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The Cord Blood Apgar: a novel scoring system to optimize selection of banked cord blood grafts for transplantation (CME).

Publication ,  Journal Article
Page, KM; Zhang, L; Mendizabal, A; Wease, S; Carter, S; Shoulars, K; Gentry, T; Balber, AE; Kurtzberg, J
Published in: Transfusion
February 2012

BACKGROUND: Engraftment failure and delays, likely due to diminished cord blood unit (CBU) potency, remain major barriers to the overall success of unrelated umbilical cord blood transplantation (UCBT). To address this problem, we developed and retrospectively validated a novel scoring system, the Cord Blood Apgar (CBA), which is predictive of engraftment after UCBT. STUDY DESIGN AND METHODS: In a single-center retrospective study, utilizing a database of 435 consecutive single cord myeloablative UCBTs performed between January 1, 2000, to December 31, 2008, precryopreservation and postthaw graft variables (total nucleated cell, CD34+, colony-forming units, mononuclear cell content, and volume) were initially correlated with neutrophil engraftment. Subsequently, based on the magnitude of hazard ratios (HRs) in univariate analysis, a weighted scoring system to predict CBU potency was developed using a randomly selected training data set and internally validated on the remaining data set. RESULTS: The CBA assigns transplanted CBUs three scores: a precryopreservation score (PCS), a postthaw score (PTS), and a composite score (CS), which incorporates the PCS and PTS values. CBA-PCS scores, which could be used for initial unit selection, were predictive of neutrophil (CBA-PCS ≥ 7.75 vs. <7.75, HR 3.5; p < 0.0001) engraftment. Likewise, CBA-PTS and CS scores were strongly predictive of Day 42 neutrophil engraftment (CBA-PTS ≥ 9.5 vs. <9.5, HR 3.16, p < 0.0001; CBA-CS ≥ 17.75 vs. <17.75, HR 4.01, p < 0.0001). CONCLUSION: The CBA is strongly predictive of engraftment after UCBT and shows promise for optimizing screening of CBU donors for transplantation. In the future, a segment could be assayed for the PTS score providing data to apply the CS for final CBU selection.

Duke Scholars

Published In

Transfusion

DOI

EISSN

1537-2995

Publication Date

February 2012

Volume

52

Issue

2

Start / End Page

272 / 283

Location

United States

Related Subject Headings

  • Young Adult
  • Retrospective Studies
  • Middle Aged
  • Male
  • Infant, Newborn
  • Infant
  • Humans
  • Fetal Blood
  • Female
  • Cryopreservation
 

Citation

APA
Chicago
ICMJE
MLA
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Page, K. M., Zhang, L., Mendizabal, A., Wease, S., Carter, S., Shoulars, K., … Kurtzberg, J. (2012). The Cord Blood Apgar: a novel scoring system to optimize selection of banked cord blood grafts for transplantation (CME). Transfusion, 52(2), 272–283. https://doi.org/10.1111/j.1537-2995.2011.03278.x
Page, Kristin M., Lijun Zhang, Adam Mendizabal, Stephen Wease, Shelly Carter, Kevin Shoulars, Tracy Gentry, Andrew E. Balber, and Joanne Kurtzberg. “The Cord Blood Apgar: a novel scoring system to optimize selection of banked cord blood grafts for transplantation (CME).Transfusion 52, no. 2 (February 2012): 272–83. https://doi.org/10.1111/j.1537-2995.2011.03278.x.
Page KM, Zhang L, Mendizabal A, Wease S, Carter S, Shoulars K, et al. The Cord Blood Apgar: a novel scoring system to optimize selection of banked cord blood grafts for transplantation (CME). Transfusion. 2012 Feb;52(2):272–83.
Page, Kristin M., et al. “The Cord Blood Apgar: a novel scoring system to optimize selection of banked cord blood grafts for transplantation (CME).Transfusion, vol. 52, no. 2, Feb. 2012, pp. 272–83. Pubmed, doi:10.1111/j.1537-2995.2011.03278.x.
Page KM, Zhang L, Mendizabal A, Wease S, Carter S, Shoulars K, Gentry T, Balber AE, Kurtzberg J. The Cord Blood Apgar: a novel scoring system to optimize selection of banked cord blood grafts for transplantation (CME). Transfusion. 2012 Feb;52(2):272–283.
Journal cover image

Published In

Transfusion

DOI

EISSN

1537-2995

Publication Date

February 2012

Volume

52

Issue

2

Start / End Page

272 / 283

Location

United States

Related Subject Headings

  • Young Adult
  • Retrospective Studies
  • Middle Aged
  • Male
  • Infant, Newborn
  • Infant
  • Humans
  • Fetal Blood
  • Female
  • Cryopreservation