Umbilical Cord Blood

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Won Soon Park - One of the best experts on this subject based on the ideXlab platform.

Yun Sil Chang - One of the best experts on this subject based on the ideXlab platform.

John E Wagner - One of the best experts on this subject based on the ideXlab platform.

  • alternative haematopoietic stem cell sources for transplantation place of Umbilical Cord Blood
    British Journal of Haematology, 2009
    Co-Authors: Angela Smith, John E Wagner
    Abstract:

    Umbilical Cord Blood has rapidly become a valuable alternative stem cell source for allogeneic haematopoietic stem cell transplantation. Extensive research over the last 20 years has established the safety and efficacy of Umbilical Cord Blood transplantation in both children and adults with a variety of malignant and non-malignant diseases. This research has clearly shown that this stem cell source has several unique characteristics resulting in distinct advantages and disadvantages when compared to transplantation with unrelated bone marrow or peripheral Blood stem cells. This article reviews the most recent literature comparing the outcomes after Umbilical Cord Blood transplantation with other alternative stem cell sources.

  • double Umbilical Cord Blood transplantation
    Current Opinion in Immunology, 2006
    Co-Authors: Navneet S Majhail, Claudio G. Brunstein, John E Wagner
    Abstract:

    Unrelated Umbilical Cord Blood (UCB) is an alternative donor source for allogeneic haematopoietic cell transplantation and, compared with unrelated donor bone marrow, has the advantages of rapid availability, greater tolerance of HLA disparity and lower incidence of severe graft-versus-host disease. Graft cell dose is an important determinant of haematopoietic recovery and overall outcome following UCB transplantation, and the limited cell dose of single UCB units has been a major barrier to its more widespread use. Transplantation with two unrelated UCB units is feasible, safe and effective and can overcome the limitation of cell dose of single UCB units.

  • increased lymphoblast like cells following Umbilical Cord Blood stem cell transplantation do not predict recurrent acute leukemia
    Leukemia, 2002
    Co-Authors: David H Mckenna, C Rupp, John E Wagner, Ronald C Mcglennen, Betsy A Hirsch, Michelle M Dolan, S Burger, M Hanson, Waclaw Jaszcz, Paul L Nguyen
    Abstract:

    Increased lymphoblast-like cells following Umbilical Cord Blood stem cell transplantation do not predict recurrent acute leukemia

  • hematopoietic engraftment and survival in adult recipients of Umbilical Cord Blood from unrelated donors
    Obstetrical & Gynecological Survey, 2001
    Co-Authors: Mary J Laughlin, David A Rizzieri, Hillard M Lazarus, Mitchell S Cairo, John E Wagner, Juliet N Barker, Barbara Bambach, Omer N Koc, Stanton L Gerson, Cladd E Stevens
    Abstract:

    Background Umbilical-Cord Blood from unrelated donors who are not HLA-identical with the recipients can restore hematopoiesis after myeloablative therapy in children. We studied the use of transplantation of Umbilical-Cord Blood to restore hematopoiesis in adults. Methods Sixty-eight adults with life-threatening hematologic disorders received intensive chemotherapy or total-body irradiation and then transplants of HLA-mismatched Umbilical-Cord Blood. We evaluated the outcomes in terms of hematologic reconstitution, the occurrence of acute and chronic graft-versus-host disease (GVHD), relapses, and event-free survival. Results Of the 68 patients, 48 (71 percent) received grafts of Umbilical-Cord Blood that were mismatched for two or more HLA antigens. Of the 60 patients who survived 28 days or more after transplantation, 55 had neutrophil engraftment at a median of 27 days (range, 13 to 59). The estimated probability of neutrophil recovery in the 68 patients was 0.90 (95 percent confidence interval, 0.85 t...

  • creation of a double chimera after the transplantation of Umbilical Cord Blood from two partially matched unrelated donors
    The New England Journal of Medicine, 2001
    Co-Authors: Juliet N Barker, Daniel J Weisdorf, John E Wagner
    Abstract:

    To the Editor: Despite promising outcomes in the transplantation into pediatric recipients of Umbilical-Cord Blood from unrelated donors, the low cell dose adversely affects both the rate of hematopoietic recovery and the probability of survival.1–3 The cell dose is a major limitation of the procedure, particularly in adults. An alternative to the ex vivo expansion of cells, which has yet to be shown to be efficacious, is the transplantation of 2 closely HLA-matched units of Umbilical-Cord Blood. We transplanted 2 units of Umbilical-Cord Blood from male infant donors into a 53-year-old, 84-kg woman with accelerated-phase chronic myelogenous leukemia and . . .

Joanne Kurtzberg - One of the best experts on this subject based on the ideXlab platform.

  • repeated autologous Umbilical Cord Blood infusions are feasible and had no acute safety issues in young babies with congenital hydrocephalus
    Pediatric Research, 2015
    Co-Authors: Jessica Sun, June Allison, Gerald A Grant, Colleen Mclaughlin, Anne Fitzgerald, Barbara Waterspick, Joanne Kurtzberg
    Abstract:

    Repeated autologous Umbilical Cord Blood infusions are feasible and had no acute safety issues in young babies with congenital hydrocephalus

  • Umbilical Cord Blood Transplantation to Treat Pelizaeus-Merzbacher Disease in 2 Young Boys
    Pediatrics, 2014
    Co-Authors: Jessica Wishnew, Kristin Page, Susan Wood, Kathryn E. Gustafson, James M. Provenzale, Maria L Escolar, Leo Galvin, Joanne Kurtzberg
    Abstract:

