A perspective on the selection of unrelated donors and cord blood units for transplantation.

Blood. 2012 May 17;

Authors: Spellman SR, Eapen M, Logan BR, Mueller C, Rubinstein P, Setterholm MI, Woolfrey AE, Horowitz MM, Confer DL, Hurley CK

Abstract
Selection of a suitable graft for allogeneic hematopoietic stem cell transplantation involves consideration of both donor and recipient characteristics. Of primary importance is sufficient donor-recipient human leukocyte antigen (HLA) matching to ensure engraftment and acceptable rates of graft-versus-host disease. In this perspective, the National Marrow Donor Program (NMDP) and the Center for International Blood and Marrow Transplant Research (CIBMTR) provide guidelines, based on large studies correlating graft characteristics with clinical transplantation outcomes, on appropriate typing strategies and matching criteria for unrelated adult donor and cord blood graft selection.

PMID: 22596257 [PubMed - as supplied by publisher]

When inner ear stem cell therapy becomes a reality.

Trends Amplif. 2012;16(1):3

Authors: Limb CJ

PMID: 22593203 [PubMed - in process]

Multiple Myeloma: Myeloablative Therapy with Autologous Stem Cell Support versus Chemotherapy: A Meta-analysis.

Anticancer Res. 2012 May;32(5):2103-9

Authors: Faussner F, Dempke WC

Abstract
BACKGROUND: Myeloablative high-dose chemotherapy (HDT) followed by single autologous stem cell transplantation is currently the standard treatment for patients younger than 65 years with newly diagnosed multiple myeloma (MM). Several randomized controlled trials (RCTs) comparing HDT with standard dose therapy (SDT) have shown some benefit in overall survival (OS) and progression-free survival (PFS), whereas other RCTs did not confirm this finding. In this study we attempted to analyze the current data in terms of the endpoints OS and PFS.
MATERIALS AND METHODS: We searched PubMed, Embase, abstracts of former ASH meetings and ClinicalTrials.gov, as well as bibliographies of included trials, and recent reviews from September 2009 until May 2010. Amongst the 3,484 results in this search, we identified 10 RCTs comparing HDT with SDT on an intention-to-treat-basis. Treatment characteristics and outcomes of OS and PFS were reported. We investigated statistical heterogenity and publication bias and performed subgroup analyses.
RESULTS: Nine RCTs including 2,600 patients were fully analyzed. Patients undergoing HDT with stem cell transplantation had a significant PFS benefit (hazard ratio=0.73; 95% CI=0.56-0.95; p=0.02) but no OS benefit (HR 0.90; 95% CI 0.74-1.10; p=0.32) as compared to patients undergoing SDT.
CONCLUSION: Although there is only a trend of OS benefit with HDT, it is currently still the first line treatment. Additional data from ongoing clinical trials and new studies using novel agents such as thalidomide, lenalidomide and bortezomib are warranted to finally evaluate the role of HDT in the treatment management of patients with newly diagnosed MM.

PMID: 22593496 [PubMed - in process]

Stem cell therapy for degenerative disc disease.

Adv Orthop. 2012;2012:961052

Authors: Drazin D, Rosner J, Avalos P, Acosta F

Abstract
Low back pain is widely recognized as one of the most prevalent pathologies in the developed world. In the United States, low back pain is the most common health problem for adults under the age of 50, resulting in significant societal and personal costs. While the causes of low back pain are myriad, it has been significantly associated with intervertebral disc (IVD) degeneration. Current first-line therapies for IVD degeneration such as physical therapy and spinal fusion address symptoms, but do not treat the underlying degeneration. The use of tissue engineering to treat IVD degeneration provides an opportunity to correct the pathological process. Novel techniques are currently being investigated and have shown mixed results. One major avenue of investigation has been stem cell injections. Mesenchymal stem cells (MSCs) have shown promise in small animal models, but results in larger vertebrates have been mixed.

PMID: 22593830 [PubMed - in process]

Cord blood stem cells and cord tissue to aid bone regeneration.

Orthop Nurs. 2012 Jan-Feb;31(1):35-6

Authors: Rodts MF

Abstract
The use of cord blood stem cells to manage disease is progressing swiftly. During the last decade, treatment of some cancers, blood dyscrasias, and immune and metabolic diseases has been enhanced by the use of stem cells. Attention to orthopaedic deficits has produced very encouraging potential uses. Research to determine the use of cord blood stem cells and cord tissue and how this might possibly change the management of common orthopaedic problems in the future is an innovative and exciting topic.

PMID: 22278650 [PubMed - indexed for MEDLINE]

[Cord blood transplantation with cytomegalovirus infection related hemolysis: a case report].

Zhonghua Xue Ye Xue Za Zhi. 2011 Aug;32(8):511

Authors: Hui LP, Han Y, Xu J

PMID: 22338170 [PubMed - indexed for MEDLINE]

Autologous umbilical cord blood transfusion in young children with type 1 diabetes fails to preserve C-peptide.

