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Published in final edited form as:
0 M- d+ K# e5 J/ }% b) {Biol Blood Marrow Transplant. 2009 December ; 15(12): 1596–1602. doi:10.1016/j.bbmt.2009.08.009.
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" G3 H) h5 x, l2 W( H1 jA “No-wash” Albumin-Dextran Dilution Strategy for Cord Blood
1 Z1 ~6 {# o& U& S; |Unit Thaw: High Rate of Engraftment and a Low Incidence of
( X# F; {5 t D+ ISerious Infusion Reactions
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Preparation of cord blood (CB) units for infusion by albumin-dextran dilution without
# o1 q6 S9 _! rcentrifugation may be advantageous for adult patients to minimize cell loss and, unlike a bedside0 y+ M5 F. ^! B7 h
thaw, is still conducted in the controlled laboratory environment. Therefore, we studied CB. m" O% s+ V" t+ c5 U
transplantation (CBT) using this technique in 54 consecutive CBT recipients ≥20 kg. Patients
7 ~1 K6 Z7 J+ r+ a[median age 42 years (range 7–66); median weight 71 kg (range 24–109)] were transplanted for
5 m& C/ r+ W2 ?& e; @0 Z: \0 Zhigh-risk hematological malignancies with ablative (n=35) or non-ablative (n=19) conditioning
) r8 h, C' v2 `) J# k$ J1 M p1 W+ Aand 4–6/6 human leukocyte antigen (HLA)-matched double unit grafts. One hundred and seven) ?. u w# y7 q
units were thawed with dilution whereas 1 red blood cell (RBC) replete unit was washed. A 5:1+ a- K2 G2 i8 ?- {3 }
dextran 40/ 25% albumin solution was used. RBC depleted units (n=104) were diluted ≥5.5 fold6 s3 |7 E4 m8 ]$ x$ R0 ?" G8 M
[median final volume 200 ml (range 200–500)] whereas RBC replete units (n=3) were diluted ≥4
" a( n4 {6 s8 I' r. S" Z' W( ~fold [median final volume 400 ml (range 400–535)]. Total nucleated cell (TNC) recovery was! [& e) G/ A2 V
86%; the median infused TNC dose was 2.17 × 107/kg/unit. While 35 patients (65%) had a total of' `4 Z9 g* A" N6 c
45 infusion reactions (6 nausea, 31 hypertension, 3 pain, 1 rigors/fever, 2 transient hypoxia, 2
8 a! Z0 @$ u4 I- b2 }2 W( ~: arenal impairment) requiring additional therapy, there were no infusion-related serious adverse
% `$ I- `( `- X9 Y: i- w( v) Devents, and reactions were not related to DMSO dose/kg. Cumulative incidence of sustained donor
3 `( Z: \0 |" I( P/ y4 Sengraftment was 94% (95%CI: 87–100) with neutrophil recovery occurring at a median of 25 days1 Y Z, Q6 |# c
(range 13–43) in ablative and 10 days (range 7–36) in non-myeloablative recipients. CB thaw with. d$ T1 n; r J7 A6 J' e, W9 e- N% g
albumin-dextran dilution reduces unit manipulation, and minimizes cell loss, speeds time to
+ E9 l: \8 |& [3 E" Cinfusion, is associated with a tolerable infusion reaction profile, and a high rate of sustained
# e4 Q. s. e) i& i9 T: k @engraftment in CBT recipients ≥20 kg.
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发表于 2014-5-6 12:15
发表于 2014-5-7 09:35
