Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Commentary
  • Published:

Going home for the holidays? Take a shortcut!

Bone Marrow Transplantation volume 52, pages 514–515 (2017)Cite this article

Subjects

In this issue of Bone Marrow Transplantation, Kurita et al.1 describe the results of a prospective phase I/II trial of intra-bone single unit cord blood transplant (IB-CBT) in 15 patients with hematologic malignancies. Clinical outcomes were compared with 150 matched pair historic controls that received intravenous cord blood transplants (IV-CBT). Although time to neutrophil engraftment was similar between cohorts, platelet recovery occurred significantly earlier in the IB-CBT group. Other outcomes such as non-relapse mortality, relapse, survival and GvHD incidence were similar.

The central hypothesis here is intriguing. Could direct intra-osseous (IO) injection of hematopoietic stem cells (HSC) facilitate homing and expedite engraftment? The benefits of cord blood as the source of HSC are well known and include the possibility of using mismatched donors,2 a potential increase in graft-versus-leukemia effect3 and lower GvHD incidence.4 The limitations include higher rates of graft failure, longer time to neutrophil and platelet recovery, and increased early transplant-related mortality.4 Nevertheless, retrospective studies have demonstrated similar overall survival after CBT when compared to human leukocyte antigen matched unrelated donor or haplo-identical donor transplants.5, 6

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Kurita N, Gosho M, Yokoyama Y, Kato T, Obara N, Sakata-Yanagimoto M et al. A phase I/II trial of intrabone marrow cord blood transplantation and comparison of the hematological recovery with the Japanese nationwide database. Bone Marrow Transplant, (e-pub ahead of print 09 January 2017; doi:10.1038/bmt.2016.319).

  2. Barker JN, Byam CE, Kernan NA, Lee SS, Hawke RM, Doshi KA et al. Availability of cord blood extends allogeneic hematopoietic stem cell transplant access to racial and ethnic minorities. Biol Blood Marrow Transplant 2010; 16: 1541–1548.

    Article  Google Scholar 

  3. Milano F, Gooley T, Wood B, Woolfrey A, Flowers ME, Doney K et al. Cord-blood transplantation in patients with minimal residual disease. N Engl J Med 2016; 375: 944–953.

    Article  Google Scholar 

  4. Zhang H, Chen J, Que W . A meta-analysis of unrelated donor umbilical cord blood transplantation versus unrelated donor bone marrow transplantation in acute leukemia patients. Biol Blood Marrow Transplant 2012; 18: 1164–1173.

    Article  Google Scholar 

  5. Ruggeri A, Labopin M, Sanz G, Piemontese S, Arcese W, Bacigalupo A et al. Comparison of outcomes after unrelated cord blood and unmanipulated haploidentical stem cell transplantation in adults with acute leukemia. Leukemia 2015; 29: 1891–1900.

    Article  CAS  Google Scholar 

  6. Atsuta Y, Morishima Y, Suzuki R, Nagamura-Inoue T, Taniguchi S, Takahashi S et al. Comparison of unrelated cord blood transplantation and HLA-mismatched unrelated bone marrow transplantation for adults with leukemia. Biol Blood Marrow Transplant 2012; 18: 780–787.

    Article  Google Scholar 

  7. Wagner JE Jr, Eapen M, Carter S, Wang Y, Schultz KR, Wall DA et al. One-unit versus two-unit cord-blood transplantation for hematologic cancers. N Engl J Med 2014; 371: 1685–1694.

    Article  CAS  Google Scholar 

  8. de Lima M, McNiece I, Robinson SN, Munsell M, Eapen M, Horowitz M et al. Cord-blood engraftment with ex vivo mesenchymal-cell coculture. N Engl J Med 2012; 367: 2305–2315.

    Article  CAS  Google Scholar 

  9. Horwitz ME, Chao NJ, Rizzieri DA, Long GD, Sullivan KM, Gasparetto C et al. Umbilical cord blood expansion with nicotinamide provides long-term multilineage engraftment. J Clin Invest 2014; 124: 3121–3128.

    Article  CAS  Google Scholar 

  10. Delaney C, Heimfeld S, Brashem-Stein C, Voorhies H, Manger RL, Bernstein ID . Notch-mediated expansion of human cord blood progenitor cells capable of rapid myeloid reconstitution. Nat Med 2010; 16: 232–236.

    Article  CAS  Google Scholar 

  11. Frassoni F, Gualandi F, Podesta M, Raiola AM, Ibatici A, Piaggio G et al. Direct intrabone transplant of unrelated cord-blood cells in acute leukaemia: A phase I/II study. Lancet Oncol 2008; 9: 831–839.

    Article  CAS  Google Scholar 

  12. Marini C, Podesta M, Massollo M, Capitanio S, Fiz F, Morbelli S et al. Intrabone transplant of cord blood stem cells establishes a local engraftment store: A functional PET/FDG study. J Biomed Biotechnol 2012; 2012: 767369.

    Article  Google Scholar 

  13. Rocha V, Labopin M, Ruggeri A, Podestà M, Gallamini A, Bonifazi F et al. Unrelated cord blood transplantation: outcomes after single-unit intrabone injection compared with double-unit intravenous injection in patients with hematological malignancies. Transplantation 27 2013; 95: 1284–1291.

    Article  Google Scholar 

  14. Brunstein CG, Barker JN, Weisdorf DJ, Defor TE, McKenna D, Chong SY et al. Intra-BM injection to enhance engraftment after myeloablative umbilical cord blood transplantation with two partially HLA-matched units. Bone Marrow Transplant 2009; 43: 935–940.

    Article  CAS  Google Scholar 

  15. Carrancio S, Romo C, Ramos T, Lopez-Holgado N, Muntion S, Prins HJ et al. Effects of MSC coadministration and route of delivery on cord blood hematopoietic stem cell engraftment. Cell Transplant 2013; 22: 1171–1183.

    Article  CAS  Google Scholar 

  16. Metheny L, Eid SK, Lingas K, Reese J, Meyerson H, Tong A et al. Intra-osseous co-transplantation of CD34-selected umbilical cord blood and mesenchymal stromal cells. Hematol Med Oncol 2016; 1: 25–29.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Stem Cell Transplant Program, University Hospitals Cleveland Medical Center and Seidman Cancer Center, Cleveland, OH, USA

    L Metheny & M de Lima

  2. Case Western Reserve University, Cleveland, OH, USA

    L Metheny & M de Lima

Authors
  1. L Metheny
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M de Lima
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M de Lima.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Metheny, L., de Lima, M. Going home for the holidays? Take a shortcut!. Bone Marrow Transplant 52, 514–515 (2017). https://doi.org/10.1038/bmt.2016.366

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2016.366

Search

Advanced search

Quick links