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Results showed significant expansion of mesenchymal progenitors (CD90؉, CD105؉, and CD166؉) in each TRC formulation. In vivo bone formation, measured by histology, was highest in the TRC group, followed by TRC-C Ad and TRC-C. The TRC product outperformed starting BM MNC and had equivalent bone forming potential to purified MSCs at the same cell dose. Post hoc analysis revealed that the presence of CD90؉, CD105؉, and CD166؉ correlated strongly with in vivo bone formation scores (r 2 > .95). These results demonstrate that this bioreactor system can be used to generate, in a single step, a population of progenitor cells with potent osteogenic potential.

Summary:Delayed engraftment, graft failure, and adverse transplant-related events have been observed in unrelated umbilical cord blood (UCB) recipients, particularly in those receiving a low leukocyte cell dose and in CML patients. We report the outcomes of two older adult patients with high risk CML who received a low leukocyte cell dose of unmanipulated UCB cells supplemented with ex vivo expanded (AastromReplicell System) UCB cells. Each engrafted promptly and neither patient experienced GVHD or life-threatening infection. Both remain engrafted with cells exclusively of donor origin and are in cytogenetic remission at 19 and 8 months follow-up. Ex vivo expanded UCB cells appear to facilitate hematopoietic recovery and therefore may increase the number of CML patients eligible for unrelated UCB transplant. Bone Marrow Transplantation (2000) 25, 797-799. Keywords: chronic myelogenous leukemia; umbilical cord blood transplant; ex vivo expansion Transplantation of umbilical cord blood (UCB) from related and unrelated donors has been performed in an attempt to increase the number of potential allogeneic stem cell donors. 1,2 The limited availability of unrelated donor UCB units of adequate nucleated cell dose, however, restricts its application in older adult patients. Ex vivo expansion of UCB in small and clinical-scale regulated perfusion experiments (AastromReplicell System, Ann Arbor, MI, USA) has been proven capable of significantly increasing the number of total nucleated cells, CFU-GM, and longterm culture initiating cells. 3 Therefore, the effect of supplementing unrelated donor UCB with ex vivo expanded UCB cells from the same donor was evaluated in two older adult patients with high risk CML and no alternative donor.