Guidelines for Cord Blood Unit Selection
Guidelines for Cord Blood Unit Selection
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DOI：
10.1016/j.bbmt.2020.07.030
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发表时间：
2020-12-01
影响因子：
4.3
通讯作者：
Barker, Juliet N.
中科院分区：
文献类型：
--
作者：
Politikos, Ioannis;Davis, Eric;Barker, Juliet N.
最佳的脐带血（CB）单位的选择是至关重要的，以最大限度地提高成功植入和CB移植（CBT）后生存的可能性。然而，单位选择可能是复杂的，因为必须考虑多种特征，包括单位细胞剂量、供体-受体人白细胞抗原（HLA）匹配和单位质量。本综述为CB单位的选择提供了基于证据和经验的综合指南。讨论的主题包括使用TNC和CD 34（+）细胞剂量，以及CD 34（+）细胞与TNC含量比来评估单位祖细胞含量和植入潜力，可接受的TNC和CD 34（+）细胞剂量标准定义了足够的单单位移植物，以及双单位移植物的适应症和可接受的细胞剂量标准。本文还对6个位点（HLA-A、-B抗原、-DRB 1等位基因）和8个等位基因（HLA-A、-B、-C、-DRB 1）供受者HLA配型的可接受标准、对具有供者特异性HLA抗体的患者的评价以及单位质量的多个决定因素进行了详细的综述。最后，一个实用的一步一步的指南CB搜索和指导最终移植物选择的原则概述。(C)2020年美国移植和细胞治疗学会。爱思唯尔公司出版
Optimal cord blood (CB) unit selection is critical to maximize the likelihood of successful engraftment and survival after CB transplantation (CBT). However, unit selection can be complex because multiple characteristics must be considered including unit cell dose, donor-recipient human leukocyte antigen (HLA) match, and unit quality. This review provides evidence-based and experience-based comprehensive guidelines for CB unit selection. Topics addressed include the use of both the TNC and the CD34(+) cell dose, as well as the CD34(+) cell to TNC content ratio to evaluate unit progenitor cell content and engraftment potential, the acceptable TNC and CD34(+) cell dose criteria that define an adequate single-unit graft, and the indication and acceptable cell dose criteria for double-unit grafts. The acceptable criteria for 6-loci (HLA-A, -B antigen, -DRB1 allele) and 8-allele (HLA-A, -B, -C, -DRB1) donor-recipient HLA match, the evaluation of patients with donor-specific HLA antibodies, and the multiple determinants of unit quality are also reviewed in detail. Finally, a practical step-by-step guide to CB searches and the principles that guide ultimate graft selection are outlined. (C) 2020 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc.