AI Article Synopsis
- Umbilical Cord Blood (UCB) is a promising alternative for patients with blood cancers who lack matched donors, and using the intrabone (IB) method may enhance outcomes due to higher cell availability.
- In a study involving 23 patients, there was a high chance of recovering blood cell counts by day 90, with low rates of severe graft-versus-host disease (GVHD) and quick immune system restoration.
- The research highlighted that the success of IB-UCB transplants could be linked to specific stem cell regulatory markers like c-Mpl, suggesting that the direct IB injection may help maintain stem cell function in a supportive environment.
Article Abstract
Umbilical Cord Blood (UCB) represents a valid option for patients with hematopoietic malignancies lacking an HLA matched donor. To overcome the limitation of the low stem cell dose of UCB, the intrabone (IB) route has been proposed. We report the results of a prospective study on a poor-prognosis cohort of 23 patients receiving intrabone single UCB transplant (Clinicaltrials.gov NCT00886522). Cumulative incidence of hematological recovery at day 90 was 82 ± 9% (ANC > 0.5 × 10/L) and 70 ± 10% (platelet > 50 × 10/L) and correlated with CD34 + cells in the graft. NRM was 20 ± 9%. No severe aGVHD and only one extensive cGVHD occurred, with fast immune reconstitution. To test the hypothesis that the direct IB injection could affect the expression of stem cells regulatory pathways, CD34 + cells from BM aspirates at day + 10, + 20, + 30, processed in hypoxic conditions mimicking the BM-microenvironment (7%pO), were studied for the expression of c-Mpl, Notch1 and CXCR4. We found that the expression of c-Mpl in CD34 + cells at day + 10 significantly correlated with hematological recovery. In conclusion, IB-UCB transplant success is associated with low incidence of GVHD and high-speed platelet recovery; intrabone route may preserve full hematopoietic stemness by direct delivery of UCB stem cells into the hypoxic HSC niche.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6760547 | PMC |
| http://dx.doi.org/10.1038/s41409-018-0335-x | DOI Listing |
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