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One or two umbilical cord blood cell units? Caveat emptor

Bone Marrow Transplantation volume 52, pages 341–343 (2017)Cite this article

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The human understanding when it has once adopted an opinion (either as being the received opinion or as being agreeable to itself) draws all things else to support and agree with it. And though there be a greater number and weight of instances to be found on the other side, yet these it either neglects and despises, or else by some distinction sets aside and rejects, in order that by this great and pernicious predetermination the authority of its former conclusions may remain inviolate.

Sir Francis Bacon, Novum Organum 1620 Aphorism 46

The human understanding when it has once adopted an opinion (either as being the received opinion or as being agreeable to itself) draws all things else to support and agree with it. And though there be a greater number and weight of instances to be found on the other side, yet these it either neglects and despises, or else by some distinction sets aside and rejects, in order that by this great and pernicious predetermination the authority of its former conclusions may remain inviolate.

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References

  1. Niederwieser D, Baldomero H, Szer J, Gratwohl M, Aljurf M, Atsuta Y et al. Hematopoietic stem cell transplantation activity worldwide in 2012 and a SWOT analysis of the Worldwide Network for Blood and Marrow Transplantation Group including the global survey. Bone Marrow Transplant 2016; 51: 778–785.

    Article  CAS  Google Scholar 

  2. Passweg JR, Baldomero H, Bader P, Bonini C, Cesaro S, Dreger P et al. Hematopoietic SCT in Europe 2013: recent trends in the use of alternative donors showing more haploidentical donors but fewer cord blood transplants. Bone Marrow Transplant 2015; 50: 476–482.

    Article  CAS  Google Scholar 

  3. Terakura S, Atsuta Y, Tsukada N, Kobayashi T, Tanaka M, Kanda J et al. Comparison of outcomes of 8/8 and 7/8 allele–matched unrelated bone marrow transplantation and single-unit cord blood transplantation in adults with acute leukemia. Biol Blood Marrow Transplant 2016; 22: 330–338.

    Article  Google Scholar 

  4. Ruggeri A, Labopin M, Sanz G, Piemontese S, Arcese W, Bacigalupo A et al. Comparison of outcomes after unrelated cord blood and unmanipulated haploidentical stem cell transplantation in adults with acute leukemia. Leukemia 2015; 29: 1891–1900.

    Article  CAS  Google Scholar 

  5. Eapen M, Rocha V, Sanz GF, Scaradavou A, Zhang M-J, Arcese W et al. Effect of graft source on unrelated donor haemopoietic stem-cell transplantation in adults with acute leukaemia: a retrospective analysis. Lancet Oncol 2010; 11: 653–660.

    Article  Google Scholar 

  6. Barker JN, Weisdorf DJ, DeFor TE, Blazar BR, McGlave PB, Miller JS et al. Transplantation of 2 partially HLA-matched umbilical cord blood units to enhance engraftment in adults with hematologic malignancy. Blood 2005; 105: 1343–1347.

    Article  CAS  Google Scholar 

  7. Gale RP, Lazarus HM . Engraftment syndrome, the emperor's new clothes and the artist formerly known as prince. Bone Marrow Transplant 2015; 50: 483–484.

    Article  CAS  Google Scholar 

  8. Otegbeye F, Gale RP, Lazarus HM . Autologous GvHD? Bone Marrow Transplant 2014; 49: 1349–1351.

    Article  CAS  Google Scholar 

  9. Oliver DCK, Milano F, Gammill H, Gentil C, Kanaan SB, Allen J et al. Persistence of the losing unit following double umbilical cord blood transplant: finding the unseen. Blood 2015; 126: 3109–3109.

    Google Scholar 

  10. Verneris MR, Brunstein CG, Barker J, MacMillan ML, DeFor T, McKenna DH et al. Relapse risk after umbilical cord blood transplantation: enhanced graft-versus-leukemia effect in recipients of 2 units. Blood 2009; 114: 4293–4299.

    Article  CAS  Google Scholar 

  11. Brunstein CG, Gutman JA, Weisdorf DJ, Woolfrey AE, Defor TE, Gooley TA et al. Allogeneic hematopoietic cell transplantation for hematologic malignancy: relative risks and benefits of double umbilical cord blood. Blood 2010; 116: 4693–4699.

