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  • Cord blood transplants supp...
    Gomez-Arteaga, Alexandra; Orfali, Nina; Guarneri, Danielle; Cushing, Melissa M; Gergis, Usama; Hsu, Jingmei; Hsu, Yen-Michael S; Mayer, Sebastian A; Phillips, Adrienne A; Chase, Stacy A; Mokhtar, Asmaa E; Shore, Tsiporah B; Van Besien, Koen

    Bone marrow transplantation (Basingstoke), 12/2020, Letnik: 55, Številka: 12
    Journal Article

    Alternative donor transplantation with the haplo-cord platform allows the use of a lower-dose single umbilical cord blood unit (CBU) by co-infusion of third-party CD34 -selected cells from a haploidentical relative, which provides early transient engraftment while awaiting durable CBU engraftment. In our experience, ~15% of patients lack a suitable haploidentical donor. Here we report 26 patients who underwent haplo-cord transplant using CD34 -selected partially matched unrelated donor grafts. Twenty-four were conditioned with fludarabine/melphalan +/- low-dose TBI (n = 16). Twenty-five received ATG and all received posttransplant tacrolimus and mycophenolate mofetil. Median time to neutrophil and platelet recovery was 11 and 18 days. CBU engraftment, with CD33 and CD3 >5% cord chimerism in the myeloid/lymphoid compartment by day +60, occurred in 20 of 24 patients (83%). Incidence of grade 2-4 acute graft-versus-host disease (GVHD) was 27% at day +100, and chronic GVHD was 4% at 1 year. Overall survival at 1 year was 54%. For patients in need of an alternative transplant who lack a haploidentical donor, haplo-cord transplantation using CD34 -selected partially matched unrelated donor grafts results in rapid engraftment with no increased rate of cord graft failure or GVHD.