Guidelines for Cord Blood Unit Selection

Ioannis Politikos , Eric Davis , Melissa Nhaissi , John E. Wagner , Claudio G. Brunstein , Sandra Cohen , Elizabeth J. Shpall , Filippo Milano , Andromachi Scaradavou , Juliet N. Barker , American Society for Transplantation and Cellular Therapy Cord Blood Special Interest Group
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引用次数: 38

Abstract

Optimal cord blood (CB) unit selection is critical to maximize the likelihood of successful engraftment and survival after CB transplantation (CBT). However, unit selection can be complex because multiple characteristics must be considered including unit cell dose, donor-recipient human leukocyte antigen (HLA) match, and unit quality. This review provides evidence-based and experience-based comprehensive guidelines for CB unit selection. Topics addressed include the use of both the TNC and the CD34+ cell dose, as well as the CD34+ cell to TNC content ratio to evaluate unit progenitor cell content and engraftment potential, the acceptable TNC and CD34+ cell dose criteria that define an adequate single-unit graft, and the indication and acceptable cell dose criteria for double-unit grafts. The acceptable criteria for 6-loci (HLA-A, -B antigen, -DRB1 allele) and 8-allele (HLA-A, -B, -C, -DRB1) donor-recipient HLA match, the evaluation of patients with donor-specific HLA antibodies, and the multiple determinants of unit quality are also reviewed in detail. Finally, a practical step-by-step guide to CB searches and the principles that guide ultimate graft selection are outlined.

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脐带血单位选择指南
最佳脐带血(CB)单位选择是最大限度地提高脐带血移植(CBT)成功植入和存活的可能性的关键。然而,单位选择可能很复杂,因为必须考虑多种特征,包括单位细胞剂量、供体-受体人类白细胞抗原(HLA)匹配和单位质量。本综述为CB单元的选择提供了基于证据和经验的综合指南。讨论的主题包括TNC和CD34+细胞剂量的使用,以及CD34+细胞与TNC含量的比值来评估单位祖细胞含量和移植潜力,定义适当的单单位移植的可接受TNC和CD34+细胞剂量标准,以及双单位移植的适应症和可接受细胞剂量标准。对6位点(HLA- a, -B抗原,-DRB1等位基因)和8位点(HLA- a, -B, -C, -DRB1)供体-受体HLA匹配的可接受标准,供体特异性HLA抗体患者的评估,以及单位质量的多个决定因素也进行了详细综述。最后,对CB搜索和指导最终移植物选择的原则进行了概述。
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来源期刊
CiteScore
6.60
自引率
0.00%
发文量
1061
审稿时长
3-6 weeks
期刊介绍: Biology of Blood and Marrow Transplantation publishes original research reports, reviews, editorials, commentaries, letters to the editor, and hypotheses and is the official publication of the American Society for Transplantation and Cellular Therapy. The journal focuses on current technology and knowledge in the interdisciplinary field of hematopoetic stem cell transplantation.
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