Riccardo Saccardi1,2, Luciana Tucunduva2, Annalisa Ruggeri2,3, Irina Ionescu4, Gesine Koegler5, Sergio Querol6, Giuliano Grazzini7, Lucilla Lecchi8, Alessandro Nanni Costa9, Cristina Navarrete10, Fabienne Pouthiers11, Jerome Larghero12, Donna Regan13, Taryn Freeman14, Henrique Bittencourt15, Chantal Kenzey2, Myriam Labopin3, Etienne Baudoux16, Vanderson Rocha2,17, Eliane Gluckman2,18. 1. Careggi University Hospital, Firenze, Italy. 2. Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, Paris, France. 3. Hospital Saint Antoine, Service d'Hématologie et Thérapie Cellulaire, AP-HP, UPMC Univ Paris 06, UMR-S 938, CEREST-TC EBMT, Paris, France. 4. Agence de la Biomedicine, Paris, France. 5. Dusseldorf Cord Blood Bank, University of Dusseldorf, Dusseldorf, Germany. 6. Barcelona Cord Blood Bank, Barcelona, Spain. 7. Centro Nazionale Sangue, Rome, Italy. 8. Milano Cord Blood Bank, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 9. Centro Nazionale Trapianti, Rome, Italy. 10. NHS-Cord Blood Bank, NHSBT, and University College London, London, UK. 11. Besançon Cord Blood Bank of the Etablissement Français du Sang, Besançon, France. 12. Paris Cord Blood Bank, Hôpital Saint Louis, Paris, France. 13. St Louis Cord Blood Bank & Cellular Therapy Laboratory, St Louis, Missouri. 14. Sydney Cord Blood Bank, Sydney, NSW, Australia. 15. CHU Sainte-Justine, Montreal, Quebec, Canada. 16. NetCord Foundation and Liege Cord Blood Bank, University of Liege, Liege, Belgium. 17. Churchill Hospital, Oxford University Hospitals, Oxford, UK. 18. Monacord, Centre Scientifique de Monaco, Monaco.
Abstract
BACKGROUND: Techniques for banking cord blood units (CBUs) as source for hematopoietic stem cell transplantation have been developed over the past 20 years, aimed to improve laboratory efficiency without altering the biologic properties of the graft. A large-scale, registry-based assessment of the impact of the banking variables on the clinical outcome is currently missing. STUDY DESIGN AND METHODS: A total of 677 single cord blood transplants (CBTs) carried out for acute leukemia in complete remission in centers affiliated with the European Society for Blood and Marrow Transplantation were selected. An extensive set of data concerning CBU banking were collected and correlations with clinical outcome were assessed. Clinical endpoints were transplant-related mortality, engraftment, and graft-versus-host disease (GVHD). RESULTS: The median time between collection and CBT was 4.1 years (range, 0.2-16.3 years). Volume reduction (VR) of CBUs before freezing was performed in 59.2% of available reports; in half of these the frozen volume was less than 30 mL. Cumulative incidences of neutrophil engraftment on Day 60, 100-day acute GVHD (II-IV), and 4-year chronic GVHD were 87, 29, and 21 ± 2%. The cumulative incidence of nonrelapse mortality (NRM) at 100 days and 4-year NRM were, respectively, 16 ± 2 and 30 ± 2%. Neither the variables related to banking procedures nor the interval between collection and CBT influenced the clinical outcome. CONCLUSION: These findings indicate a satisfactory validation of the techniques associated with CBU VR across the banks. Cell viability assessment varied among the banks, suggesting that efforts to improve the standardization of CBU quality controls are needed.
BACKGROUND: Techniques for banking cord blood units (CBUs) as source for hematopoietic stem cell transplantation have been developed over the past 20 years, aimed to improve laboratory efficiency without altering the biologic properties of the graft. A large-scale, registry-based assessment of the impact of the banking variables on the clinical outcome is currently missing. STUDY DESIGN AND METHODS: A total of 677 single cord blood transplants (CBTs) carried out for acute leukemia in complete remission in centers affiliated with the European Society for Blood and Marrow Transplantation were selected. An extensive set of data concerning CBU banking were collected and correlations with clinical outcome were assessed. Clinical endpoints were transplant-related mortality, engraftment, and graft-versus-host disease (GVHD). RESULTS: The median time between collection and CBT was 4.1 years (range, 0.2-16.3 years). Volume reduction (VR) of CBUs before freezing was performed in 59.2% of available reports; in half of these the frozen volume was less than 30 mL. Cumulative incidences of neutrophil engraftment on Day 60, 100-day acute GVHD (II-IV), and 4-year chronic GVHD were 87, 29, and 21 ± 2%. The cumulative incidence of nonrelapse mortality (NRM) at 100 days and 4-year NRM were, respectively, 16 ± 2 and 30 ± 2%. Neither the variables related to banking procedures nor the interval between collection and CBT influenced the clinical outcome. CONCLUSION: These findings indicate a satisfactory validation of the techniques associated with CBU VR across the banks. Cell viability assessment varied among the banks, suggesting that efforts to improve the standardization of CBU quality controls are needed.
Authors: L Faivre; H Boucher; R Zerbib; T Domet; A Desproges; C Couzin; V Vanneaux; J Larghero; A Cras Journal: Bone Marrow Transplant Date: 2017-07-10 Impact factor: 5.483