Evaluation of the impact of banking umbilical cord blood units with high cell dose for ethnically diverse patients
| Autor: | Kimberly Wadsworth, Kelly Buck, Gretta Stritesky, Merry Duffy, Jason Dehn |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
business.industry
Immunology Hematology Cord Blood Stem Cell Transplantation Ethnically diverse Umbilical cord Transplantation 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Nucleated cell 030220 oncology & carcinogenesis Anesthesia Cord blood Immunology and Allergy Medicine Blood units Stem cell business 030215 immunology |
| Zdroj: | Transfusion. 58:345-351 |
| ISSN: | 0041-1132 |
| DOI: | 10.1111/trf.14410 |
| Popis: | Background Umbilical cord blood units provide an important stem cell source for transplantation, particularly for patients of ethnic diversity who may not have suitably matched available, adult-unrelated donors. However, with the cost of cord blood unit acquisition from public banks significantly higher than that for adult-unrelated donors, attention is focused on decreasing cost yet still providing cord blood units to patients in need. Historical practices of banking units with low total nucleated cell counts, including units with approximately 90 × 107 total nucleated cells, indicates that most banked cord blood units have much lower total nucleated cell counts than are required for transplant. Study design and methods The objective of this study was to determine the impact on the ability to identify suitable cord blood units for transplantation if the minimum total nucleated cell count for banking were increased from 90 × 107 to 124 or 149 × 107 . We analyzed ethnically diverse patients (median age, 3 years) who underwent transplantation of a single cord blood unit in 2005 to 2016. A cord blood unit search was evaluated to identify units with equal or greater human leukocyte antigen matching and a greater total nucleated cell count than that of the transplanted cord blood unit (the replacement cord blood unit). Results If the minimum total nucleated cell count for banking increased to 124 or 149 × 107 , then from 75 to 80% of patients would still have at least 1 replacement cord blood unit in the current (2016) cord blood unit inventory. The best replacement cord blood units were often found among cords with the same ethnic background as the patient. Conclusion The current data suggest that, if the minimum total nucleated cell count were increased for banking, then it would likely lead to an inventory of more desirable cord blood units while having minimal impact on the identification of suitable cord blood units for transplantation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text