scholarly journals A Comparison of Outcomes for Cord Blood Transplantation and Unrelated Bone Marrow Transplantation in Adult Aplastic Anemia

2016 ◽  
Vol 22 (10) ◽  
pp. 1836-1843 ◽  
Author(s):  
Yachiyo Kuwatsuka ◽  
Junya Kanda ◽  
Hirohito Yamazaki ◽  
Takehiko Mori ◽  
Koichi Miyamura ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Cord Blood ◽  
Aplastic Anemia ◽  
Marrow Transplantation ◽  
Cord Blood Transplantation ◽  
Unrelated Bone Marrow Transplantation ◽  
Blood Transplantation

Single-institute comparative analysis of unrelated bone marrow transplantation and cord blood transplantation for adult patients with hematologic malignancies

Blood ◽  
2004 ◽  
Vol 104 (12) ◽  
pp. 3813-3820 ◽  
Author(s):  
Satoshi Takahashi ◽  
Tohru Iseki ◽  
Jun Ooi ◽  
Akira Tomonari ◽  
Kashiya Takasugi ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Cord Blood ◽  
Marrow Transplantation ◽  
Cord Blood Transplantation ◽  
Disease Free Survival ◽  
Hematologic Malignancies ◽  
Adult Patients ◽  
Transplant Recipients ◽  
Blood Transplantation

Unrelated cord blood transplantation (CBT) has now become more common, but as yet there have been only a few reports on its outcome compared with bone marrow transplantation (BMT), especially for adults. We studied the clinical outcomes of 113 adult patients with hematologic malignancies who received unrelated BM transplants (n = 45) or unrelated CB transplants (n = 68). We analyzed the hematopoietic recovery, rates of graft-versus-host disease (GVHD), risks of transplantation-related mortality (TRM) and relapse, and disease-free survival (DFS) using Cox proportional hazards models. The time from donor search to transplantation was significantly shorter among CB transplant recipients (median, 2 months) than BM transplant recipients (median, 11 months; P < .01). Multivariate analysis demonstrated slow neutrophil (P < .01) and platelet (P < .01) recoveries in CBT patients compared with BMT patients. Despite rapid tapering of immunosuppressants after transplantation and infrequent use of steroids to treat severe acute GVHD, there were no GVHD-related deaths among CB transplant recipients compared with 10 deaths of 24 among BM transplant recipients. Unrelated CBT showed better TRM and DFS results compared with BMT (P = .02 and P < .01, respectively), despite the higher human leukocyte antigen mismatching rate and lower number of infused cells. These data strongly suggest that CBT could be safely and effectively used for adult patients with hematologic malignancies.

Outcome of patients with hemoglobinopathies given either cord blood or bone marrow transplantation from an HLA-identical sibling

Blood ◽  
2013 ◽  
Vol 122 (6) ◽  
pp. 1072-1078 ◽  
Author(s):  
Franco Locatelli ◽  
Nabil Kabbara ◽  
Annalisa Ruggeri ◽  
Ardeshir Ghavamzadeh ◽  
Irene Roberts ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Sickle Cell Disease ◽  
Cord Blood ◽  
Marrow Transplantation ◽  
Cord Blood Transplantation ◽  
Thalassemia Major ◽  
Cell Disease ◽  
Blood Transplantation ◽  
Key Points

Key Points Patients with thalassemia major or sickle cell disease had excellent outcomes after both CBT and BMT from an HLA-identical sibling. Related cord blood transplantation is a suitable transplant option for patients with hemoglobinopathies.

Rapid NKG2D Reconstitution on NK Cells Possibly Plays a Major Role in the Development of Graft-Versus-Leukemia Effect in the Early Period after Unrelated Cord Blood Transplantation.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1973-1973
Author(s):  
Zimin Sun ◽  
Jie Chen ◽  
Huilan Liu ◽  
Xingbing Wang ◽  
Liangquan Geng ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Cord Blood ◽  
Nk Cells ◽  
Marrow Transplantation ◽  
Cord Blood Transplantation ◽  
Early Period ◽  
Target Cells ◽  
Blood Transplantation ◽  
Activating Receptor

Abstract Background: Cord blood transplantation (CBT) is being increasingly used for treatment of hematologic malignancies due to its potent anti-leukemic effects and the low incidence of graft-versus-host disease (GVHD). Recent study has shown that recovery of natural killer (NK) cells is prompt in the blood of CBT recipients both in numbers and functions during the first two months, suggesting that NK cells play an important role in the GVL effect in CBT. NKG2D is an activating receptor expressed by NK cells, which recognizes human MHC class I chain related A and B (MICA/B) and UL16-binding protein 1–4 (ULBP1-4) on target cells, and regulates NK cell activity. However, NKG2D reconstitution following CBT is presently unclear. In this study, we investigated the dynamic expression of NKG2D and other receptors on CD3−CD56+ NK cells in the early period after CBT. Material and methods: The study panel comprised 21 leukemia patients receiving allogeneic hematopoietic cell transplants. Of these, 10 received unrelated CBT and 11 received allogeneic transplants with peripheral blood (PB) combined with bone marrow (BM). To examine the recovery of NKG2D, and other receptors expressed by NK cells, flow cytometry was used to evaluate samples obtained from the recipients on day of clinical engraftment, 30, 60, and 90, respectively following transplantation. Results: Recovery of NK cells was prompt in both transplantation groups (CBT and PB combining with BM), which is consistent with the previous reports. Interestingly, there are significant differences in NKG2D reconstitution between CBT and PB combining with BM transplantation in early stage after transplantation. CBT recipients showed significantly increased expression of NKG2D compared to PB combining with BM transplantation recipients on day of clinical engraftment (79.58±8.71 VS 36.7±14.33 P<0.03 ) and day 30 after transplantation ( 80.03±13.49 VS 56.8±18.21 p<0.035 ). However there was no differences for NKG2D expression between the CBT and PB combined with BM transplantation groups on day 60(82.55±9.10 VS 82.3±28.64 p<0.01 )and on day 90 (85.82±18.21 VS 90.3±27.89 p<0.01), respectively. The inhibitory NK receptor NKG2A reconstitution occurred at the early period, and the expression was not significantly changed during the first three months in CBT, although the level was lower than the other transplantation group. The reconstitution of other inhibitory NK receptors (CD94, CD158a and CD158b) and activating receptor (NKp46) was not found statistically significant differences between the two transplantation groups. T and B cells reconstitution started gradually, and remained at low level at the end of investigation period in CBT recipients. Conclusion: NK cells contribute to GVL effects after transplantation maybe due to rapid NKG2D reconstitution. Rapid NKG2D reconstitution on NK cells in CBT recipients than blood combined bone marrow transplantation suggests that CBT appears superior to blood combined bone marrow transplantation in the treatment of leukemia patients.

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