Influence of infused cell dose and HLA match on engraftment after double-unit cord blood allografts
Influence of infused cell dose and HLA match on engraftment after double-unit cord blood allografts
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DOI：
10.1182/blood-2010-08-300491
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发表时间：
2011-03-24
期刊：
影响因子：
20.3
通讯作者：
Barker, Juliet N.
中科院分区：
文献类型：
--
作者：
Avery, Sharon;Shi, Weiji;Barker, Juliet N.
细胞剂量和人类白细胞抗原(HLA)配型对双单位脐血(CB)植入的影响尚未确定。因此，我们分析了细胞剂量和高分辨率HLA配型对84例双单位脐血移植受者中性粒细胞植入的影响。在几乎所有患者中，94%的持续植入率为1个单位。较高的CD3(+)细胞剂量(P=0.04)和CD34(+)细胞活性百分比(P=0.008)与单位优势相关。清髓预适应后，优势单位总有核细胞(TNC)、CD34(+)细胞和集落形成单位剂量越高，持续植入率越高，中性粒细胞恢复越快(分别为P=0.07，P=0.008和P<；0.0001)。总输注TNC(P=.0007)和CD3(+)细胞剂量(P<；.001)也显著影响植入。在高分辨率下，供受者之间的差异很常见，但对植入(P=.66)或单位优势(P=.13)没有影响。虽然单位-单位的人类白细胞抗原配型也不影响持续植入(P=1.0)，但相互匹配的单位(7-10到10-10)的受者更有可能表现出两个单位的初始植入(P<；.0001)。我们的发现对单位选择具有重要的意义，并为双单位生物学提供了进一步的见解。(血。2011；117(12)：3277-3285)
The influence of cell dose and human leukocyte antigen (HLA) match on double-unit cord blood (CB) engraftment is not established. Therefore, we analyzed the impact of cell dose and high-resolution HLA match on neutrophil engraftment in 84 double-unit CB transplant recipients. The 94% sustained engraftment rate was accounted for by 1 unit in nearly all patients. Higher CD3(+) cell doses (P = .04) and percentage of CD34(+) cell viability (P = .008) were associated with unit dominance. After myeloablative conditioning, higher dominant unit total nucleated cell (TNC), CD34(+) cell, and colony-forming unit doses were associated with higher sustained engraftment and faster neutrophil recovery (P = .07, P = .0008, and P < .0001, respectively). Total infused TNC (P = .0007) and CD3(+) cell doses (P < .001) also significantly influenced engraftment. At high-resolution extensive donor-recipient HLA disparity was frequent, but had no influence on engraftment (P = .66), or unit dominance (P = .13). Although the unit-unit HLA match also did not affect sustained engraftment (P = 1.0), recipients of units closely (7-10 to 10-10) HLA-matched to each other were more likely to demonstrate initial engraftment of both units (P < .0001). Our findings have important implications for unit selection and provide further insight into double-unit biology. (Blood. 2011;117(12):3277-3285)