What's up with 2 cord transplantation?

摘要

Transplantation of 2 cord blood units to a single patient has been enthusiastically adopted as a strategy to increase access to unrelated donor cord blood transplantation (UCBT) for larger pediatric and adult patients. With this strategy, 1 cord blood unit ultimately dominates and confers durable engraftment, but prospective identification of the engrafting unit has not been possible.The article by Avery and colleagues in this issue of the Blood sheds light on this biologic mystery in double umbilical CBT by demonstrating, in a series of 84 patients, that indicators of cord blood unit potency, for example, total nucleated cell count (TNC), colony-forming unit (CFU), CD3, and yiable CD34 cell content, predict the dominating unit. Surprising to some, human leukocyte antigen (HLA) matching does not appear to play a role in unit dominance.