Enhanced engraftment of a very low-dose cord blood unit in an adult haemopoietic transplant by addition of six mismatched viable cord units

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Abstract

The report describes the feasibility of the addition of multiple viable HLA-mismatched unrelated cord blood units, to a low cell number matched unrelated cord, to assist clinical engraftment. An ablative stem cell transplant was performed in an adult with relapsed acute lymphoblastic leukaemia (ALL), using a single HLA-matched cord blood unit (mononuclear cell dose 0.8 × 107), supported by six mismatched cord blood units (one unit per 10kg recipient weight). No adverse reaction occurred following the infusion of mismatched units and engraftment of the suboptimal-dose matched unit occurred rapidly, with no molecular evidence of engraftment of mismatched cords. Early molecular remission of ALL was demonstrated using a novel PCR for a mitochondrial DNA mutation in the leukaemic clone. The cell dose of the matched cord was well below that recommended to engraft a 70kg recipient. We suggest that a factor or factors in the mismatched cords enhanced/supported engraftment of the matched cord. Copyright © 2010 Stephen J. Proctor et al.

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Proctor, S. J., Chapman, C. E., Sharples, R., Lucraft, H. L., Wilkinson, J., Conn, J., & Middleton, P. G. (2010). Enhanced engraftment of a very low-dose cord blood unit in an adult haemopoietic transplant by addition of six mismatched viable cord units. Stem Cells International. https://doi.org/10.4061/2010/431909

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