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Cord blood transplantation in adults

Bone Marrow Transplantation volume 44, pages 661–666 (2009)Cite this article

Abstract

Umbilical cord blood has several advantages of immediate availability, no risk to donors, a lower risk for acute and chronic GVHD despite major human leukocyte Ag (HLA) disparity, and a lower risk of transmitting infections. As a result of the early successes with pediatric cord blood transplantation (CBT), cord blood from unrelated donors have been increasingly used as an alternative stem cell source for adult patients with hematological malignancies. Recent single-institute and registry-based studies suggest that CBT is a safe, feasible and effective strategy for adult patients without suitable related or unrelated BM donors. In this review, we focus on recent results of myeloablative CBT in adults.

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References

  1. Gluckman E, Rocha V, Boyer-Chammard A, Locatelli F, Arcese W, Pasquini R et al. Outcome of cord-blood transplantation from related and unrelated donors. Eurocord Transplant Group and the European Blood and Marrow Transplantation Group. N Engl J Med 1997; 337: 373–381.

    Article  CAS  PubMed  Google Scholar 

  2. Rubinstein P, Carrier C, Scaradavou A, Kurtzberg J, Adamson J, Migliaccio AR et al. Outcomes among 562 recipients of placental-blood transplants from unrelated donors. N Engl J Med 1998; 339: 1565–1577.

    Article  CAS  PubMed  Google Scholar 

  3. Laughlin MJ, Barker J, Bambach B, Omeb NK, Rizzieri DA, Wagner JE et al. Hematopoietic engraftment and survival in adult recipients of umbilical-cord blood from unrelated donors. N Engl J Med 2001; 344: 1815–1822.

    Article  CAS  PubMed  Google Scholar 

  4. Sanz GF, Saavedra S, Planelles D, Senent L, Cervera J, Barragan E et al. Standardized, unrelated donor cord blood transplantation in adults with hematologic malignancies. Blood 2001; 98: 2332–2338.

    Article  CAS  PubMed  Google Scholar 

  5. Long GD, Laughlin M, Madan B, Kurtzberg J, Gasparetto C, Morris A et al. Unrelated umbilical cord blood transplantation in adult patients. Biol Blood Marrow Transplant 2003; 9: 772–780.

    Article  PubMed  Google Scholar 

  6. Ooi J, Iseki T, Takahashi S, Tomonari A, Ishii K, Takasugi K et al. Unrelated cord blood transplantation for adult patients with advanced myelodysplastic syndrome. Blood 2003; 101: 4711–4713.

    Article  CAS  PubMed  Google Scholar 

  7. Ooi J, Iseki T, Takahashi S, Tomonari A, Takasugi K, Shimohakamada Y et al. Unrelated cord blood transplantation for adult patients with de novo acute myeloid leukemia. Blood 2004; 103: 489–491.

    Article  CAS  PubMed  Google Scholar 

  8. Ooi J, Iseki T, Takahashi S, Tomonari A, Tojo A, Asano S . Unrelated cord blood transplantation for adult patients with acute lymphoblastic leukemia. Leukemia 2004; 18: 1905–1907.

    Article  CAS  PubMed  Google Scholar 

  9. Cornetta K, Laughlin M, Carter S, Wall D, Weinthal J, Delaney C et al. Umbilical cord blood transplantation in adults: results of the prospective Cord Blood Transplantation (COBLT). Biol Blood Marrow Transplant 2005; 11: 149–160.

    Article  PubMed  Google Scholar 

  10. Lekakis L, Giralt S, Couriel D, Shpall EJ, Hosing C, Khouri IF, Anderlini P, Korbling M, Martin T, Champlin RE, de Lima M . Phase II study of unrelated cord blood transplantation for adults with high-risk hematologic malignancies. Bone Marrow Transplant 2006; 38: 421–426.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Arcese W, Rocha V, Labopin M, Sanz G, Iori AP, de Lima M et al. Unrelated cord blood transplants in adults with hematologic malignancies. Haematologica 2006; 91: 223–230.

    PubMed  Google Scholar 

  12. van Heeckeren WJ, Fanning LR, Meyerson HJ, Fu P, Lazarus HM, Cooper BW et al. Influence of human leucocyte antigen disparity and graft lymphocytes on allogeneic engraftment and survival after umbilical cord blood transplant in adults. Br J Haematol 2007; 139: 464–474.

    Article  PubMed  Google Scholar 

  13. Ooi J, Takahashi S, Tomonari A, Tsukada N, Konuma T, Kato S et al. Unrelated cord blood transplantation after myeloablative conditioning in adults with acute myelogenous leukemia. Biol Blood Marrow Transplant 2008; 14: 1341–1347.

    Article  CAS  PubMed  Google Scholar 

  14. Gluckman E . Current status of umbilical cord blood hematopoietic stem cell transplantation. Exp Hematol 2000; 28: 1197–1205.

