Cord blood transplantation for acute leukemia

Mattia Algeri, Stefania Gaspari, Franco Locatelli

Research output: Contribution to journalArticle

Abstract

Introduction: Umbilical cord blood transplantation (UCBT) is a suitable alternative for patients with acute leukemia (AL) in need of an allograft and who lack an HLA-matched donor. Single-institution and registry studies have shown that, in both children and adults with AL, the outcome of UCBT is comparable to that of matched unrelated donor. At the same time, these studies have highlighted some limitations of UCBT, such as increased early mortality and delayed recovery of both hematopoietic and immune compartment, which hamper a more widespread adoption of this approach. Areas covered: In this review, we will analyze the current results of UCBT in children and adults with AL, including comparisons with other hematopoietic stem cell sources and transplant strategies. We will also discuss important factors to be considered when selecting UCB units, as well as future strategies to further improve the outcome of UCBT recipients. Expert opinion: The utilization of UCBT for the treatment of AL patients has decreased in recent years. However, recent clinical data suggesting that UCBT might offer better results in patients with minimal residual disease, as well as innovative strategies to facilitate engraftment, reduce transplant-related mortality, and optimize anti-leukemic activity, may pave the way toward a second youth for use of UCB cells.
Original languageEnglish
Pages (from-to)1223-1236
Number of pages14
JournalExpert Opinion on Biological Therapy
Volume20
DOIs
Publication statusPublished - 2020

Keywords

  • Acute leukemia
  • adoptive cell therapy
  • cell dose
  • umbilical cord blood transplantation
  • double cord transplantation
  • engraftment
  • minimal residual disease
  • cord blood expansion and homing

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