eJHaem (May 2023)
Refining eligibility criteria of unit selection for myeloablative cord blood transplantation in acute leukemia: Real‐world experience of a referral center
- Zimin Sun,
- Yu Hu,
- Yanping Ji,
- Xueou Liu,
- Xiaowen Gong,
- Yahui Feng,
- Huilan Liu,
- Wei Zhang,
- Saibing Qi,
- Qiujin Shen,
- Kaidi Song,
- Liangquan Geng,
- Wen Yao,
- Xiang Wan,
- Baolin Tang,
- Xiaoyu Zhu,
- Guangyu Sun,
- Ping Qiang,
- Zhen Song,
- Junren Chen
Affiliations
- Zimin Sun
- Department of Hematology The First Affiliated Hospital of University of Science and Technology of China Hefei China
- Yu Hu
- State Key Laboratory of Experimental Hematology National Clinical Research Center for Blood Diseases Haihe Laboratory of Cell Ecosystem Institute of Hematology and Blood Diseases Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Tianjin China
- Yanping Ji
- School of Clinical Medicine Anhui Medical University Hefei China
- Xueou Liu
- State Key Laboratory of Experimental Hematology National Clinical Research Center for Blood Diseases Haihe Laboratory of Cell Ecosystem Institute of Hematology and Blood Diseases Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Tianjin China
- Xiaowen Gong
- State Key Laboratory of Experimental Hematology National Clinical Research Center for Blood Diseases Haihe Laboratory of Cell Ecosystem Institute of Hematology and Blood Diseases Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Tianjin China
- Yahui Feng
- State Key Laboratory of Experimental Hematology National Clinical Research Center for Blood Diseases Haihe Laboratory of Cell Ecosystem Institute of Hematology and Blood Diseases Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Tianjin China
- Huilan Liu
- Department of Hematology The First Affiliated Hospital of University of Science and Technology of China Hefei China
- Wei Zhang
- State Key Laboratory of Experimental Hematology National Clinical Research Center for Blood Diseases Haihe Laboratory of Cell Ecosystem Institute of Hematology and Blood Diseases Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Tianjin China
- Saibing Qi
- State Key Laboratory of Experimental Hematology National Clinical Research Center for Blood Diseases Haihe Laboratory of Cell Ecosystem Institute of Hematology and Blood Diseases Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Tianjin China
- Qiujin Shen
- State Key Laboratory of Experimental Hematology National Clinical Research Center for Blood Diseases Haihe Laboratory of Cell Ecosystem Institute of Hematology and Blood Diseases Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Tianjin China
- Kaidi Song
- Department of Hematology The First Affiliated Hospital of University of Science and Technology of China Hefei China
- Liangquan Geng
- Department of Hematology The First Affiliated Hospital of University of Science and Technology of China Hefei China
- Wen Yao
- Department of Hematology The First Affiliated Hospital of University of Science and Technology of China Hefei China
- Xiang Wan
- Department of Hematology The First Affiliated Hospital of University of Science and Technology of China Hefei China
- Baolin Tang
- Department of Hematology The First Affiliated Hospital of University of Science and Technology of China Hefei China
- Xiaoyu Zhu
- Department of Hematology The First Affiliated Hospital of University of Science and Technology of China Hefei China
- Guangyu Sun
- Department of Hematology The First Affiliated Hospital of University of Science and Technology of China Hefei China
- Ping Qiang
- Department of Hematology The First Affiliated Hospital of University of Science and Technology of China Hefei China
- Zhen Song
- State Key Laboratory of Experimental Hematology National Clinical Research Center for Blood Diseases Haihe Laboratory of Cell Ecosystem Institute of Hematology and Blood Diseases Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Tianjin China
- Junren Chen
- State Key Laboratory of Experimental Hematology National Clinical Research Center for Blood Diseases Haihe Laboratory of Cell Ecosystem Institute of Hematology and Blood Diseases Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Tianjin China
- DOI
- https://doi.org/10.1002/jha2.703
- Journal volume & issue
-
Vol. 4,
no. 2
pp. 470 – 475
Abstract
Abstract The algorithm for cord blood (CB) unit selection is still somewhat ambiguous. We retrospectively analyzed 620 cases of acute leukemia between 2015 and 2020, who were treated with myeloablative single‐unit umbilical CB transplantation (UCBT). We found that, when human leukocyte antigen (HLA) mismatch was ≤3/10, CD34+ cell dosage <0.83 × 105/kg—considerably lower than prevalent guidelines—was permissible without affecting survival. Moreover, synergy between donor killer‐cell immunoglobulin‐like receptors (KIR) haplotypes‐B and donor‐recipient HLA‐C mismatch protected against relapse‐related mortality. We submit that minimum required CD34+ cell dosage can possibly be relaxed to broaden access to UCBT, and donor KIR genotyping should be considered during unit selection.
Keywords
