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" N8 }, F; ?2 e7 |! z/ |Published in final edited form as:) P+ B" B- w0 }
Biol Blood Marrow Transplant. 2009 December ; 15(12): 1596–1602. doi:10.1016/j.bbmt.2009.08.009.
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! I, x! g, M7 i8 O& z* I- }A “No-wash” Albumin-Dextran Dilution Strategy for Cord Blood
8 V) H+ w: b7 ~: y7 [" l$ Y* kUnit Thaw: High Rate of Engraftment and a Low Incidence of
& }& c& U/ U" i ~1 n, v" x2 _! ZSerious Infusion Reactions' c0 W4 E( _( l9 G3 P* J/ e8 C
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Abstract' H/ D+ P- E2 f" ]' b, W
Preparation of cord blood (CB) units for infusion by albumin-dextran dilution without0 n' @5 M7 O& X) |9 H
centrifugation may be advantageous for adult patients to minimize cell loss and, unlike a bedside
0 K( ^- o) C" }5 J/ d9 W6 V8 p3 ethaw, is still conducted in the controlled laboratory environment. Therefore, we studied CB
( |+ V' X6 A; [! y9 x$ q( M7 Ztransplantation (CBT) using this technique in 54 consecutive CBT recipients ≥20 kg. Patients) w9 i; T8 p( e" W2 a, d1 _1 l
[median age 42 years (range 7–66); median weight 71 kg (range 24–109)] were transplanted for0 v: W/ R; v" h3 l3 f' K8 G
high-risk hematological malignancies with ablative (n=35) or non-ablative (n=19) conditioning) h3 y) I- F- E% Y9 E6 \* h, o
and 4–6/6 human leukocyte antigen (HLA)-matched double unit grafts. One hundred and seven* }( R+ T. g' R
units were thawed with dilution whereas 1 red blood cell (RBC) replete unit was washed. A 5:1, U" {6 O# w Y8 R
dextran 40/ 25% albumin solution was used. RBC depleted units (n=104) were diluted ≥5.5 fold# X8 J) ?: P. w6 [" k2 s
[median final volume 200 ml (range 200–500)] whereas RBC replete units (n=3) were diluted ≥4
5 d! K, o6 g2 I4 ufold [median final volume 400 ml (range 400–535)]. Total nucleated cell (TNC) recovery was
) h: C/ X$ m( W8 M86%; the median infused TNC dose was 2.17 × 107/kg/unit. While 35 patients (65%) had a total of- \( E( B2 V0 K7 K* s6 f6 V9 i+ I1 C
45 infusion reactions (6 nausea, 31 hypertension, 3 pain, 1 rigors/fever, 2 transient hypoxia, 2 q; s2 l3 E) }
renal impairment) requiring additional therapy, there were no infusion-related serious adverse
$ S. H7 Q. O1 jevents, and reactions were not related to DMSO dose/kg. Cumulative incidence of sustained donor& c3 ]/ K8 d9 c- q1 P( a$ y
engraftment was 94% (95%CI: 87–100) with neutrophil recovery occurring at a median of 25 days
g: A, H& X' s" E(range 13–43) in ablative and 10 days (range 7–36) in non-myeloablative recipients. CB thaw with
* Z) l) Q7 _3 e5 ^3 ^$ kalbumin-dextran dilution reduces unit manipulation, and minimizes cell loss, speeds time to' \7 E- a$ f2 N
infusion, is associated with a tolerable infusion reaction profile, and a high rate of sustained, \; e% {5 V% Q2 C
engraftment in CBT recipients ≥20 kg.1 V+ V7 l9 l7 t) d& V
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