Umbilical Cord Blood Transplantation Supported by Third-Party Donor Cells: Rationale, Results, and Applications Koen Van Besien, Hongtao Liu, Nitin Jain,

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Presentation transcript:

Umbilical Cord Blood Transplantation Supported by Third-Party Donor Cells: Rationale, Results, and Applications Koen Van Besien, Hongtao Liu, Nitin Jain, Wendy Stock, Andrew Artz Biology of Blood and Marrow Transplantation Volume 19, Issue 5, Pages 682-691 (May 2013) DOI: 10.1016/j.bbmt.2012.11.001 Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 1 Model for transition from fetal to adult hematopoiesis (reproduced from Mold and McCune [13]). Several potential scenarios could account for the layering of the adaptive immune system during development. Based on the linear decline in the frequency of T regulatory (Treg) cells in umbilical cord blood across the third trimester of development, we propose that a shift in hematopoietic stem cell (HSC) identity from fetal to adult occurs at some point during this time. Whether this occurs through the de novo generation of adult hematopoietic stem cells from an upstream progenitor cell or from a direct conversion of fetal hematopoietic stem cells to adult-type hematopoietic stem cells remains unknown. Examples of different hematopoietic lineages that have been shown to arise during fetal development and after birth are listed below the figure. BM indicates bone marrow; HSPC, hematopoietic stem and progenitor cells. Biology of Blood and Marrow Transplantation 2013 19, 682-691DOI: (10.1016/j.bbmt.2012.11.001) Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 2 Time to neutrophil engraftment: results from (A) Madrid and (B) Chicago (reproduced from Sebrango et al. [94] and Liu et al. [84]). ANC-500 indicates time to neutrophil count of 500; CB ANC-500, time to achieve 500 neutrophils from the UCB graft; CB full chimerism, time to full cord blood chimerism. Biology of Blood and Marrow Transplantation 2013 19, 682-691DOI: (10.1016/j.bbmt.2012.11.001) Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 3 Time to platelet recovery. (A) Madrid cumulative incidence of platelet count >20,000/μL and >50,000/μL. (B) Chicago cumulative incidence of platelet count >20,000/μL (reproduced from Sebrango et al. [94] and Liu et al. [84]). Biology of Blood and Marrow Transplantation 2013 19, 682-691DOI: (10.1016/j.bbmt.2012.11.001) Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 4 Evolution of chimerism in the Chicago series. (A) Unfractionated peripheral blood cells. (B) CD3 cells (reproduced from Liu et al. [84]). Biology of Blood and Marrow Transplantation 2013 19, 682-691DOI: (10.1016/j.bbmt.2012.11.001) Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions