Association between Nondominant Unit Total Nucleated Cell Dose and Engraftment in Myeloablative Double-Unit Cord Blood Transplantation

Abstract Sustained hematopoiesis after double-unit cord blood transplantation (dCBT) is mediated by 1 unit in nearly all patients. To investigate the associations between nondominant unit characteristics and neutrophil engraftment, we studied 129 consecutive myeloablative dCBT recipients. Ninety-fiv...

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Bibliographic Details
Published in:Biology of blood and marrow transplantation 2015-11, Vol.21 (11), p.1981-1984
Main Authors: Purtill, Duncan, Stevens, Cladd E, Lubin, Marissa, Ponce, Doris, Hanash, Alan, Giralt, Sergio, Scaradavou, Andromachi, Young, James W, Barker, Juliet N
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Cell Nucleus - immunology
Child
Child, Preschool
Cord Blood Stem Cell Transplantation - methods
Cord blood transplantation
Double unit
Engraftment
Female
Graft Survival
Hematologic Neoplasms - immunology
Hematologic Neoplasms - mortality
Hematologic Neoplasms - pathology
Hematologic Neoplasms - therapy
Hematology, Oncology and Palliative Medicine
Hematopoiesis - drug effects
Hematopoiesis - immunology
Histocompatibility Testing
Humans
Infant
Male
Middle Aged
Myeloablative Agonists - therapeutic use
Neutrophils - cytology
Neutrophils - immunology
Retrospective Studies
Survival Analysis
Tissue Donors
Transplantation Conditioning
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Summary:Abstract Sustained hematopoiesis after double-unit cord blood transplantation (dCBT) is mediated by 1 unit in nearly all patients. To investigate the associations between nondominant unit characteristics and neutrophil engraftment, we studied 129 consecutive myeloablative dCBT recipients. Ninety-five percent (95% confidence interval, 90 to 98) of patients engrafted. Detection of the nondominant unit 21 to 28 days after dCBT was not associated with improved neutrophil engraftment. In univariate analyses, nondominant unit characteristics (infused total nucleated cell [TNC] and viable CD3+ cell doses) were significantly associated with speed and success of neutrophil engraftment as were dominant unit characteristics (infused TNC; viable CD34+ , viable CD3+ , and viable CD3-56+ 16+ cell doses; and post-thaw CD34+ cell viability). In multivariate analysis, higher infused TNC dose of the nondominant unit was independently associated with improved neutrophil engraftment, even when this unit did not contribute to donor hematopoiesis. In further subgroup analysis, this association was only evident when the infused viable CD34+ cell dose of the dominant unit was low (
ISSN:1083-8791
1523-6536
DOI:10.1016/j.bbmt.2015.07.015