    Article  CAS  PubMed  Google Scholar 

  15. Rocha V, Sanz G, Gluckman E . Umbilical cord blood transplantation. Curr Opin Hematol 2004; 11: 375–385.

    Article  PubMed  Google Scholar 

  16. Koh LP, Chao NJ . Umbilical cord blood transplantation in adults using myeloablative and nonmyeloablative preparative regimens. Biol Blood Marrow Transplant 2004; 10: 1–22.

    Article  PubMed  Google Scholar 

  17. Ballen KK . New trends in umbilical cord blood transplantation. Blood 2005; 105: 3786–3792.

    Article  CAS  PubMed  Google Scholar 

  18. Tse W, Laughlin M . Cord blood transplantation in adult patients. Cytotherapy 2005; 7: 228–242.

    Article  CAS  PubMed  Google Scholar 

  19. Gluckman E, Rocha V . Donor selection for unrelated cord blood transplants. Curr Opin Immunol 2006; 18: 565–570.

    Article  CAS  PubMed  Google Scholar 

  20. Rocha V, Gluckman E . Clinical use of umbilical cord blood hematopoietic stem cells. Biol Blood Marrow Transplant 2006; 12: 34–41.

    Article  PubMed  Google Scholar 

  21. Brunstein CG, Wagner JE . Umbilical cord blood transplantation and banking. Annu Rev Med 2006; 57: 403–417.

    Article  CAS  PubMed  Google Scholar 

  22. Schoemans H, Theunissen K, Maertens J, Boogaerts M, Verfaillie C, Wagner J . Adult umbilical cord blood transplantation: a comprehensive review. Bone Marrow Transplant 2006; 38: 83–93.

    Article  CAS  PubMed  Google Scholar 

  23. Brunstein CG, Wagner JE . Cord blood transplantation for adults. Vox Sang 2006; 91: 195–205.

    Article  PubMed  Google Scholar 

  24. Barker JN . Who should get cord blood transplants? Biol Blood Marrow Transplant 2007; 13 (Suppl 1): 78–82.

    Article  Google Scholar 

  25. Brunstein CG, Baker KS, Wagner JE . Umbilical cord blood transplantation for myeloid malignancies. Curr Opin Hematol 2007; 14: 162–169.

    Article  PubMed  Google Scholar 

  26. Brunstein CG, Setubal DC, Wagner JE . Expanding the role of umbilical cord blood transplantation. Br J Haematol 2007; 137: 20–35.

    Article  PubMed  Google Scholar 

  27. Hwang WY, Samuel M, Tan D, Koh LP, Lim W, Linn YC . A meta-analysis of unrelated donor umbilical cord blood transplantation versus unrelated donor bone marrow transplantation in adult and pediatric patients. Biol Blood Marrow Transplant 2007; 13: 444–453.

    Article  PubMed  Google Scholar 

  28. Takahashi S . Leukemia: cord blood for allogeneic stem cell transplantation. Curr Opin Oncol 2007; 19: 667–672.

    Article  PubMed  Google Scholar 

  29. Wall DA, Chan KW . Selection of cord blood unit(s) for transplantation. Bone Marrow Transplant 2008; 42: 1–7.

    Article  CAS  PubMed  Google Scholar 

  30. Tse WW, Zang SL, Bunting KD, Laughlin MJ . Umbilical cord blood transplantation in adult myeloid leukemia. Bone Marrow Transplant 2008; 41: 465–472.

    Article  CAS  PubMed  Google Scholar 

  31. Tse W, Bunting KD, Laughlin MJ . New insights into cord blood stem cell transplantation. Curr Opin Hematol 2008; 15: 279–284.

    Article  PubMed  Google Scholar 

  32. Sauter C, Barker JN . Unrelated donor umbilical cord blood transplantation for the treatment of hematologic malignancies. Curr Opin Hematol 2008; 15: 568–575.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Gluckman E, Rocha V, Arcese W, Michel G, Sanz G, Chan KW et al. Factors associated with outcomes of unrelated cord blood transplant: guidelines for donor choice. Exp Hematol 2004; 32: 397–407.

    Article  CAS  PubMed  Google Scholar 

  34. Laughlin MJ, Eapen M, Rubinstein P, Wagner JE, Zhang MJ, Champlin RE et al. Outcomes after transplantation of cord blood or bone marrow from unrelated donors in adults with leukemia. N Engl J Med 2004; 351: 2265–2275.

    Article  CAS  PubMed  Google Scholar 

  35. Rocha V, Labopin M, Sanz G, Arcese W, Schwerdtfeger R, Bosi A et al. Transplants of umbilical-cord blood or bone marrow from unrelated donors in adults with acute leukemia. N Engl J Med 2004; 351: 2276–2285.

    Article  CAS  PubMed  Google Scholar 

  36. Takahashi S, Iseki T, Ooi J, Tomonari A, Takasugi K, Shimohakamada Y et al. Single-institute comparative analysis of unrelated bone marrow transplantation and cord blood transplantation for adult patients with hematological malignancies. Blood 2004; 104: 3813–3820.

