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Cord blood unit factors influencing transplant outcomes from the Asian multiethnic Singapore Cord Blood Bank

Bone Marrow Transplantation volume 50, pages 1256–1258 (2015)Cite this article

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Cord blood transplants (CBTs) require less stringent matching for HLA, extending hematopoietic stem cell transplant to patients from ethnic minorities who are less likely to find an unrelated adult donor through registries. However, delayed engraftment and graft failure remain higher in CBT compared with transplants using other stem cell sources. The ability to predict the likelihood of successful engraftment of cord blood (CB) units based on information provided by CB banks is important for transplant success. The Singapore Cord Blood Bank (SCBB) is a NetCord-FACT-accredited center that has been operating since 2005 and has provided over 200 CB units for transplant globally. CB units come from a multiethnic donor database, which provides an opportunity to evaluate transplant outcomes in a predominantly non-Caucasian population. There is also no prior study evaluating the impact of donor–recipient race-matching on GvHD in a South Asian population. Hence, we undertook an analysis to determine the graft characteristics that affect engraftment and risk of GvHD in a group of patients who received CB grafts from the SCBB.

We retrospectively analyzed data from the SCBB for the first CB units distributed for transplant in 100 patients with ALL (30%), AML (45%), CML (17%) or myelodysplastic syndrome (MDS, 8%) between March 2008 and June 2013. The types of transplant included single (n=53) and double (n=47) CBT, with the majority receiving myeloablative conditioning regimens (73%). Most recipients in this study were over 18 years of age (65%). The ethnic distribution of the recipients was 49 Chinese, 13 Malay, 4 Indian, 21 Caucasian and 16 other or mixed ethnicity. In double CBT, donor–recipient HLA disparity was assigned on the basis of the dominant unit in double CB grafts. Most recipients (n=82) received grafts matched at 5/6 or 6/6 HLA loci (HLA-A, HLA-B at intermediate resolution and HLA-DRB1 at high-resolution typing), whereas 18 received grafts matched at 4/6 loci. Patients gave informed consent for data entry into the SCBB registry database and for its use for analysis in accordance with the Declaration of Helsinki.

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Authors and Affiliations

  1. Department of Haematology, Singapore General Hospital, Singapore

    S-Y Ong, C Phipps, A Y L Ho & W Hwang

  2. Singapore Cord Blood bank, Singapore

    P Chu, A Prasath, S J Sobak & W Hwang

Authors
  1. S-Y Ong
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  2. C Phipps
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  3. P Chu
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  4. A Prasath
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  5. A Y L Ho
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  6. S J Sobak
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  7. W Hwang
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Correspondence to S-Y Ong.

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Ong, SY., Phipps, C., Chu, P. et al. Cord blood unit factors influencing transplant outcomes from the Asian multiethnic Singapore Cord Blood Bank. Bone Marrow Transplant 50, 1256–1258 (2015). https://doi.org/10.1038/bmt.2015.134

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