Optimal Practices in Unrelated Donor Cord Blood Transplantation for Hematologic Malignancies
| Autor: | Michael Boo, Corey Cutler, Karen K. Ballen, Joanne Kurtzberg, Claudio G. Brunstein, Stephen R. Spellman, John E. Wagner, Mitchell E. Horwitz, Juliet N. Barker, Filippo Milano, Elizabeth J. Shpall, Amanda Olson, Colleen Delaney |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Allogeneic transplantation Disease Article 03 medical and health sciences 0302 clinical medicine Unrelated Donor medicine Humans In patient Intensive care medicine Cord blood transplantation Transplantation business.industry Hematopoietic stem cell Hematology surgical procedures operative medicine.anatomical_structure Hematologic Neoplasms 030220 oncology & carcinogenesis Cord blood Practice Guidelines as Topic Cord Blood Stem Cell Transplantation Unrelated Donors business 030215 immunology |
| Zdroj: | Biology of Blood and Marrow Transplantation. 23:882-896 |
| ISSN: | 1083-8791 |
| DOI: | 10.1016/j.bbmt.2017.03.006 |
| Popis: | Unrelated donor cord blood transplantation (CBT) results in disease-free survival comparable to that of unrelated adult donor transplantation in patients with hematologic malignancies. Extension of allograft access to racial and ethnic minorities, rapid graft availability, flexibility of transplantation date, and low risks of disabling chronic graft-versus-host disease (GVHD) and relapse are significant advantages of CBT, and multiple series have reported a low risk of late transplantation-related mortality (TRM) post-transplantation. Nonetheless, early post-transplantation morbidity and TRM and the requirement for intensive early post-transplantation management have slowed the adoption of CBT. Targeted care strategies in CBT recipients can mitigate early transplantation complications and reduce transplantation costs. Herein we provide a practical "how to" guide to CBT for hematologic malignancies on behalf of the National Marrow Donor Program and the American Society of Blood and Marrow Transplantation's Cord Blood Special Interest Group. It shares the best practices of 6 experienced US transplantation centers with a special interest in the use of cord blood as a hematopoietic stem cell source. We address donor search and unit selection, unit thaw and infusion, conditioning regimens, immune suppression, management of GVHD, opportunistic infections, and other factors in supportive care appropriate for CBT. Meticulous attention to such details has improved CBT outcomes and will facilitate the success of CBT as a platform for future graft manipulations. |
| Databáze: | OpenAIRE |
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