Cord blood units with low CD34+ cell viability have a low probability of engraftment after double unit transplantation.
Cord blood units with low CD34+ cell viability have a low probability of engraftment after double unit transplantation.
复制标题
DOI：
10.1016/j.bbmt.2009.11.013
复制
发表时间：
2010-04
期刊：
影响因子：
--
通讯作者：
Barker JN
中科院分区：
文献类型：
--
作者：
Scaradavou A;Smith KM;Hawke R;Schaible A;Abboud M;Kernan NA;Young JW;Barker JN
双单位脐带血（CB）移植（CBT）似乎增加了移植，尽管只有一个单位移植在大多数患者。我们假设，较好的单位质量，如通过解冻后较高的活细胞百分比来衡量，将决定移植单位。因此，我们使用改良门控的流式细胞术前瞻性地分析了46例解冻后的双单位移植，包括所有死细胞。使用75%阈值（平均活力减去2SD）， 20%的单位具有低CD34+细胞活力，其活力根据来源库而变化。此外，在44例单单元移植患者中，CD34+细胞活力在移植单元中更高（p=0.0016）。如果两个细胞都具有高CD34+活力，那么任何一个细胞都可以移植，而活力<75%的细胞则不太可能移植：在接受一个高CD34+活力单位和一个低CD34+活力单位的16名患者中，只有1/16个活力<75%的细胞移植（p=0.0006）。此外，在未植入任何一个单位的单个患者中，两个单位的CD34+活力均<75%。最后，较差的CD34+活力与较低的cfu相关（p=0.02）。我们的数据表明，双单元CBT可以改善移植的一种机制是通过增加移植至少一个具有足够活力和移植潜力的单元的可能性。
Double unit cord blood (CB) transplantation (CBT) appears to augment engraftment despite only one unit engrafting in most patients. We hypothesized that superior unit quality, as measured by a higher percentage of viable cells post-thaw, would determine the engrafting unit. Therefore, we prospectively analyzed 46 double unit transplants post-thaw using flow cytometry with modified gating that included all dead cells. Using a 75% threshold (mean viability minus 2SD), 20% of units had low CD34+ cell viability, with viability varying according to the bank of origin. Further, in the 44 patients with single unit engraftment, CD34+ cell viability was higher in engrafting units (p=0.0016). While either unit engrafted if both had high CD34+ viability, units with <75% viability were very unlikely to engraft: in 16 patients that received one high and one low CD34+ viability unit, only 1/16 units with viability <75% engrafted (p=0.0006). Further, in the single patient without engraftment of either unit, both had CD34+ viability <75%. Finally, poor CD34+ viability correlated with lower CFUs (p=0.02). Our data suggests one mechanism by which double unit CBT can improve engraftment is by increasing the probability of transplanting at least one unit with adequate viability and the potential to engraft.