    Article  CAS  Google Scholar 

  12. Brunstein CG, Fuchs EJ, Carter SL, Karanes C, Costa LJ, Wu J et al. Alternative donor transplantation after reduced intensity conditioning: results of parallel phase 2 trials using partially HLA-mismatched related bone marrow or unrelated double umbilical cord blood grafts. Blood 2011; 118: 282–288.

    Article  CAS  Google Scholar 

  13. Scaradavou A, Brunstein CG, Eapen M, Le-Rademacher J, Barker JN, Chao N et al. Double unit grafts successfully extend the application of umbilical cord blood transplantation in adults with acute leukemia. Blood 2013; 121: 752–758.

    Article  CAS  Google Scholar 

  14. Ruggeri A, Sanz G, Bittencourt H, Sanz J, Rambaldi A, Volt F et al. Comparison of outcomes after single or double cord blood transplantation in adults with acute leukemia using different types of myeloablative conditioning regimen, a retrospective study on behalf of Eurocord and the Acute Leukemia Working Party of EBMT. Leukemia 2014; 28: 779–786.

    Article  CAS  Google Scholar 

  15. Sanz J, Wagner JE, Sanz MA, DeFor T, Montesinos P, Bachanova V et al. Myeloablative cord blood transplantation in adults with acute leukemia: comparison of two different transplant platforms. Biol Blood Marrow Transplant 2013; 19: 1725–1730.

    Article  Google Scholar 

  16. Wagner JE Jr, Eapen M, Carter S, Wang Y, Schultz KR, Wall DA et al. One-unit versus two-unit cord-blood transplantation for hematologic cancers. N Engl J Med 2014; 371: 1685–1694.

    Article  CAS  Google Scholar 

  17. Michel G, Galambrun C, Sirvent A, Pochon C, Bruno B, Jubert C et al. Single-versus double-unit cord blood transplantation for children and young adults with acute leukemia or myelodysplastic syndrome. Blood 2016; 127: 3450–3457.

    Article  CAS  Google Scholar 

  18. MacMillan ML, Weisdorf DJ, Brunstein CG, Cao Q, Defor TE, Verneris MR et al. Acute graft-versus-host disease after unrelated donor umbilical cord blood transplantation: analysis of risk factors. Blood 2009; 113: 2410–2415.

    Article  CAS  Google Scholar 

  19. Shoulars K, Noldner P, Troy JD, Cheatham L, Parrish A, Page K et al. Development and validation of a rapid, aldehyde dehydrogenase bright-based cord blood potency assay. Blood 2016; 127: 2346–2354.

    Article  CAS  Google Scholar 

  20. Nadler SB, Hidalgo JH, Bloch T . Prediction of blood volume in normal human adults. Surgery 1962; 51: 224–232.

    PubMed  Google Scholar 

  21. Hellman S, Botnick LE, Hannon EC, Vigneulle RM . Proliferative capacity of murine hematopoietic stem cells. Proc Natl Acad Sci USA 1978; 75: 490–494.

    Article  CAS  Google Scholar 

  22. Ogden DA, Mickliem HS . The fate of serially transplanted bone marrow cell populations from young and old donors. Transplantation 1976; 22: 287–293.

    Article  CAS  Google Scholar 

  23. Koller PC, Doak SM . Serial transfer of donor marrow in radiation mouse chimaeras. Int J Radiat Biol 1960; 2: 1–7.

    CAS  Google Scholar 

  24. Caracappa PF, Chao TCE, Xu XG . A study of predicted bone marrow distribution on calculated marrow dose from external radiation exposures using two sets of image data for the same individual. Health Phys 2009; 96: 661–674.

    Article  CAS  Google Scholar 

  25. Jones RJ, Celano P, Sharkis SJ, Sensenbrenner LL . Two phases of engraftment established by serial bone marrow transplantation in mice. Blood 1989; 73: 397–401.

    CAS  PubMed  Google Scholar 

  26. Jordan CT, Lemischka IR . Clonal and systemic analysis of long-term hematopoiesis in the mouse. Genes Dev 1990; 4: 220–232.

    Article  CAS  Google Scholar 

  27. Guenechea G, Gan OI, Dorrell C, Dick JE . Distinct classes of human stem cells that differ in proliferative and self-renewal potential. Nat Immunol 2001; 2: 75–82.

