scholarly journals Immune reconstitution after cord blood transplants supported by coinfusion of mobilized hematopoietic stem cells from a third party donor

2009 ◽  
Vol 44 (4) ◽  
pp. 213-225 ◽  
Author(s):  
T Martín-Donaire ◽  
M Rico ◽  
G Bautista ◽  
R Gonzalo-Daganzo ◽  
C Regidor ◽  
...  
Keyword(s):  
Stem Cells ◽  
Hematopoietic Stem Cells ◽  
Cord Blood ◽  
Immune Reconstitution ◽  
Third Party ◽  
Hematopoietic Stem

Post-Engraftment Infections in Adult Patients Transplanted with Single Cord Blood Units Supported by Co-Infusion of Mobilized Purified Hematopoietic Stem Cells from a Third Party Donor.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3240-3240
Author(s):  
J. Rafael Cabrera ◽  
Isabel Krsnik ◽  
Rafael Fores ◽  
Elena Ruiz ◽  
Guiomar Bautista ◽  
...  
Keyword(s):  
Stem Cells ◽  
High Risk ◽  
Hematopoietic Stem Cells ◽  
Cord Blood ◽  
Cord Blood Transplantation ◽  
Third Party ◽  
Long Term Results ◽  
Cell Mediated Immunity ◽  
Hbv Reactivation ◽  
Hematopoietic Stem

Abstract We have co-infused mobilized purified hematopoietic stem cells (HSC) from a third party donor to shorten neutropenia in single unit cord blood transplantation (CBT). We describe post-engraftment infectious complications in 33 consecutive adults with high-risk hematologic malignancies. Median age was 30 (range 16–59), 22 were male. Patients were conditioned with TBI or busulfan, fludarabine, cyclophosphamide and ATG. GVHD prophylaxis included CyA and steroids. Non-bacterial prophylaxis included fluconazol, acyclovir, trimethoprim-sulfamethoxazole and azithromycin or Fansidar (toxopositive cases). Median total infused CB cell dose was 2.26 x 107/kg (1.31–3.7). Pre-CBT toxoplasma serology was positive in 12, negative in 13 (4 received HSC from a seropositive donor) and unknown in 8 cases. Pre-CBT CMV serology was positive in 30 cases. Pre-CBT, 7 patients were HBsAb(+), HBsAg(−) and 1 HBsAg(+) HBsAb(−). ANC>500/uL was achieved by 32/33, median time 10 days (9–36). Full CB chimerism was achieved in 32/33 cases. Most clinically significant infections occurred after ANC recovery (no major neutropenic infections).There were 34 episodes of CMV reactivation (3 patients developed CMV peumonitis and died <+60).Three patients developed CNS toxoplasmosis (2 seropositive pre-CBT): 1 died as a result (day +70); 1 died of acute GVHD (+120); 1 is alive on Fansidar (+547). One patient had visceral leishmaniasis (day +180) (BM aspirate for FUO; alive on amphotericin, day +379). Seven patients developed hemorrhagic cystitis, 6 related to polyomavirus (PCR on urine): 4 resolved without specific treatment and 2 with treatment (cidofovir, leflunomide). One had asymptomatic viruria. Reappearance of HBsAg occurred in 3/7 of the HBsAb (+) HBsAg(–) patients after day 100: 1 asymptomatic, 1 acute hepatitis and 1 cirrhosis. A HBsAg(+) patient was transplanted on adefovir (no increase in the viral load or liver enzymes). Four late (≥120) episodes of HZV were seen. A 27-year-old native Spaniard died (day +39) of tripanosomiasis (BM aspirate for FUO, positive PCR). Activation of pre-CBT transfusion-related infection is suspected. Short and long term results in adult CBT are improving. However we and others are reporting high incidence of post-engraftment unusual infections which seem related to delayed recovery of cell-mediated immunity. CMV, for which early diagnostic techniques and antiviral agents are available, heads the list. Our toxoplasma cases have prompted us to use prophylaxis in seropositive patients. HBV reactivation among HBsAb(+) HBsAg(−) patients raises the issue of prophylaxis during CBT versus close serological monitoring and pre-emptive therapy. Leishmaniasis is endemic among our city’s dogs, so we actively search for it in FUO (BM examination and culture). Polyomavirus can be found in the urine of up to 50% of BM recipients, viruria preceding symptoms. The value of prospective monitoring and the role of antivirals are unknown. Other unusual infections (as tripanosomiasis in our country) require high index of awareness and consideration in FUO protocols (BM, PB smears). Adult CB recipients are at very high risk of fastidious non-bacterial infections requiring wide pre-BMT screening, close analytical and clinical monitoring, prophylactic/preemptive strategies or early aggressive therapy and innovative immunotherapeutic approaches.

scholarly journals Cord blood transplants supported by co-infusion of mobilized hematopoietic stem cells from a third-party donor

2008 ◽  
Vol 43 (5) ◽  
pp. 365-373 ◽  
Author(s):  
G Bautista ◽  
J R Cabrera ◽  
C Regidor ◽  
R Forés ◽  
J A García-Marco ◽  
...  
Keyword(s):  
Stem Cells ◽  
Hematopoietic Stem Cells ◽  
Cord Blood ◽  
Third Party ◽  
Hematopoietic Stem

scholarly journals Human amniotic mesenchymal stromal cells support the ex vivo expansion of cord blood hematopoietic stem cells

2021 ◽  
Author(s):  
Valentina Orticelli ◽  
Andrea Papait ◽  
Elsa Vertua ◽  
Patrizia Bonassi Signoroni ◽  
Pietro Romele ◽  
...  
Keyword(s):  
Stem Cells ◽  
Hematopoietic Stem Cells ◽  
Cord Blood ◽  
Mesenchymal Stromal Cells ◽  
Stromal Cells ◽  
Ex Vivo ◽  
Ex Vivo Expansion ◽  
Hematopoietic Stem

scholarly journals Application of Umbilical Cord Blood Stem Cells in Regenerative Medicine

2014 ◽  
Vol 6 (3) ◽  
pp. 115
Author(s):  
Anna Meiliana ◽  
Andi Wijaya
Keyword(s):  
Stem Cells ◽  
Hematopoietic Stem Cells ◽  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Embryonic Stem ◽  
Hematopoietic Stem ◽  
Blood Stem Cells ◽  
Induced Pluripotent ◽  
Nerve Muscle

BACKGROUND: Since the first umbilical cord blood (UCB) transplant, performed 25 years ago, UCB banks have been established worldwide for the collection and cryopreservation of UCB for autologous and allogeneic transplants.CONTENT: Much has been learned in a relatively short time on the properties of UCB hematopoietic progenitors and their clinical application. More interestingly, non-hematopoietic stem cells have been isolated from UCB. These cells can be grown and differentiated into various tissues including bone, cartilage, liver, pancreas, nerve, muscle and so on. The non-hematopoietic stem cells have an advantage over other sources of stem cells, such as embryonic stem cells or induced pluripotent stem cells, because their supply is unlimited, they can be used in autologous or allogeneic situations, they need minimal manipulation and they raise no ethical concerns. Future studies will test the potential of UCB cells for the treatment of several diseases including, among other possibilities, diabetes, arthritis, burns, neurological disorder and myocardial infarction.SUMMARY: In addition to hematopoietic stem cells, UCB contain a large number of non-hematopoietic stem cells. In the absence of ethical concern, the unlimited supply of UCB cells explains the increasing interest of using UCB for developing regenerative medicine.KEYWORDS: UCB, transplantation, UCB bank, HSC, MSC, CD34, CD133, VSEL

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