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回复 s02260441 的帖子" N* V' Z" c$ S B: p. _3 E; I2 V/ z* n
- d3 D9 `8 }- D9 hPublished in final edited form as:
) P- E% a2 Z$ A. xBiol Blood Marrow Transplant. 2009 December ; 15(12): 1596–1602. doi:10.1016/j.bbmt.2009.08.009.0 C1 X" A/ _3 @4 _; H
3 q: N& m6 a1 e- r" r7 RA “No-wash” Albumin-Dextran Dilution Strategy for Cord Blood2 ~( ]2 l1 \/ b. o! Z9 F* `: v$ J
Unit Thaw: High Rate of Engraftment and a Low Incidence of& M1 _8 q6 u, d% ]: x
Serious Infusion Reactions0 Y- J- e" C# f" C" U
+ z& S' o+ D9 i/ B$ R% [. ~2 ~
Abstract7 E+ |4 p) ~; I6 W8 e6 |
Preparation of cord blood (CB) units for infusion by albumin-dextran dilution without
' m2 c5 ~6 A8 v8 i+ z' f: t$ Ycentrifugation may be advantageous for adult patients to minimize cell loss and, unlike a bedside* Q& y5 t6 ^1 ]8 V3 R
thaw, is still conducted in the controlled laboratory environment. Therefore, we studied CB
* s3 b/ n" ? x# N+ Z' d* r+ _transplantation (CBT) using this technique in 54 consecutive CBT recipients ≥20 kg. Patients1 x e" r, C) s2 }4 r
[median age 42 years (range 7–66); median weight 71 kg (range 24–109)] were transplanted for
1 W. P8 U0 g$ P0 phigh-risk hematological malignancies with ablative (n=35) or non-ablative (n=19) conditioning
/ `4 P/ }7 r3 Q# k' Q" b/ Xand 4–6/6 human leukocyte antigen (HLA)-matched double unit grafts. One hundred and seven. | z4 X |/ s; m
units were thawed with dilution whereas 1 red blood cell (RBC) replete unit was washed. A 5:1- a" G4 i x. j& J& ]- H
dextran 40/ 25% albumin solution was used. RBC depleted units (n=104) were diluted ≥5.5 fold B0 s0 {7 @; ]% m: f- s- @( T9 `& e
[median final volume 200 ml (range 200–500)] whereas RBC replete units (n=3) were diluted ≥4
( O# }" t ]& r8 |1 G. S+ zfold [median final volume 400 ml (range 400–535)]. Total nucleated cell (TNC) recovery was# M/ x/ G0 ^. w. z2 c
86%; the median infused TNC dose was 2.17 × 107/kg/unit. While 35 patients (65%) had a total of
# P; n" F, M# X' W45 infusion reactions (6 nausea, 31 hypertension, 3 pain, 1 rigors/fever, 2 transient hypoxia, 2
! W" ?& O0 E2 F: Yrenal impairment) requiring additional therapy, there were no infusion-related serious adverse+ ?' q0 F$ o! r1 C b
events, and reactions were not related to DMSO dose/kg. Cumulative incidence of sustained donor
2 U2 t2 r* e3 C0 w* ^engraftment was 94% (95%CI: 87–100) with neutrophil recovery occurring at a median of 25 days3 p: u7 U; ?8 h# _3 H% l' R
(range 13–43) in ablative and 10 days (range 7–36) in non-myeloablative recipients. CB thaw with
+ }; O6 Q/ f. b9 d6 `albumin-dextran dilution reduces unit manipulation, and minimizes cell loss, speeds time to8 R! R5 D3 z; h1 r9 L
infusion, is associated with a tolerable infusion reaction profile, and a high rate of sustained
0 i4 I# U. u p; t4 Vengraftment in CBT recipients ≥20 kg./ y! X4 D9 z$ Q5 Q% q
7 p: ~+ X! e3 U
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发表于 2014-5-6 12:15
发表于 2014-5-7 09:35
