TY - JOUR
T1 - CD34+ cell content of 126 341 cord blood units in the US inventory
T2 - Implications for transplantation and banking
AU - Barker, Juliet N.
AU - Kempenich, Jane
AU - Kurtzberg, Joanne
AU - Brunstein, Claudio G.
AU - Delaney, Colleen
AU - Milano, Filippo
AU - Politikos, Ioannis
AU - Shpall, Elizabeth J.
AU - Scaradavou, Andromachi
AU - Dehn, Jason
N1 - Publisher Copyright:
© 2019 by The American Society of Hematology.
PY - 2019
Y1 - 2019
N2 - CD34+ cell dose is critical for cord blood (CB) engraftment. However, the CD34+ content of the CB inventory in the United States is unknown. We examined the CD34+ cell content of 126 341 red blood cell-depleted US units banked from January 2007 to September 2017 with a total nucleated cell (TNC) count of ≥90 × 107 and a cryovolume of 24-55 mL. Median precryopreservation TNC content was 127 × 107 (interquartile range [IQR], 108-156 × 107); CD34+ cell contentwas 44×105 (IQR, 29 to 67×105). Themedian CD341:TNC ratiowas 0.34%. TNC and CD34+ cell content correlation was weak (r 5 0.24). Of 7125 units with TNCs of ≥210 ×107, only 47%had CD34+ content of ≥100×105. However, some units had high CD34+ content for a given TNC count. Only 4%of CB units were acceptable as single-unit grafts (TNCs, ≥2.5×107/kg; CD34+ cells, ≥1.5 × 105/kg) for 70-kg patients; 22% of units were adequate for 70-kg patients using lower dose criteria (TNCs, ≥1.5 × 107/kg; CD34+ cells, ≥1.0 × 105/kg) suitable for a double-unit graft. These findings highlight that units with the highest TNC dose may not have the highest CD34+ dose, units with unexpectedly high CD34+ content (a ratio of .1.0%) should be verified, and the US CB inventory of adequately sized single units for larger patients is small. They also support the ongoing use of double-unit grafts, a focus on banking high-dose units, and development of expansion technologies.
AB - CD34+ cell dose is critical for cord blood (CB) engraftment. However, the CD34+ content of the CB inventory in the United States is unknown. We examined the CD34+ cell content of 126 341 red blood cell-depleted US units banked from January 2007 to September 2017 with a total nucleated cell (TNC) count of ≥90 × 107 and a cryovolume of 24-55 mL. Median precryopreservation TNC content was 127 × 107 (interquartile range [IQR], 108-156 × 107); CD34+ cell contentwas 44×105 (IQR, 29 to 67×105). Themedian CD341:TNC ratiowas 0.34%. TNC and CD34+ cell content correlation was weak (r 5 0.24). Of 7125 units with TNCs of ≥210 ×107, only 47%had CD34+ content of ≥100×105. However, some units had high CD34+ content for a given TNC count. Only 4%of CB units were acceptable as single-unit grafts (TNCs, ≥2.5×107/kg; CD34+ cells, ≥1.5 × 105/kg) for 70-kg patients; 22% of units were adequate for 70-kg patients using lower dose criteria (TNCs, ≥1.5 × 107/kg; CD34+ cells, ≥1.0 × 105/kg) suitable for a double-unit graft. These findings highlight that units with the highest TNC dose may not have the highest CD34+ dose, units with unexpectedly high CD34+ content (a ratio of .1.0%) should be verified, and the US CB inventory of adequately sized single units for larger patients is small. They also support the ongoing use of double-unit grafts, a focus on banking high-dose units, and development of expansion technologies.
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U2 - 10.1182/bloodadvances.2018029157
DO - 10.1182/bloodadvances.2018029157
M3 - Article
C2 - 30995984
AN - SCOPUS:85068626626
SN - 2473-9529
VL - 3
SP - 1267
EP - 1271
JO - Blood Advances
JF - Blood Advances
IS - 8
ER -