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Differences in quality between privately and publicly banked umbilical cord blood units: a pilot study of autologous cord blood infusion in children with acquired neurologic disorders

Authors

  • Jessica Sun,

    1. From the Pediatric Blood and Marrow Transplant Program and the Carolinas Cord Blood Bank, Duke University, Durham, North Carolina; and the EMMES Corporation, Rockville, Maryland.
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  • June Allison,

    1. From the Pediatric Blood and Marrow Transplant Program and the Carolinas Cord Blood Bank, Duke University, Durham, North Carolina; and the EMMES Corporation, Rockville, Maryland.
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  • Colleen McLaughlin,

    1. From the Pediatric Blood and Marrow Transplant Program and the Carolinas Cord Blood Bank, Duke University, Durham, North Carolina; and the EMMES Corporation, Rockville, Maryland.
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  • Linda Sledge,

    1. From the Pediatric Blood and Marrow Transplant Program and the Carolinas Cord Blood Bank, Duke University, Durham, North Carolina; and the EMMES Corporation, Rockville, Maryland.
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  • Barbara Waters-Pick,

    1. From the Pediatric Blood and Marrow Transplant Program and the Carolinas Cord Blood Bank, Duke University, Durham, North Carolina; and the EMMES Corporation, Rockville, Maryland.
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  • Stephen Wease,

    1. From the Pediatric Blood and Marrow Transplant Program and the Carolinas Cord Blood Bank, Duke University, Durham, North Carolina; and the EMMES Corporation, Rockville, Maryland.
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  • Joanne Kurtzberg

    1. From the Pediatric Blood and Marrow Transplant Program and the Carolinas Cord Blood Bank, Duke University, Durham, North Carolina; and the EMMES Corporation, Rockville, Maryland.
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  • Supported by Training Grant 5-T32-HL007057-34.

Jessica Sun, Box 102382, DUMC, 365 Hanes House, Trent Drive, Durham, NC 27710; e-mail: jessica.sun@duke.edu.

Abstract

BACKGROUND: A pilot study was conducted to determine the safety and feasibility of intravenous administration of autologous umbilical cord blood (CB) in young children with acquired neurologic disorders. Most CB units (CBUs) were electively stored in private CB banks. Unlike public banks, which utilize specific criteria and thresholds for banking, private banks generally store all collected CBUs.

STUDY DESIGN AND METHODS: CBUs of eligible patients containing more than 1 × 107 cells/kg were shipped to Duke from the banks of origin after confirming identity by HLA typing. On the day of infusion, CBUs were thawed and washed in dextran-albumin and infused intravenously. Patients were medicated with acetaminophen, diphenhydramine, and methylprednisolone before transfusion. Data regarding patients, infusions, and CBUs were collected retrospectively. Characteristics of CBUs were compared to existing data from CBUs publicly banked at the Carolinas Cord Blood Bank.

RESULTS: From March 2004 to December 2009, 184 children received 198 CB infusions. Three patients had infusion reactions, all responsive to medical therapy and stopping the infusion. Median precryopreservation volume (60 mL vs. 89 mL, p < 0.0001), total nucleated cell count (4.7 × 108 vs. 10.8 × 108, p < 0.0001), and CD34 count (1.8 × 106 vs. 3.0 × 106, p < 0.0001) were significantly lower than publicly stored CBUs. Postthaw sterility cultures were positive in 7.6% of infused CBUs.

CONCLUSION: IV infusion of autologous CB is safe and feasible in young children with neurologic injuries. Quality parameters of privately banked CBUs are inferior to those stored in public banks. If efficacy of autologous CB is established clinically, the quality of autologous units should be held to the same standards as those stored in public banks.

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