Diabetes Care. 2011 Dec;34(12):2567-9

Authors: Haller MJ, Wasserfall CH, Hulme MA, Cintron M, Brusko TM, McGrail KM, Sumrall TM, Wingard JR, Theriaque DW, Shuster JJ, Atkinson MA, Schatz DA

Abstract
OBJECTIVE: We conducted an open-label, phase I study using autologous umbilical cord blood (UCB) infusion to ameliorate type 1 diabetes (T1D). Having previously reported on the first 15 patients reaching 1 year of follow-up, herein we report on the complete cohort after 2 years of follow-up.
RESEARCH DESIGN AND METHODS: A total of 24 T1D patients (median age 5.1 years) received a single intravenous infusion of autologous UCB cells and underwent metabolic and immunologic assessments.
RESULTS: No infusion-related adverse events were observed. β-Cell function declined after UCB infusion. Area under the curve C-peptide was 24.3% of baseline 1 year postinfusion (P < 0.001) and 2% of baseline 2 years after infusion (P < 0.001). Flow cytometry revealed increased regulatory T cells (Tregs) (P = 0.04) and naive Tregs (P = 0.001) 6 and 9 months after infusion, respectively.
CONCLUSIONS: Autologous UCB infusion in children with T1D is safe and induces changes in Treg frequency but fails to preserve C-peptide.

PMID: 22011412 [PubMed - indexed for MEDLINE]

Autologous umbilical cord blood transfusion in young children with type 1 diabetes fails to preserve C-peptide.

Diabetes Care. 2011 Dec;34(12):2567-9

Authors: Haller MJ, Wasserfall CH, Hulme MA, Cintron M, Brusko TM, McGrail KM, Sumrall TM, Wingard JR, Theriaque DW, Shuster JJ, Atkinson MA, Schatz DA

Abstract
OBJECTIVE: We conducted an open-label, phase I study using autologous umbilical cord blood (UCB) infusion to ameliorate type 1 diabetes (T1D). Having previously reported on the first 15 patients reaching 1 year of follow-up, herein we report on the complete cohort after 2 years of follow-up.
RESEARCH DESIGN AND METHODS: A total of 24 T1D patients (median age 5.1 years) received a single intravenous infusion of autologous UCB cells and underwent metabolic and immunologic assessments.
RESULTS: No infusion-related adverse events were observed. β-Cell function declined after UCB infusion. Area under the curve C-peptide was 24.3% of baseline 1 year postinfusion (P < 0.001) and 2% of baseline 2 years after infusion (P < 0.001). Flow cytometry revealed increased regulatory T cells (Tregs) (P = 0.04) and naive Tregs (P = 0.001) 6 and 9 months after infusion, respectively.
CONCLUSIONS: Autologous UCB infusion in children with T1D is safe and induces changes in Treg frequency but fails to preserve C-peptide.

PMID: 22011412 [PubMed - indexed for MEDLINE]

Post-transcriptional down-regulation of Toll-like receptor signaling pathway in umbilical cord blood plasmacytoid dendritic cells.

Cell Immunol. 2012 Apr 27;

Authors: Charrier E, Cordeiro P, Cordeau M, Dardari R, Michaud A, Harnois M, Merindol N, Herblot S, Duval M

Abstract
Plasmacytoid dendritic cells (PDCs) from human umbilical cord blood (UCB) produce lower amounts of IFN-α upon TLR stimulation compared with adult counterparts. This difference may play a role in the low graft-versus-host disease rate after UCB transplantation and in the impaired immune response of the neonate to pathogens. Comparing UCB PDC to their adults counterparts, we found that they exhibited a mature surface phenotype and a normal antigen uptake. They upregulated costimulatory molecules upon activation, although with delayed kinetics. Protein, but not ARN, levels of TLR-9, MyD88, IRAK1 and IRF-7, involved in the TLR-9 signaling pathway were reduced. The expression levels of miR-146a and miR-155, known to be involved in the post-transcriptional down-regulation of immune responses, were higher. These data point out a post-transcriptional down-regulation of the TLR-9/IRF-7 signaling pathway in UCB PDC.

PMID: 22578600 [PubMed - as supplied by publisher]

Post-transcriptional down-regulation of Toll-like receptor signaling pathway in umbilical cord blood plasmacytoid dendritic cells.

Cell Immunol. 2012 Apr 27;

Authors: Charrier E, Cordeiro P, Cordeau M, Dardari R, Michaud A, Harnois M, Merindol N, Herblot S, Duval M

Abstract
Plasmacytoid dendritic cells (PDCs) from human umbilical cord blood (UCB) produce lower amounts of IFN-α upon TLR stimulation compared with adult counterparts. This difference may play a role in the low graft-versus-host disease rate after UCB transplantation and in the impaired immune response of the neonate to pathogens. Comparing UCB PDC to their adults counterparts, we found that they exhibited a mature surface phenotype and a normal antigen uptake. They upregulated costimulatory molecules upon activation, although with delayed kinetics. Protein, but not ARN, levels of TLR-9, MyD88, IRAK1 and IRF-7, involved in the TLR-9 signaling pathway were reduced. The expression levels of miR-146a and miR-155, known to be involved in the post-transcriptional down-regulation of immune responses, were higher. These data point out a post-transcriptional down-regulation of the TLR-9/IRF-7 signaling pathway in UCB PDC.

PMID: 22578600 [PubMed - as supplied by publisher]