    Article  CAS  PubMed  Google Scholar 

  37. Eapen M, Rocha V, Scaradavou A, Gluckman E, Laughlin M, Stevens C et al. Effect of stem cell source on transplant outcomes in adults with leukemia: a comparison of unrelated bone marrow (BM), peripheral blood (PB), and cord blood (PB). Blood 2008; 112: 62a.

    Google Scholar 

  38. Takahashi S, Ooi J, Tomonari A, Konuma T, Tsukada N, Oiwa-Monna M et al. Comparative single-institute analysis of cord blood transplantation from unrelated donors with bone marrow or peripheral blood stem-cell transplants from related donors in adult patients with hematologic malignancies after myeloablative conditioning regimen. Blood 2007; 109: 1322–1330.

    Article  CAS  PubMed  Google Scholar 

  39. Kumar P, Defor TE, Brunstein C, Barker JN, Wagner JE, Weisdorf DJ et al. Allogeneic hematopoietic stem cell transplantation in adult acute lymphocytic leukemia: impact of donor source on survival. Biol Blood Marrow Transplant 2008; 14: 1394–1400.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Ooi J, Takahashi S, Tomonari A, Tsukada N, Konuma T, Kato S et al. Unrelated cord blood transplantation after myeloablative conditioning in adults with ALL. Bone Marrow Transplant 2009; 43: 455–459.

    Article  CAS  PubMed  Google Scholar 

  41. Nagamura-Inoue T, Kai S, Azuma H, Takanashi M, Isoyama K, Kato K et al. Unrelated cord blood transplantation in CML: Japan Cord Blood Bank Network analysis. Bone Marrow Transplant 2008; 42: 241–251.

    Article  CAS  PubMed  Google Scholar 

  42. Ooi J . The efficacy of unrelated cord blood transplantation for adult myelodysplastic syndrome. Leuk Lymphoma 2006; 47: 599–602.

    Article  PubMed  Google Scholar 

  43. Rodrigues CA, Sanz G, Brunstein CG, Sanz J, Wagner JE, Renaud M et al. Analysis of risk Factors for outcomes after unrelated cord blood transplantation in adults with lymphoid malignancies: a study by the Eurocord-Netcord and Lymphoma Working Party of the European Group for Blood and Marrow Transplantation. J Clin Oncol 2009; 27: 256–263.

    Article  PubMed  Google Scholar 

  44. Barker JN, Weisdorf DJ, DeFor TE, Blazar BR, McGlave PB, Miller JS et al. Transplantation of 2 partially HLA-matched umbilical cord blood units to enhance engraftment in adults with hematologic malignancy. Blood 2005; 105: 1343–1347.

    Article  CAS  PubMed  Google Scholar 

  45. Macmillan ML, Weisdorf DJ, Brunstein CG, Cao Q, Defor TE, Verneris MR et al. Acute graft-versus-host disease after unrelated donor umbilical cord blood transplantation: analysis of risk factors. Blood 2009; 113: 2410–2415.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Frassoni F, Gualandi F, Podestà 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  PubMed  Google Scholar 

  47. Fernández MN, Regidor C, Cabrera R, García-Marco JA, Forés R, Sanjuán I et al. Unrelated umbilical cord blood transplants in adults: early recovery of neutrophils by supportive co-transplantation of a low number of highly purified peripheral blood CD34+ cells from an HLA-haploidentical donor. Exp Hematol 2003; 31: 535–544.

    Article  PubMed  Google Scholar 

  48. Magro E, Regidor C, Cabrera R, Sanjuán I, Forès R, Garcia-Marco JA et al. Early hematopoietic recovery after single unit unrelated cord blood transplantation in adults supported by co-infusion of mobilized stem cells. Haematologica 2006; 91: 640–648.

    PubMed  Google Scholar 

  49. Bautista G, Cabrera JR, Regidor C, Forés R, García-Marco JA, Ojeda E et al. Cord blood transplants supported by co-infusion of mobilized hematopoietic stem cells from a third-party donor. Bone Marrow Transplant 2009; 43: 365–373.

    Article  CAS  PubMed  Google Scholar 

  50. Brunstein CG, Barker JN, Weisdorf DJ, DeFor TE, Miller JS, Blazar BR et al. Umbilical cord blood transplantation after nonmyeloablative conditioning: impact on transplantation outcomes in 110 adults with hematologic disease. Blood 2007; 110: 3064–3070.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Ballen KK, Spitzer TR, Yeap BY, McAfee S, Dey BR, Attar E et al. Double unrelated reduced-intensity umbilical cord blood transplantation in adults. Biol Blood Marrow Transplant 2007; 13: 82–89.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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  1. Department of Hematology and Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan

    J Ooi

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Ooi, J. Cord blood transplantation in adults. Bone Marrow Transplant 44, 661–666 (2009). https://doi.org/10.1038/bmt.2009.282

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