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Optimal Practices in Unrelated Donor Cord Blood Transplantation for Hematologic Malignancies.

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Date
2017-06
Authors
Barker, Juliet N
Kurtzberg, Joanne
Ballen, Karen
Boo, Michael
Brunstein, Claudio
Cutler, Corey
Horwitz, Mitchell
Milano, Filippo
Olson, Amanda
Spellman, Stephen
Wagner, John E
Delaney, Colleen
Shpall, Elizabeth
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(13 total)
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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 article
Subject
Humans
Hematologic Neoplasms
Cord Blood Stem Cell Transplantation
Practice Guidelines as Topic
Unrelated Donors
Permalink
https://hdl.handle.net/10161/24619
Published Version (Please cite this version)
10.1016/j.bbmt.2017.03.006
Publication 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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Scholars@Duke

Horwitz

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.
Kurtzberg

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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