    Pelizaeus-Merzbacher Disease (PMD) is a rare X-linked recessive leukodystrophy caused by mutations in the proteolipid protein 1 gene on the Xq22 chromosome. PMD is a dysmyelinating disorder characterized by variable clinical presentation and course. Symptoms range from mild motor deficits to progressive spasticity and neurologic decline resulting in death at an early age. There is no definitive curative treatment. This report presents the clinical course of 2 young boys with PMD who are the first known patients to receive Umbilical Cord Blood transplantation as a therapeutic intervention to stabilize disease progression. Pretransplantation evaluation revealed that both patients had significant motor deficits as well as delayed cognitive function as compared with age-matched peers. Brain imaging revealed varying degrees of hypomyelination. Both patients received myeloablative chemotherapy followed by an unrelated donor Umbilical Cord Blood infusion, which they tolerated well with no major transplantation-related complications. At 7-years and 1-year posttransplantation, respectively, both boys are making slow neurocognitive improvements and show no evidence of functional decline. Imaging results show stable or improving myelination. Although the results of unrelated donor Umbilical Cord Blood transplantation in these 2 boys with PMD are encouraging, longer-term follow-up will be necessary to assess the effect of this treatment on the variable natural disease course.

  • long term functional outcomes of children with hurler syndrome treated with unrelated Umbilical Cord Blood transplantation
    JIMD reports, 2014
    Co-Authors: Hannah Y. Coletti, Joanne Kurtzberg, Michele D Poe, Mieke Aldenhoven, Karina Yelin, Maria L Escolar
    Abstract:

    Objectives: Hurler syndrome is characterized by progressive multisystem deterioration leading to early death in childhood. This prospective study evaluated the long-term outcomes of patients with Hurler syndrome who underwent Umbilical Cord Blood transplantation from unrelated donors.

  • outcomes of transplantation of unrelated donor Umbilical Cord Blood and bone marrow in children with acute leukaemia a comparison study
    The Lancet, 2007
    Co-Authors: Mary Eapen, Joanne Kurtzberg, Pablo Rubinstein, Cladd E Stevens, Andromachi Scaradavou, Fausto R Loberiza, Richard E Champlin, John P Klein, Mary M Horowitz
    Abstract:

    Summary Background Although Umbilical Cord Blood is an accepted alternative to bone marrow for transplantation, allele-matched bone marrow is generally regarded as the preferred graft source. Our aim was to assess leukaemia-free survival after transplantations of these alternatives compared with present HLA-matching practices, and to assess the relative effect of cell dose and HLA match, and their potential interaction on leukaemia-free survival after Cord-Blood transplantation. Methods Outcomes of 503 children ( Findings In comparison with allele-matched bone-marrow transplants, 5-year leukaemia-free survival was similar to that after transplants of Umbilical Cord Blood mismatched for either one or two antigens and possibly higher after transplants of HLA-matched Umbilical Cord Blood. Transplant-related mortality rates were higher after transplants of two-antigen HLA-mismatched Umbilical Cord Blood (relative risk 2·31, p=0·0003) and possibly after one-antigen HLA-mismatched low-cell-dose Umbilical-Cord-Blood transplants (1·88, p=0·0455). Relapse rates were lower after two-antigen HLA-mismatched Umbilical-Cord-Blood transplants (0·54, p=0·0045). Interpretation These data support the use of HLA-matched and one- or two-antigen HLA-mismatched Umbilical Cord Blood in children with acute leukaemia who need transplantation. Because better HLA matching and higher cell doses significantly decrease the risk of transplant-related mortality after Umbilical-Cord-Blood transplantation, greater investment in large-scale banking is needed to increase HLA diversity.

  • a staging system for infantile krabbe disease to predict outcome after unrelated Umbilical Cord Blood transplantation
    Pediatrics, 2006
    Co-Authors: Maria L Escolar, Michele D Poe, Holly R Martin, Joanne Kurtzberg
    Abstract:

    OBJECTIVE. Infantile Krabbe disease, a rare neurodegenerative disorder that leads to rapid demyelination, dysmyelination, and death in the first 2 years of life, is responsive to treatment with Umbilical Cord Blood transplantation provided that the patient is treated in the first weeks of life. At present, family history is the only way to identify patients that are asymptomatic with most patients being diagnosed after onset of symptoms. We hypothesized that a staging system based on clinical indicators and neurophysiological and neuroimaging measures can predict posttreatment variation in patients diagnosed with infantile Krabbe disease. METHODS. A retrospective review of pretransplant clinical indicators and neurodevelopmental, brain imaging and neurophysiological measures was performed in 42 patients being considered for treatment with Umbilical Cord Blood transplantation. Based on these evaluations, an expert system approach was used to develop a staging system for infantile Krabbe disease. Another set of analyses in the subset of patients who were transplanted ( n = 29) evaluated the association between pretransplant stage of disease and posttransplant neurodevelopmental outcomes. RESULTS. A staging algorithm for infants with infantile Krabbe disease was developed and tested for predicting neurodevelopmental outcome after Umbilical Cord Blood transplantation. Standard neurophysiological and neuroimaging tests were not useful in the staging algorithm. Clinical indicators were found to best classify stage of disease. Pretransplant stage was found to be predictive of neurodevelopmental outcome. CONCLUSIONS. We conclude that the clinical staging system based solely on signs and symptoms of disease can be used to predict outcomes after Umbilical Cord Blood transplantation. This staging system can be used prospectively to guide physicians unfamiliar with the disorder in evaluating, monitoring, and counseling families about treatment outcomes. The staging will be useful for both patients diagnosed with infantile Krabbe disease because of clinical symptoms and those identified through neonatal screening programs.

Nino Stocchetti - One of the best experts on this subject based on the ideXlab platform.

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