Scoring system for optimal cord blood unit selection for single cord blood transplantation

脐带血 川地34 医学 移植 内科学 骨髓 免疫学 人类白细胞抗原 男科 干细胞 胃肠病学 生物 抗原 遗传学
作者
Mizuki Watanabe,Takaaki Konuma,Nobuhiko Imahashi,Seitaro Terakura,Sachiko Seo,Satoko Morishima,Naoyuki Uchida,Noriko Doki,Masatsugu Tanaka,Tetsuya Nishida,Toshiro Kawakita,Tetsuya Eto,Satoshi Takahashi,Masashi Sawa,Yasufumi Uehara,Sung‐Won Kim,Fumihiko Ishimaru,Tatsuo Ichinohe,Takahiro Fukuda,Yoshiko Atsuta,Junya Kanda
出处
期刊:Cytotherapy [Elsevier BV]
卷期号:26 (3): 286-298
标识
DOI:10.1016/j.jcyt.2023.12.001
摘要

We conducted a retrospective study to categorize the cord blood unit (CBU)s to identify the optimal units.A total of 8503 adults (female, n = 3592; male, n = 4911) receiving their first single cord blood transplantation (CBT) in 2000-2019 were analyzed. Factors associated with CBUs affecting overall survival (OS) and neutrophil engraftment were selected to create ranked categorization for each outcome, followed by comparison with transplantation using HLA-matched bone marrow (BMT)/peripheral blood stem cell (PBSCT) from unrelated (n = 6052) and related donors (n = 4546).Sex-mismatch, CD34+ cell and CFU-GM counts were selected in the OS analysis. Considering the strong interaction between sex mismatch and CD34+ cell counts, we analyzed females and males separately. For females, female CBU with CD34+ cell counts {greater than or equal to} 0.5 × 10e5/kg and CFU-GM counts {greater than or equal to} 15 × 10e3/kg offered the best OS (Group I), followed by other groups with any (Groups II-IV) or all (Group V) of the risk factors. Group I consistently showed favorable OS (Group IV: HR1.22, P = 0.027; Group V: HR1.31, P = 0.047), comparable to those of rBMT/PBSCT (OS: HR1.02, P = 0.654) and uBM/PBSCT in patients with higher rDRI (HR1.07, P = 0.353). Male patients lacked significant factors affecting OS. Categorization for neutrophil engraftment consisting of CD34+ cell and CFU-GM counts, sex-mismatch, presence of donor-specific antibodies, and the number of HLA-mismatches was effective but not predicted OS.Our ranked categorizations sufficiently predicted female OS and engraftment. The best-ranked CBUs offered preferable outcomes comparable to conventional BM/PB donors in female but not in male patients.
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