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Cord Blood Stem Cells

Early peripheral blood and T-cell chimerism dynamics after umbilical cord blood transplantation supported with haploidentical cells

Bone Marrow Transplantation volume 49, pages 212–218 (2014)Cite this article

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Abstract

Single-unit umbilical cord blood (CB) SCT is limited by low total nucleated cell (TNC) dose. Co-infusion of CD34+ cells from a third party HLA-mismatched donor, known as dual or haplo-cord transplant, reduces the period of post-transplant neutropenia and related complications. The aim of this study was to analyze the value of early post-transplant peripheral blood (PB) and T cell chimerism after 28 dual transplants regarding CB engraftment. Cumulative incidence of myeloid engraftment at 30 days was 93% with a median time to engraftment of 14 days (10–29). Patients who developed CB graft failure (n=5) showed very low percentages of CB cells on days +14, +21 and +28 with decreasing dynamics. On the other hand, percentages of CB cells in patients who achieved CB engraftment increased over time. Interestingly, such patients showed two distinct chimerism dynamics in PB, but all of them showed a predominance of CB T cells early after SCT with increasing dynamics over time. Early post-transplant chimerism dynamics in PB and T cells predicts CB graft failure enabling rapid therapeutic measures to be applied. On the other hand, early increasing percentages of CB T cells correlates with ultimate CB engraftment.

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Acknowledgements

We wish to thank José María Bellón from the Instituto de Investigación Sanitaria Gregorio Marañón for statistical analysis. This work was partially supported with grants (PI05-2505, PI08-1463, PI11-007089, RD12/0036/0061) from the Fondo de Investigaciones Sanitarias, Instituto de Salud Carlos III, Spain and the Spanish Association Against Cancer.

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  1. Department of Hematology, Gregorio Marañón Institute for Health Research, Hospital General Universitario Gregorio Marañón, Madrid, Spain

    M Kwon, C Martínez-Laperche, P Balsalobre, D Serrano, J Anguita, J Gayoso, J L Díez-Martín & I Buño

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  1. M Kwon
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  2. C Martínez-Laperche
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Correspondence to M Kwon.

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Author Contributions

Conception and design: MK and IB. Provision of study materials or patients: MK, CML and IB. Collection and assembly of data: MK, CML, PB and IB. Data analysis and interpretation: All authors. Manuscript writing: MK and IB. Final approval of manuscript: All authors.

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Kwon, M., Martínez-Laperche, C., Balsalobre, P. et al. Early peripheral blood and T-cell chimerism dynamics after umbilical cord blood transplantation supported with haploidentical cells. Bone Marrow Transplant 49, 212–218 (2014). https://doi.org/10.1038/bmt.2013.177

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