Optimal Practices in Unrelated Donor Cord Blood Transplantation for Hematologic Malignancies.
Abstract
Unrelated donor cord blood transplantation (CBT) results in disease-free survival
comparable to that of unrelated adult donor transplantation in patients with hematologic
malignancies. Extension of allograft access to racial and ethnic minorities, rapid
graft availability, flexibility of transplantation date, and low risks of disabling
chronic graft-versus-host disease (GVHD) and relapse are significant advantages of
CBT, and multiple series have reported a low risk of late transplantation-related
mortality (TRM) post-transplantation. Nonetheless, early post-transplantation morbidity
and TRM and the requirement for intensive early post-transplantation management have
slowed the adoption of CBT. Targeted care strategies in CBT recipients can mitigate
early transplantation complications and reduce transplantation costs. Herein we provide
a practical "how to" guide to CBT for hematologic malignancies on behalf of the National
Marrow Donor Program and the American Society of Blood and Marrow Transplantation's
Cord Blood Special Interest Group. It shares the best practices of 6 experienced US
transplantation centers with a special interest in the use of cord blood as a hematopoietic
stem cell source. We address donor search and unit selection, unit thaw and infusion,
conditioning regimens, immune suppression, management of GVHD, opportunistic infections,
and other factors in supportive care appropriate for CBT. Meticulous attention to
such details has improved CBT outcomes and will facilitate the success of CBT as a
platform for future graft manipulations.
Type
Journal articleSubject
HumansHematologic Neoplasms
Cord Blood Stem Cell Transplantation
Practice Guidelines as Topic
Unrelated Donors
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https://hdl.handle.net/10161/24619Published Version (Please cite this version)
10.1016/j.bbmt.2017.03.006Publication Info
Barker, Juliet N; Kurtzberg, Joanne; Ballen, Karen; Boo, Michael; Brunstein, Claudio;
Cutler, Corey; ... Shpall, Elizabeth (2017). Optimal Practices in Unrelated Donor Cord Blood Transplantation for Hematologic Malignancies.
Biology of blood and marrow transplantation : journal of the American Society for
Blood and Marrow Transplantation, 23(6). pp. 882-896. 10.1016/j.bbmt.2017.03.006. Retrieved from https://hdl.handle.net/10161/24619.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Mitchell Eric Horwitz
Professor of Medicine
Allogeneic stem cell transplantation with a focus on the use of umbilical cord blood
grafts; Allogenic stem cell transplantation for Sickle Cell Disease; Prevention of
acute and chronic graft versus host disease; Improving immune recovery following alternative
donor stem cell transplantation using donor graft manipulation.
Joanne Kurtzberg
Jerome S. Harris Distinguished Professor of Pediatrics
Dr. Kurtzberg is an internationally renowned expert in pediatric hematology/oncology,
pediatric blood and marrow transplantation, umbilical cord blood banking and transplantation,
and novel applications of cord blood and birthing tissues in the emerging fields of
cellular therapies and regenerative medicine. Dr. Kurtzberg serves as the Director
of the Marcus Center for Cellular Cures (MC3), Director of the Pediatric Transplant
and Cellular Therapy Program, Director of the Carolina
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