Transplant of Ex Vivo Expanded Cord Blood Safe, Effective
(HealthDay News) – For patients with hematologic cancers receiving transplant of cord-blood, expansion with allogeneic mesenchymal stromal cells seems safe and significantly improves engraftment, according to a study published in the Dec. 13 issue of the New England Journal Medicine.
Marcos de Lima, MD, from the University of Texas MD Anderson Cancer Center in Houston, and colleagues studied engraftment results in 31 adults with hematologic cancers who received transplants of two cord-blood units. One unit contained cord blood that was expanded ex vivo in cocultures with allogeneic mesenchymal stromal cells. Results were compared to records from 80 historical controls who received two units of unmanipulated cord blood.
The researchers found that coculture with mesenchymal stromal cells led to an expansion of total nucleated cells and CD34+ cells by a median factor of 12.2 and 30.1, respectively. Patients who received transplantation of expanded and unmanipulated cord blood received higher doses of total nucleated and CD34+ cells than historical controls. The median time to neutrophil engraftment was significantly shorter for the recipients of expanded cord blood (15 days vs. 24 days in controls who received unmanipulated cord blood only; P<0.001). For platelet engraftment the median time was 42 and 49 days, respectively (P=0.03). The cumulative incidence of neutrophil engraftment on Day 26 was 88% with expansion vs. 53% without expansion (P<0.001), and the cumulative incidence of platelet engraftment on Day 60 was 71% and 31%, respectively (P<0.001).
"Transplantation of cord-blood cells expanded with mesenchymal stromal cells appeared to be safe and effective," the authors write. "Expanded cord blood in combination with unmanipulated cord blood significantly improved engraftment, as compared with unmanipulated cord blood only."
The study was funded in part by Mesoblast; several authors disclosed financial ties to Mesoblast and other biotechnology and pharmaceutical companies.