Document Detail


Importance of day 21 BM chimerism in sustained neutrophil engraftment following double-unit cord blood transplantation.
MedLine Citation:
PMID:  22139066     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Delayed or failed engraftment remains a concern after cord blood transplantation (CBT) even when using double-unit grafts. Therefore, we analyzed the association between BM assessment performed approximately 21 days after transplantation, and the speed and success of sustained donor-derived neutrophil engraftment in 56 myeloablative double-unit CBT (DCBT) recipients. Overall, the cumulative incidence of sustained neutrophil engraftment was 95% (95% confidence intervals (CI): 89-100). Of the percentage of myeloid precursors, the BM cellularity and the total donor chimerism the total donor chimerism percentage had the most critical association with the speed and success of engraftment. DCBT recipients who were 100% donor achieved a 98% engraftment rate at a median of 22 days. This compared with 100% engraftment in patients who were 90-99% donor, but at a delayed median of 29 days and only 68% engraftment in patients <90% donor at a median of 37 days (P=0.001). Multivariate analysis was performed in the subgroup of patients who had not engrafted at the time the BM analysis was performed, the subgroup of most clinical concern. This confirmed donor chimerism was predictive of subsequent neutrophil recovery (P=0.004). These findings demonstrate the importance of the day 21 BM chimerism determinations after DCBT.
Authors:
S Avery; M H Voss; A M Gonzales; M Lubin; H Castro-Malaspina; S Giralt; N A Kernan; A Scaradavou; C V Hedvat; C E Stevens; J N Barker
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-12-05
Journal Detail:
Title:  Bone marrow transplantation     Volume:  47     ISSN:  1476-5365     ISO Abbreviation:  Bone Marrow Transplant.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-08-08     Completed Date:  2012-12-17     Revised Date:  2014-04-02    
Medline Journal Info:
Nlm Unique ID:  8702459     Medline TA:  Bone Marrow Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  1056-60     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Bone Marrow Cells / cytology*
Cell Count
Child
Child, Preschool
Cord Blood Stem Cell Transplantation*
Female
Graft Survival*
Hematologic Neoplasms / pathology,  therapy
Humans
Male
Middle Aged
Neutrophils / cytology*
Time Factors
Transplantation Chimera*
Transplantation, Homologous
Grant Support
ID/Acronym/Agency:
P01 CA023766/CA/NCI NIH HHS; P01 CA23766/CA/NCI NIH HHS
Comments/Corrections

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