Are backup BM harvests worthwhile in unrelated donor allogeneic transplants?

Stotler, Christy; Bolwell, Brian J.; Sobecks, Ronald; Dean, Robert M.; Serafino, Sheila; Rybicki, Lisa; Andrèsen, Steven; Pohlman, Brad; Kalaycio, Matt; Copelan, Edward A.

doi:10.1038/bmt.2009.95

Cited by 9 publications

(3 citation statements)

References 14 publications

(8 reference statements)

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“…Indication of harvesting an autologous back‐up bone marrow or peripheral haematopoietic stem cell is controversial for patients with high risk of graft failure. In 130 unrelated HSCT recipients who had backup harvests, 15 (11%) had their back‐up harvests re‐infused, all for graft failure (Stotler et al , 2009). Five patients are alive, four died of relapse and six of infection.…”

Section: Other Considerations When Selecting a Cb Unitmentioning

confidence: 99%

Improving outcomes of cord blood transplantation: HLA matching, cell dose and other graft‐ and transplantation‐related factors

Rocha

Gluckman

registry³

2009

Br J Haematol

253

190

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SummaryThe use of unrelated umbilical cord blood (UCB) as an alternative source of haematopoietic stem cells transplantation (HSCT) has been widely used for patients lacking a human leucocyte antigen (HLA) matched donor. One of the disadvantages of using UCB is the limited number of haematopoietic stem cells and, consequently, delayed engraftment and increased risk of early mortality. Many approaches have been investigated in the attempt to improve engraftment and survival. Among those, studies analysing prognostic factors related to patients, disease, donor and transplantation have been performed. Variable factors have been identified, such as factors related to donor choice (HLA, cell dose and others) and transplantation (conditioning and graft-versus-host disease prophylaxis regimens). This review will focus on the interactions between HLA, cell dose and other modifiable factors related to the UCB unit selection and transplantation that may improve outcomes after UCB transplantation.

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Section: Other Considerations When Selecting a Cb Unitmentioning

confidence: 99%

Improving outcomes of cord blood transplantation: HLA matching, cell dose and other graft‐ and transplantation‐related factors

Rocha

Gluckman

registry³

2009

Br J Haematol

253

190

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“…Bone marrow transplantation (BMT) is an important procedure for curing hematological malignancies, although engraftment failure [1] and graft-versus-host disease (GVHD) [2] remain serious complications following allogeneic BMT. To examine these complications, it is important to monitor the transplanted donor cells in the initial phase after BMT because donor cell homing is a rapid process.…”

Section: Introductionmentioning

confidence: 99%

Noninvasive Tracking of Donor Cell Homing by Near-Infrared Fluorescence Imaging Shortly after Bone Marrow Transplantation

et al. 2010

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BackgroundMany diseases associated with bone marrow transplantation (BMT) are caused by transplanted hematopoietic cells, and the onset of these diseases occurs after homing of donor cells in the initial phase after BMT. Noninvasive observation of donor cell homing shortly after transplantation is potentially valuable for improving therapeutic outcomes of BMT by diagnosing the early stages of these diseases.Methodology/Principal FindingsFreshly harvested near-infrared fluorescence-labeled cells were noninvasively observed for 24 h after BMT using a photon counting device to track their homing process. In a congenic BMT model, the homing of Alexa Fluor 750-labeled donor cells in the tibia was detected less than 1 h after BMT. In addition, subsequent cell distribution in an intraBM BMT model was successfully monitored for the first time using this method. In the allogeneic BMT model, T-cell depletion decreased the near-infrared fluorescence (NIRF) signals of the reticuloendothelial system.Conclusions/SignificanceThis approach in several murine BMT models revealed that the transplanted cells homed within 24 h after transplantation. NIRF labeling is useful for tracking transplanted cells in the initial phase after BMT, and this approach can contribute to in vivo studies aimed at improving the therapeutic outcomes of BMT.

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“…The preferred source of transplantable hematopoietic stem cells in the pediatric setting is generally bone marrow, particularly for nonmalignant conditions [ 13 ], which is easy to collect, relies on simple nucleated cell count, and does not require cryopreservation. The need for an autologous back up is questionable [ 14 ]. Considering all these peculiarities, it seems reasonable in the pediatric setting to start directly from allogeneic transplant before moving to autologous, which generally has more limited indications and success rates.…”

Section: Autologous Vs Allogeneic Transplantation At Start-upmentioning

confidence: 99%

Setting up and sustaining blood and marrow transplant services for children in middle-income economies: an experience-driven position paper on behalf of the EBMT PDWP

Faulkner¹,

Verna

Rovelli

et al. 2020

Bone Marrow Transplant

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Severe blood disorders and cancer are the leading cause of death and disability from noncommunicable diseases in the global pediatric population and a major financial burden. The most frequent of these conditions, namely sickle cell disease and severe thalassemia, are highly curable by blood or bone marrow transplantation (BMT) which can restore a normal health-related quality of life and be cost-effective. This position paper summarizes critical issues in extending global access to BMT based on ground experience in the start-up of several BMT units in middle-income countries (MICs) across South-East Asia and the Middle East where close to 700 allogeneic BMTs have been performed over a 10-year period. Basic requirements in terms of support systems, equipment, and consumables are summarized keeping in mind WHO’s model essential lists and recommendations. BMT unit setup and maintenance costs are summarized as well as those per transplant. Low-risk BMT is feasible and safe in MICs with outcomes comparable to high-income countries but at a fraction of the cost. This report might be of assistance to health care institutions in MICs interested in developing hematopoietic stem cell transplantation services and strengthening context appropriate tertiary care and higher medical education.

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Are backup BM harvests worthwhile in unrelated donor allogeneic transplants?

Cited by 9 publications

References 14 publications

Improving outcomes of cord blood transplantation: HLA matching, cell dose and other graft‐ and transplantation‐related factors

Improving outcomes of cord blood transplantation: HLA matching, cell dose and other graft‐ and transplantation‐related factors

Noninvasive Tracking of Donor Cell Homing by Near-Infrared Fluorescence Imaging Shortly after Bone Marrow Transplantation

Setting up and sustaining blood and marrow transplant services for children in middle-income economies: an experience-driven position paper on behalf of the EBMT PDWP

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