Immunological and clinical aspects of double cord blood transplants
Minneapolis, United States of America
47 slide(s) – 00:19:31 – English – 2008-06-13
1. Understand the indications of double UCB transplant
2. Understand the the expected outcomes of double UCB transplant
3. Review the data on immunological aspects of double UCB transplant
Umbilical cord blood (UCB) has been increasingly used as a source of hematopoietic stem cells for transplantation of children and adults, with malignant and nonmalignant disease, in the myeloablative and in the nonmyeloablative setting. However, the cell dose of a single unit remains an important limitation for transplantation of larger adolescent and adult patients. Among several possible strategies to overcome the cell dose limitation, the utilization of two UCB units to compose a graft has been shown to allow transplantation of this patient population with potentially improved engraftment, low risk of treatment related mortality and enhanced survival, as compared to adults previously transplanted with single UCB units. While many aspects of this approach using two UCB units remain to be elucidated, it is clear that 1) the double UCB platform has broadened patient eligibility, and 2) use of two UCB units is associated with greater risk of grade II acute graft-versus-host disease. How the coinfusion of two UCB units enhances engraftment or reduces the risk of relapse remains to be proven. Here, we will discuss the current state of knowledge on the immunological properties and clinical aspects of this novel treatment strategy.