|
- 积分
- 237
- 威望
- 237
- 包包
- 1133
|
回复 s02260441 的帖子
; |) ]5 T- U2 B% s$ P+ L
5 }- f: X$ t1 ^$ x7 QPublished in final edited form as:
, M! C$ w- h; a$ a4 `Biol Blood Marrow Transplant. 2009 December ; 15(12): 1596–1602. doi:10.1016/j.bbmt.2009.08.009.
( H9 d* B7 f+ m0 R/ H9 ?( L3 i; |+ U+ ~/ D1 g
A “No-wash” Albumin-Dextran Dilution Strategy for Cord Blood6 Z9 U3 p$ a0 `2 e2 O( ?5 b
Unit Thaw: High Rate of Engraftment and a Low Incidence of E; o& l5 u5 m, O4 I2 ^
Serious Infusion Reactions$ |" W' ?) }$ T4 J" A2 j
0 m1 M$ r8 C/ }/ W( y
Abstract
" T4 Z! o' f9 h+ \5 A" X( o0 W3 LPreparation of cord blood (CB) units for infusion by albumin-dextran dilution without% u& o' T, r; {( P7 v
centrifugation may be advantageous for adult patients to minimize cell loss and, unlike a bedside8 g& P0 q" m3 B9 F
thaw, is still conducted in the controlled laboratory environment. Therefore, we studied CB
, k6 I& D5 ^% q9 utransplantation (CBT) using this technique in 54 consecutive CBT recipients ≥20 kg. Patients5 |% V( P7 @- u; A+ ^. M* ?
[median age 42 years (range 7–66); median weight 71 kg (range 24–109)] were transplanted for
; y, {" A8 \4 x2 a/ m" A" shigh-risk hematological malignancies with ablative (n=35) or non-ablative (n=19) conditioning- C2 I1 y- C# j; A
and 4–6/6 human leukocyte antigen (HLA)-matched double unit grafts. One hundred and seven
7 _5 E, W- v( X9 V( j8 Junits were thawed with dilution whereas 1 red blood cell (RBC) replete unit was washed. A 5:1
+ E7 J) p$ V( n* Y, m+ L% U& ]! Ydextran 40/ 25% albumin solution was used. RBC depleted units (n=104) were diluted ≥5.5 fold' t6 [1 H7 W( W3 A: t( r3 P
[median final volume 200 ml (range 200–500)] whereas RBC replete units (n=3) were diluted ≥4
; f0 M _& E9 @; Mfold [median final volume 400 ml (range 400–535)]. Total nucleated cell (TNC) recovery was
% e8 E+ M6 [6 F0 X( p6 S0 {( r86%; the median infused TNC dose was 2.17 × 107/kg/unit. While 35 patients (65%) had a total of
/ Q9 w' I# }& g1 Z+ [45 infusion reactions (6 nausea, 31 hypertension, 3 pain, 1 rigors/fever, 2 transient hypoxia, 2
8 t' A$ N; Y9 o1 xrenal impairment) requiring additional therapy, there were no infusion-related serious adverse
. [5 U7 I% P" p- A6 M* Revents, and reactions were not related to DMSO dose/kg. Cumulative incidence of sustained donor1 U8 f4 i( H8 e; v2 n
engraftment was 94% (95%CI: 87–100) with neutrophil recovery occurring at a median of 25 days
5 |3 g2 R. P/ \2 f$ J(range 13–43) in ablative and 10 days (range 7–36) in non-myeloablative recipients. CB thaw with
& g0 N0 U& \% @: Q* x# Jalbumin-dextran dilution reduces unit manipulation, and minimizes cell loss, speeds time to
. }, k9 s2 m# p8 u# a Jinfusion, is associated with a tolerable infusion reaction profile, and a high rate of sustained8 m7 I9 ^; _- Y, H/ @# a
engraftment in CBT recipients ≥20 kg.
8 P. M# Z( ?6 `/ J$ r
0 X( K& k4 H0 E
2 D) k6 A7 s- [% o. `8 g( N4 i4 T |
-
总评分: 威望 + 1
包包 + 5
查看全部评分
|
发表于 2014-5-6 12:15
发表于 2016-7-22 14:59
