Transplantation of unrelated placental blood cells in children with high-risk sickle cell disease

T. V. Adamkiewicz, P. S. Mehta, M. W. Boyer, A. Kedar, T. A. Olson, E. Olson, K. Y. Chiang, D. Maurer, M. J. Mogul, J. R. Wingard, Andrew M Yeager

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

The lack of healthy HLA-identical sibs limits the use of allogeneic hematopoietic cell transplantation in children with high-risk sickle cell disease (SCD). We evaluated unrelated placental blood cell transplantation (UPBCT) after a preparative regimen of busulfan, cyclophosphamide and antithymocyte globulin in three children with SCD who had cerebrovascular accidents (CVAs) and did not have HLA-matched sib donors. The placental blood cell units were matched with the recipients at four of six HLA-A, HLA-B and HLA-DRB1 antigens. Neutrophil levels above 0.5 × 109/l occurred at 23, 38 and 42 days after UPBCT, and platelet levels above 50 × 109/l without transfusions occurred at 62, 81 and 121 days after UPBCT. All patients developed acute graft-versus-host disease (GVHD; two grade II, one grade III), and one developed extensive chronic GVHD. One patient had graft failure and autologous hematopoietic recovery. Two patients have complete donor hematopoietic chimerism without detectable hemoglobin S or symptoms of SCD at 40 and 61 months, respectively, after UPBCT. These observations demonstrate the feasibility of UPBCT in children with SCD. Further studies of UPBCT for SCD are needed but, because of risks of procedure-related morbidity and graft rejection, should be restricted to pediatric patients with high-risk manifestations of SCD.

Original languageEnglish (US)
Pages (from-to)405-411
Number of pages7
JournalBone Marrow Transplantation
Volume34
Issue number5
DOIs
StatePublished - Sep 2004
Externally publishedYes

Fingerprint

Cell Transplantation
Sickle Cell Anemia
Blood Cells
Transplantation
Tissue Donors
Sickle Hemoglobin
HLA-DRB1 Chains
Busulfan
Chimerism
HLA-A Antigens
Antilymphocyte Serum
HLA-B Antigens
Graft Rejection
Graft vs Host Disease
Cyclophosphamide
Neutrophils
Blood Platelets
Stroke
Pediatrics
Morbidity

Keywords

  • Allogeneic hematopoietic cell transplantation
  • Allogeneic transplantation
  • Placental (cord blood) cells
  • Sickle cell disease

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Transplantation of unrelated placental blood cells in children with high-risk sickle cell disease. / Adamkiewicz, T. V.; Mehta, P. S.; Boyer, M. W.; Kedar, A.; Olson, T. A.; Olson, E.; Chiang, K. Y.; Maurer, D.; Mogul, M. J.; Wingard, J. R.; Yeager, Andrew M.

In: Bone Marrow Transplantation, Vol. 34, No. 5, 09.2004, p. 405-411.

Research output: Contribution to journalArticle

Adamkiewicz, TV, Mehta, PS, Boyer, MW, Kedar, A, Olson, TA, Olson, E, Chiang, KY, Maurer, D, Mogul, MJ, Wingard, JR & Yeager, AM 2004, 'Transplantation of unrelated placental blood cells in children with high-risk sickle cell disease', Bone Marrow Transplantation, vol. 34, no. 5, pp. 405-411. https://doi.org/10.1038/sj.bmt.1704606
Adamkiewicz, T. V. ; Mehta, P. S. ; Boyer, M. W. ; Kedar, A. ; Olson, T. A. ; Olson, E. ; Chiang, K. Y. ; Maurer, D. ; Mogul, M. J. ; Wingard, J. R. ; Yeager, Andrew M. / Transplantation of unrelated placental blood cells in children with high-risk sickle cell disease. In: Bone Marrow Transplantation. 2004 ; Vol. 34, No. 5. pp. 405-411.
@article{79a2ad8c15a6412c8b5832c8ac310d43,
title = "Transplantation of unrelated placental blood cells in children with high-risk sickle cell disease",
abstract = "The lack of healthy HLA-identical sibs limits the use of allogeneic hematopoietic cell transplantation in children with high-risk sickle cell disease (SCD). We evaluated unrelated placental blood cell transplantation (UPBCT) after a preparative regimen of busulfan, cyclophosphamide and antithymocyte globulin in three children with SCD who had cerebrovascular accidents (CVAs) and did not have HLA-matched sib donors. The placental blood cell units were matched with the recipients at four of six HLA-A, HLA-B and HLA-DRB1 antigens. Neutrophil levels above 0.5 × 109/l occurred at 23, 38 and 42 days after UPBCT, and platelet levels above 50 × 109/l without transfusions occurred at 62, 81 and 121 days after UPBCT. All patients developed acute graft-versus-host disease (GVHD; two grade II, one grade III), and one developed extensive chronic GVHD. One patient had graft failure and autologous hematopoietic recovery. Two patients have complete donor hematopoietic chimerism without detectable hemoglobin S or symptoms of SCD at 40 and 61 months, respectively, after UPBCT. These observations demonstrate the feasibility of UPBCT in children with SCD. Further studies of UPBCT for SCD are needed but, because of risks of procedure-related morbidity and graft rejection, should be restricted to pediatric patients with high-risk manifestations of SCD.",
keywords = "Allogeneic hematopoietic cell transplantation, Allogeneic transplantation, Placental (cord blood) cells, Sickle cell disease",
author = "Adamkiewicz, {T. V.} and Mehta, {P. S.} and Boyer, {M. W.} and A. Kedar and Olson, {T. A.} and E. Olson and Chiang, {K. Y.} and D. Maurer and Mogul, {M. J.} and Wingard, {J. R.} and Yeager, {Andrew M}",
year = "2004",
month = "9",
doi = "10.1038/sj.bmt.1704606",
language = "English (US)",
volume = "34",
pages = "405--411",
journal = "Bone Marrow Transplantation",
issn = "0268-3369",
publisher = "Nature Publishing Group",
number = "5",