    Article  CAS  Google Scholar 

  28. Heslop HE, Rooney CM, Rill DR, Krance RA, Brenner MK . Use of gene marking in bone marrow transplantation. Cancer Detect Prev 1996; 20: 108–113.

    CAS  PubMed  Google Scholar 

  29. Rill DR, Moen RC, Buschle M, Bartholomew C, Foreman NK, Mirro JJ et al. An approach for the analysis of relapse and marrow reconstitution after autologous marrow transplantation using retrovirus-mediated gene transfer. Blood 1992; 79: 2694–2700.

    CAS  PubMed  Google Scholar 

  30. Baranov A, Gale RP, Guskova A, Piatkin E, Selidovkin G, Muravyova L et al. Bone marrow transplantation after the Chernobyl nuclear accident. N Engl J Med 1989; 321: 205–212.

    Article  CAS  Google Scholar 

  31. Harris JE, Ford CE, Barnes DW, Evans EP . Evidence from parabiosis for an afferent stream of cells. Nature 1964; 201: 886–887.

    Article  CAS  Google Scholar 

  32. Kamran P, Sereti K-I, Zhao P, Ali SR, Weissman IL, Ardehali R . Parabiosis in mice: a detailed protocol. J Vis Exp 2013: (80): e50556, doi:10.3791/50556.

  33. Till JE, McCulloch EA . The ‘f-factor’ of the spleen-colony assay for hemopoietic stem cells. Ser Haematol 1972; 5: 15–21.

    CAS  PubMed  Google Scholar 

  34. Dumenil D, Lauret E, Frindel E . Effects of various treatments of CFU-S seeding efficiency in mice. Exp Hematol 1984; 12: 749–752.

    CAS  PubMed  Google Scholar 

  35. Coggle JE, Gordon MY . Quantitative measurements on the haemopoietic systems of three strains of mice. Exp Hematol 1975; 3: 181–186.

    CAS  PubMed  Google Scholar 

  36. Visser JW, Bauman JG, Mulder AH, Eliason JF, de Leeuw AM . Isolation of murine pluripotent hemopoietic stem cells. J Exp Med 1984; 159: 1576–1590.

    Article  CAS  Google Scholar 

  37. Milano F, Gooley T, Wood B, Woolfrey A, Flowers ME, Doney K et al. Cord-blood transplantation in patients with minimal residual disease. N Engl J Med. 2016; 375: 944–953.

    Article  Google Scholar 

  38. Thompson PA, Rezvani K, Hosing CM, Oran B, Olson AL, Popat UR et al. Umbilical cord blood graft engineering: challenges and opportunities. Bone Marrow Transplant 2015; 50 (Suppl 2): S55–S62.

    Article  Google Scholar 

  39. Norkin M, Lazarus HM, Wingard JR . Umbilical cord blood graft enhancement strategies: has the time come to move these into the clinic? Bone Marrow Transplant 2013; 48: 884–889.

    Article  CAS  Google Scholar 

  40. Butler S . Hudibras. 1678. Part III, Canto iii, lines 547–550.

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Acknowledgements

Profs. Hillard Lazarus (Case Western Reserve Univ.), Joanne Kurtzberg (Duke University), Claudio Brunstein (Univ. Michigan), Hal Broxmeyer (Indiana Univ.), Yair Reisner (Weizmann Inst.) and Elaine Gluckman (Hospital St. Louis) kindly reviewed the typescript and contributed many interesting comments and good ideas as did Dr. Roni Shouval (Tel Aviv Univ.). RPG acknowledges support from the National Institute of Health Research (NIHR) Biomedical Research Centre funding scheme.

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Authors and Affiliations

  1. Department of Hematology, Hospital Universitari i Politècnic La Fe, Valencia, Spain

    J Sanz

  2. Division of Experimental Medicine, Department of Medicine, Haematology Research Centre, Imperial College London, London, UK

    R P Gale

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  1. J Sanz
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Correspondence to J Sanz.

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Sanz, J., Gale, R. One or two umbilical cord blood cell units? Caveat emptor. Bone Marrow Transplant 52, 341–343 (2017). https://doi.org/10.1038/bmt.2016.277

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