2015
N2 - The quantity of cells is widely accepted as the main factor influencing the outcome after umbilical cord blood transplantation (UCBT) however, the quality of the cord blood units (CBUs) has been less studied. In order to determine the impact of qualitative variables in UCBT outcomes, we conducted a multicenter retrospective study in adult patients with hematological malignancies who underwent single UCBT after a common myeloablative conditioning regimen. One hundred and ten patients from 3 institutions [median age, 35 years (range 18-55)] were included. Quantitative (TNC and total CD34+cells) and qualitative variables [viable CD45+ (vCD45+), vCD34+ and clonogenic efficiency [(CLONE), quotient of post-thaw colony-forming units (CFU)] and pre-freeze CD34+ cells predicted engraftment in univariate analysis however, only 2 qualitative variables remained significant in the multivariate analysis. Infusion of more than 2 × 10 post-thaw vCD45+ cells per kilogram was significantly associated with faster neutrophil (P =.01), platelet engraftment (P =.01), higher disease-free (P =.01) and overall survival (0.02). In addition, CLONE ≥ 20% predicted a faster neutrophil (P =.005), platelet engraftment (P =.01) and contributed to decrease the non-relapse mortality (P =.02). Our study suggests that the vCD45+ cells dose and CLONE are powerful surrogate markers of graft quality and can potentially help on CBUs selection if tested with representative reference samples.
AB - The quantity of cells is widely accepted as the main factor influencing the outcome after umbilical cord blood transplantation (UCBT) however, the quality of the cord blood units (CBUs) has been less studied. In order to determine the impact of qualitative variables in UCBT outcomes, we conducted a multicenter retrospective study in adult patients with hematological malignancies who underwent single UCBT after a common myeloablative conditioning regimen. One hundred and ten patients from 3 institutions [median age, 35 years (range 18-55)] were included. Quantitative (TNC and total CD34+cells) and qualitative variables [viable CD45+ (vCD45+), vCD34+ and clonogenic efficiency [(CLONE), quotient of post-thaw colony-forming units (CFU)] and pre-freeze CD34+ cells predicted engraftment in univariate analysis however, only 2 qualitative variables remained significant in the multivariate analysis. Infusion of more than 2 × 10 post-thaw vCD45+ cells per kilogram was significantly associated with faster neutrophil (P =.01), platelet engraftment (P =.01), higher disease-free (P =.01) and overall survival (0.02). In addition, CLONE ≥ 20% predicted a faster neutrophil (P =.005), platelet engraftment (P =.01) and contributed to decrease the non-relapse mortality (P =.02). Our study suggests that the vCD45+ cells dose and CLONE are powerful surrogate markers of graft quality and can potentially help on CBUs selection if tested with representative reference samples.
KW - Quality
KW - Transplantation
KW - Umbilical cord blood
U2 - 10.1016/j.bbmt.2015.08.016
DO - 10.1016/j.bbmt.2015.08.016
M3 - Article
C2 - 26319094
SN - 1523-6536
VL - 21
SP - 2167
EP - 2172
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 12
ER -