Scoring system for optimal cord blood unit selection for single cord blood transplantation.

We conducted a retrospective study to categorize the cord blood unit (CBU)s to identify the optimal units. A total of 8503 adults (female, n = 3592; male, n = 4911) receiving their first single cord blood transplantation (CBT) in 2000-2019 were analyzed. Factors associated with CBUs affecting overall survival (OS) and neutrophil engraftment were selected to create ranked categorization for each outcome, followed by comparison with transplantation using HLA-matched bone marrow (BMT)/peripheral blood stem cell (PBSCT) from unrelated (n = 6052) and related donors (n = 4546). Sex-mismatch, CD34+ cell and CFU-GM counts were selected in the OS analysis. Considering the strong interaction between sex mismatch and CD34+ cell counts, we analyzed females and males separately. For females, female CBU with CD34+ cell counts {greater than or equal to} 0.5 × 10e5/kg and CFU-GM counts {greater than or equal to} 15 × 10e3/kg offered the best OS (Group I), followed by other groups with any (Groups II-IV) or all (Group V) of the risk factors. Group I consistently showed favorable OS (Group IV: HR1.22, P = 0.027; Group V: HR1.31, P = 0.047), comparable to those of rBMT/PBSCT (OS: HR1.02, P = 0.654) and uBM/PBSCT in patients with higher rDRI (HR1.07, P = 0.353). Male patients lacked significant factors affecting OS. Categorization for neutrophil engraftment consisting of CD34+ cell and CFU-GM counts, sex-mismatch, presence of donor-specific antibodies, and the number of HLA-mismatches was effective but not predicted OS. Our ranked categorizations sufficiently predicted female OS and engraftment. The best-ranked CBUs offered preferable outcomes comparable to conventional BM/PB donors in female but not in male patients. Copyright © 2023 International Society for Cell & Gene Therapy. Published by Elsevier Inc. All rights reserved.

Citation

Mizuki Watanabe, Takaaki Konuma, Nobuhiko Imahashi, Seitaro Terakura, Sachiko Seo, Satoko Morishima, Naoyuki Uchida, Noriko Doki, Masatsugu Tanaka, Tetsuya Nishida, Toshiro Kawakita, Tetsuya Eto, Satoshi Takahashi, Masashi Sawa, Yasufumi Uehara, Sung-Won Kim, Fumihiko Ishimaru, Tatsuo Ichinohe, Takahiro Fukuda, Yoshiko Atsuta, Junya Kanda. Scoring system for optimal cord blood unit selection for single cord blood transplantation. Cytotherapy. 2024 Mar;26(3):286-298

Mesh Tags

Substances

PMID: 38149949

search → result