Ex Vivo Mesenchymal Precursor Cell-Expanded Cord Blood Transplantation after Reduced-Intensity Conditioning Regimens Improves Time to Neutrophil Recovery

Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
Rohtesh S MehtaBetul Oran

Abstract

We previously showed the safety of using cord blood (CB) expanded ex vivo in cocultures with allogeneic mesenchymal precursor cells (MPC) after myeloablative conditioning with faster recovery of neutrophils and platelets compared with historical controls. Herein, we report the transplantation outcomes of 27 patients with hematologic cancers who received 1 CB unit expanded ex vivo with MPCs in addition to an unmanipulated CB (MPC group) after reduced-intensity conditioning (RIC). The results in this group were compared with 51 historical controls who received 2 unmanipulated CB units (control group). The analyses were stratified for 2 RIC treatment groups: (1) total body irradiation 200 cGy + cyclophosphamide + fludarabine) (TCF), and (2) fludarabine + melphalan  (FM). Coculture of CB with MPCs led to an expansion of total nucleated cells by a median factor of 12 and of CD34+ cells by a median factor of 49. In patients in whom engraftment occurred, the median time to neutrophil engraftment was 12 days in the MPC group, as compared with 16 days in controls (P = .02). The faster neutrophil engraftment was observed in both RIC groups. The cumulative incidence of neutrophil engraftment on day 26 was 75% with expansion versus 50% wit...Continue Reading

Citations

Jun 2, 2018·Expert Review of Hematology·Luciana TeofiliOrnella Parolini
Sep 22, 2018·Current Opinion in Hematology·Melody Becnel, Elizabeth J Shpall
Jul 4, 2020·Stem Cells Translational Medicine·Tamila L Kindwall-Keller, Karen K Ballen
Mar 20, 2021·Molecular Therapy. Methods & Clinical Development·Sandeep K SrivastavaSandhya R Panch
Apr 5, 2021·Acta Biomaterialia·Chandralekha ChatterjeeCornelia Lee-Thedieck
Apr 11, 2021·Cytotherapy·Ignatius M ViljoenMichael S Pepper
Nov 2, 2021·Stem Cells Translational Medicine·Xiaoyu ZhuZimin Sun

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