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Placental blood as a source of hematopoietic stem cells for transplantation into unrelated recipients.

Publication ,  Journal Article
Kurtzberg, J; Laughlin, M; Graham, ML; Smith, C; Olson, JF; Halperin, EC; Ciocci, G; Carrier, C; Stevens, CE; Rubinstein, P
Published in: N Engl J Med
July 18, 1996

BACKGROUND: Transplantation of bone marrow from unrelated donors is limited by a lack of HLA-matched donors and the risk of graft-versus-host disease (GVHD). Placental blood from sibling donors can reconstitute hematopoiesis. We report preliminary results of transplantation using partially HLA-mismatched placental blood from unrelated donors. METHODS: Twenty-five consecutive patients, primarily children, with a variety of malignant and non-malignant conditions received placental blood from unrelated donors and were evaluated for hematologic and immunologic reconstitution and GVHD. HLA matching was performed before transplantation by serologic typing for class I HLA antigens and low-resolution molecular typing for class II HLA alleles. In donor-recipient pairs who differed by no more than one HLA antigen or allele, high-resolution class II HLA typing was done retrospectively. Fordonor-recipient pairs who were mismatched for two HLA antigens or alleles, high-resolution typing was used prospectively to select the best match for HLA-DRB1. RESULTS: Twenty-four of the 25 donor-recipient pairs were discordant for one to three HLA antigens. In 23 of the 25 transplant recipients, the infused hematopoletic stem cells engrafted. Acute grade III GVHD occurred in 2 of the 21 patients who could be evaluated, and 2 patients had chronic GVHD. In vitro proliferative responses of T cells and B cells to plant mitogens were detected 60 days after transplantation. With a median follow-up of 12 1/2 months and a minimal follow-up of 100 days, the overall 100-day survival rate among these patients was 64 percent, and the overall event-free survival was 48 percent. CONCLUSIONS: HLA-mismatched placental blood from unrelated donors is an alternative source of stem cells for hematopoietic reconstitution in children.

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Published In

N Engl J Med

DOI

ISSN

0028-4793

Publication Date

July 18, 1996

Volume

335

Issue

3

Start / End Page

157 / 166

Location

United States

Related Subject Headings

  • Survival Rate
  • Placenta
  • Male
  • Infant, Newborn
  • Infant
  • Humans
  • Histocompatibility Testing
  • Hematopoietic Stem Cell Transplantation
  • Hematologic Diseases
  • HLA Antigens
 

Citation

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Kurtzberg, J., Laughlin, M., Graham, M. L., Smith, C., Olson, J. F., Halperin, E. C., … Rubinstein, P. (1996). Placental blood as a source of hematopoietic stem cells for transplantation into unrelated recipients. N Engl J Med, 335(3), 157–166. https://doi.org/10.1056/NEJM199607183350303
Kurtzberg, J., M. Laughlin, M. L. Graham, C. Smith, J. F. Olson, E. C. Halperin, G. Ciocci, C. Carrier, C. E. Stevens, and P. Rubinstein. “Placental blood as a source of hematopoietic stem cells for transplantation into unrelated recipients.N Engl J Med 335, no. 3 (July 18, 1996): 157–66. https://doi.org/10.1056/NEJM199607183350303.
Kurtzberg J, Laughlin M, Graham ML, Smith C, Olson JF, Halperin EC, et al. Placental blood as a source of hematopoietic stem cells for transplantation into unrelated recipients. N Engl J Med. 1996 Jul 18;335(3):157–66.
Kurtzberg, J., et al. “Placental blood as a source of hematopoietic stem cells for transplantation into unrelated recipients.N Engl J Med, vol. 335, no. 3, July 1996, pp. 157–66. Pubmed, doi:10.1056/NEJM199607183350303.
Kurtzberg J, Laughlin M, Graham ML, Smith C, Olson JF, Halperin EC, Ciocci G, Carrier C, Stevens CE, Rubinstein P. Placental blood as a source of hematopoietic stem cells for transplantation into unrelated recipients. N Engl J Med. 1996 Jul 18;335(3):157–166.
Journal cover image

Published In

N Engl J Med

DOI

ISSN

0028-4793

Publication Date

July 18, 1996

Volume

335

Issue

3

Start / End Page

157 / 166

Location

United States

Related Subject Headings

  • Survival Rate
  • Placenta
  • Male
  • Infant, Newborn
  • Infant
  • Humans
  • Histocompatibility Testing
  • Hematopoietic Stem Cell Transplantation
  • Hematologic Diseases
  • HLA Antigens