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Research Explores the Effects of Stem Cell Source and Patient Age on Stem Cell Transplantation Outcomes
Date:12/7/2008

olleen Delaney, MD, Fred HutchinsonCancer Research Center, Seattle, WA

This phase I study found that cord blood that is cultured to increase the number of CD34+ stem cells prior to transplantation helped to decrease the time to engraftment in patients with acute myeloid leukemia.

Cord blood is a valuable source of hematopoietic stem cells as it has a higher concentration of these cells than is normally found in adult blood. However, as only a small quantity of blood can typically be obtained from an umbilical cord, resulting in fewer available stem cells for transplantation, researchers have been investigating novel methods to expand the number of stem cells available from cord blood to help increase the success rates of cord blood stem cell transplants.

The objective of this study is to evaluate the safety and potential efficacy of giving increased numbers of cord blood progenitor cells that have been generated through a novel methodology whereby CD34+ cord blood progenitor cells are cultured prior to infusion to rapidly multiply in order to decrease the time required for the transplanted cells to engraft and begin production of healthy blood cells.

A total of six patients with acute myeloid leukemia were treated with a transplantation- preparation regimen of cytoxan (120 mg/kg), fludarabine (75 mg/m^2), and TBI (1320 cGy), followed one day later by an infusion of one unit of non-cultured cord blood and one unit of cord blood that had been CD34+ enriched and cultured for 16 days. The non-cultured unit was given to provide long-term repopulating stem cells that had not been previously manipulated, while the goal of the expanded unit was to provide cells capable of rapid myeloid recovery.

To achieve best results, cord blood units that most closely genetically matched the patient were selected for transfusion. All non-cultured cord blood stem cell
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SOURCE American Society of Hematology
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