Optimal Practices in Unrelated Donor Cord Blood Transplantation for Hematologic Malignancies.

Published

Journal Article (Review)

Unrelated donor cord blood transplantation (CBT) results in disease-free survival comparable to that of unrelated adult donor transplantation in patients with hematologic malignancies. Extension of allograft access to racial and ethnic minorities, rapid graft availability, flexibility of transplantation date, and low risks of disabling chronic graft-versus-host disease (GVHD) and relapse are significant advantages of CBT, and multiple series have reported a low risk of late transplantation-related mortality (TRM) post-transplantation. Nonetheless, early post-transplantation morbidity and TRM and the requirement for intensive early post-transplantation management have slowed the adoption of CBT. Targeted care strategies in CBT recipients can mitigate early transplantation complications and reduce transplantation costs. Herein we provide a practical "how to" guide to CBT for hematologic malignancies on behalf of the National Marrow Donor Program and the American Society of Blood and Marrow Transplantation's Cord Blood Special Interest Group. It shares the best practices of 6 experienced US transplantation centers with a special interest in the use of cord blood as a hematopoietic stem cell source. We address donor search and unit selection, unit thaw and infusion, conditioning regimens, immune suppression, management of GVHD, opportunistic infections, and other factors in supportive care appropriate for CBT. Meticulous attention to such details has improved CBT outcomes and will facilitate the success of CBT as a platform for future graft manipulations.

Full Text

Duke Authors

Cited Authors

  • Barker, JN; Kurtzberg, J; Ballen, K; Boo, M; Brunstein, C; Cutler, C; Horwitz, M; Milano, F; Olson, A; Spellman, S; Wagner, JE; Delaney, C; Shpall, E

Published Date

  • June 2017

Published In

Volume / Issue

  • 23 / 6

Start / End Page

  • 882 - 896

PubMed ID

  • 28279825

Pubmed Central ID

  • 28279825

Electronic International Standard Serial Number (EISSN)

  • 1523-6536

Digital Object Identifier (DOI)

  • 10.1016/j.bbmt.2017.03.006

Language

  • eng

Conference Location

  • United States