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Can intra-osseous transplantation improve results of umbilical cord blood transplantation in adult patients?

Bone Marrow Transplantation volume 37, page 335 (2006)Cite this article

Some recently published studies1, 2, 3 have raised intriguing questions which may be clinically relevant for future clinical trials of umbilical cord blood (UCB) transplantation in adults. Using a nonobese diabetic/severe combined immunodeficiency (NOD/SCID) xenotransplant model for studying the engraftment of human rapid short-term SCID repopulating cells (R-SRC), McKenzie et al.1 demonstrated higher engraftment 2 and 6 weeks after transplanting Lin− CD34+ CD38+/lo cells from human UCB by direct intrafemoral injection compared with the usual intravenous (IV) route.1 Earlier Castello et al.2 demonstrated that intraosseous (IO) transplantation of UCB mononuclear cells was associated with a seeding efficiency 15 times greater than IV transplantation.2 Based on their findings in mice and monkey models, Ikehara et al.3 considered intra-bone marrow (BM) transplantation a potentially important strategy.

The concept of using the IO route of infusion in emergencies is re-emerging4 and its safety is well established.5 In addition to IO needles and BM biopsy needles, semiautomated devices are being evaluated for this purpose. The IO route of BM transplantation, using posterior iliac crests, has already been tested successfully in a prospective randomized fashion both in children6 and adults.7 Although engraftment was not faster, a significant reduction in the number of days on total parenteral nutrition and a tendency toward a reduction in the number of days on antibiotics was noted in the IO compared with the IV group.7 Interestingly bacteremia did not occur in the IO group.7

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Authors and Affiliations

  1. Section of Adult Hematology & Hematopoietic Stem Cell Transplantation, King Faisal Cancer Center (MBC 59), King Faisal Specialist Hospital & Research Center, PO Box 3354, Riyadh, 11211, Saudi Arabia

    S Z A Zaidi, E A Sahovic, A S Al-Shanqeeti & M Aljurf

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  1. S Z A Zaidi
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  2. E A Sahovic
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  3. A S Al-Shanqeeti
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  4. M Aljurf
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Correspondence to S Z A Zaidi.

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Zaidi, S., Sahovic, E., Al-Shanqeeti, A. et al. Can intra-osseous transplantation improve results of umbilical cord blood transplantation in adult patients?. Bone Marrow Transplant 37, 335 (2006). https://doi.org/10.1038/sj.bmt.1705237

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