}

TY - JOUR

T1 - Transplantation of unrelated placental blood cells in children with high-risk sickle cell disease

AU - Adamkiewicz, T. V.

AU - Mehta, P. S.

AU - Boyer, M. W.

AU - Kedar, A.

AU - Olson, T. A.

AU - Olson, E.

AU - Chiang, K. Y.

AU - Maurer, D.

AU - Mogul, M. J.

AU - Wingard, J. R.

AU - Yeager, Andrew M

PY - 2004/9

Y1 - 2004/9

N2 - The lack of healthy HLA-identical sibs limits the use of allogeneic hematopoietic cell transplantation in children with high-risk sickle cell disease (SCD). We evaluated unrelated placental blood cell transplantation (UPBCT) after a preparative regimen of busulfan, cyclophosphamide and antithymocyte globulin in three children with SCD who had cerebrovascular accidents (CVAs) and did not have HLA-matched sib donors. The placental blood cell units were matched with the recipients at four of six HLA-A, HLA-B and HLA-DRB1 antigens. Neutrophil levels above 0.5 × 109/l occurred at 23, 38 and 42 days after UPBCT, and platelet levels above 50 × 109/l without transfusions occurred at 62, 81 and 121 days after UPBCT. All patients developed acute graft-versus-host disease (GVHD; two grade II, one grade III), and one developed extensive chronic GVHD. One patient had graft failure and autologous hematopoietic recovery. Two patients have complete donor hematopoietic chimerism without detectable hemoglobin S or symptoms of SCD at 40 and 61 months, respectively, after UPBCT. These observations demonstrate the feasibility of UPBCT in children with SCD. Further studies of UPBCT for SCD are needed but, because of risks of procedure-related morbidity and graft rejection, should be restricted to pediatric patients with high-risk manifestations of SCD.

AB - The lack of healthy HLA-identical sibs limits the use of allogeneic hematopoietic cell transplantation in children with high-risk sickle cell disease (SCD). We evaluated unrelated placental blood cell transplantation (UPBCT) after a preparative regimen of busulfan, cyclophosphamide and antithymocyte globulin in three children with SCD who had cerebrovascular accidents (CVAs) and did not have HLA-matched sib donors. The placental blood cell units were matched with the recipients at four of six HLA-A, HLA-B and HLA-DRB1 antigens. Neutrophil levels above 0.5 × 109/l occurred at 23, 38 and 42 days after UPBCT, and platelet levels above 50 × 109/l without transfusions occurred at 62, 81 and 121 days after UPBCT. All patients developed acute graft-versus-host disease (GVHD; two grade II, one grade III), and one developed extensive chronic GVHD. One patient had graft failure and autologous hematopoietic recovery. Two patients have complete donor hematopoietic chimerism without detectable hemoglobin S or symptoms of SCD at 40 and 61 months, respectively, after UPBCT. These observations demonstrate the feasibility of UPBCT in children with SCD. Further studies of UPBCT for SCD are needed but, because of risks of procedure-related morbidity and graft rejection, should be restricted to pediatric patients with high-risk manifestations of SCD.

KW - Allogeneic hematopoietic cell transplantation

KW - Allogeneic transplantation

KW - Placental (cord blood) cells

KW - Sickle cell disease

UR - http://www.scopus.com/inward/record.url?scp=4544258595&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=4544258595&partnerID=8YFLogxK

U2 - 10.1038/sj.bmt.1704606

DO - 10.1038/sj.bmt.1704606

M3 - Article

VL - 34

SP - 405

EP - 411

JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

SN - 0268-3369

IS - 5

ER -