Current thawing and infusion practice of cryopreserved cord blood: the impact on graft quality, recipient safety, and transplantation outcomes

Akel, Salem; Regan, Donna; Wall, Donna A.; Petz, L.; McCullough, Jeffrey

doi:10.1111/trf.12719

Cited by 40 publications

(37 citation statements)

References 55 publications

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“…24 These methods have been shown to reduce RBC debris and DMSO volume/concentration and may contribute to lower rates of ARs. A no-wash dilution technique for CBSC resulted in infusion reactions that required additional therapy in 65% of patients; however, no serious life-threatening events occurred.…”

Section: Discussionmentioning

confidence: 99%

Adverse reactions during stem cell infusion in children treated with autologous and allogeneic stem cell transplantation

Truong

Moorjani

Dewey

et al. 2016

Bone Marrow Transplant

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Adverse reactions (ARs) during the infusion of cellular therapy products (CTPs) are common in patients undergoing hematopoietic stem cell transplantation (HSCT). We retrospectively studied pediatric patients undergoing autologous and allogeneic HSCT to determine the incidence and grade of ARs during stem cell infusion and their predictors. We analyzed data from 213 patients (120 allogeneic and 93 autologous) who received at least 1 CTP, totaling 361 infusion episodes. Serious ARs, defined as grade 2 and 3, occurred in 25 and 11% of infusions, respectively. No grade 4 or 5 ARs were noted. Independent risk factors for developing a serious AR included stem cell source (PBSC vs marrow (odds ratio (OR) 1.8, 95% confidence interval (CI): 0.4-9); cord vs marrow (OR 7.3, 95% CI: 1.3-40), overall P = 0.0001) but manipulated CTPs were protective (OR 0.4, 95% CI: 0.2-0.7, P = 0.004). Unlike previous adult studies, WBC and granulocyte content were not found to be risk factors in this pediatric population. These data suggest that children tolerate higher WBC content during infusion of CTPs and support the use of manipulated CTP, as indicated, to reduce the risk of adverse infusion reactions.

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Section: Discussionmentioning

confidence: 99%

Adverse reactions during stem cell infusion in children treated with autologous and allogeneic stem cell transplantation

Truong

Moorjani

Dewey

et al. 2016

Bone Marrow Transplant

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“…Typical cell cultures can present with 5–20% of nonviable cells 1–4 , which may confound the accuracy of any assay measuring cellular product or function. In some sensitive cell cultures, such as of embryonic stem cells, the presence of necrotic cells release factors that negatively impact the health of the entire culture in a cascading manner 2, 5 , therefore periodic removal of dead cells improves culture health.…”

Section: Introductionmentioning

confidence: 99%

Microfluidic Sorting of Cells by Viability Based on Differences in Cell Stiffness

Islam

Brink

Blanche

et al. 2017

Sci Rep

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The enrichment of viable cells is an essential step to obtain effective products for cell therapy. While procedures exist to characterize the viability of cells, most methods to exclude nonviable cells require the use of density gradient centrifugation or antibody-based cell sorting with molecular labels of cell viability. We report a label-free microfluidic technique to separate live and dead cells that exploits differences in cellular stiffness. The device uses a channel with repeated ridges that are diagonal with respect to the direction of cell flow. Stiff nonviable cells directed through the channel are compressed and translated orthogonally to the channel length, while soft live cells follow hydrodynamic flow. As a proof of concept, Jurkat cells are enriched to high purity of viable cells by a factor of 185-fold. Cell stiffness was validated as a sorting parameter as nonviable cells were substantially stiffer than live cells. To highlight the utility for hematopoietic stem cell transplantation, frozen samples of cord blood were thawed and the purity of viable nucleated cells was increased from 65% to over 94% with a recovery of 73% of the viable cells. Thus, the microfluidic stiffness sorting can simply and efficiently obtain highly pure populations of viable cells.

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“…UCB units that are not RBC depleted should be washed to remove cellular debris and to prevent serious infusion reactions. 9 The Cord Blood Transplantation (COBLT) Study was the first prospective, open-label, study of UCB banking and transplantation in the world. Three additional public banks, at Duke, Children's Hospital of Orange County and University of California at Los Angeles, were established in the United States with this funding.…”

Section: Overview Of Banking Technologymentioning

confidence: 99%

Umbilical cord blood donation: public or private?

Ballen

Verter²,

Kurtzberg

2015

Bone Marrow Transplant

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Umbilical cord blood (UCB) is a graft source for patients with malignant or genetic diseases who can be cured by allogeneic hematopoietic cell transplantation (HCT), but who do not have an appropriately HLA-matched family or volunteer unrelated adult donor. Starting in the 1990s, unrelated UCB banks were established, accepting donations from term deliveries and storing UCB units for public use. An estimated 730 000 UCB units have been donated and stored to date and ∼ 35 000 UCB transplants have been performed worldwide. Over the past 20 years, private and family banks have grown rapidly, storing ∼ 4 million UCB units for a particular patient or family, usually charging an up-front and yearly storage fee; therefore, these banks are able to be financially sustainable without releasing UCB units. Private banks are not obligated to fulfill the same regulatory requirements of the public banks. The public banks have released ∼ 30 times more UCB units for therapy. Some countries have transitioned to an integrated banking model, a hybrid of public and family banking. Today, pregnant women, their families, obstetrical providers and pediatricians are faced with multiple choices about the disposition of their newborn's cord blood. In this commentary, we review the progress of UCB banking technology; we also analyze the current data on pediatric and adult unrelated UCB, including the recent expansion of interest in transplantation for hemoglobinopathies, and discuss emerging studies on the use of autologous UCB for neurologic diseases and regenerative medicine. We will review worldwide approaches to UCB banking, ethical considerations, criteria for public and family banking, integrated banking ideas and future strategies for UCB banking.

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Current thawing and infusion practice of cryopreserved cord blood: the impact on graft quality, recipient safety, and transplantation outcomes

Cited by 40 publications

References 55 publications

Adverse reactions during stem cell infusion in children treated with autologous and allogeneic stem cell transplantation

Adverse reactions during stem cell infusion in children treated with autologous and allogeneic stem cell transplantation

Microfluidic Sorting of Cells by Viability Based on Differences in Cell Stiffness

Umbilical cord blood donation: public or private?

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