Clinical analysis shows that the most cr itical factor pr edicting the stem cell engraftment is the high dose of progenitor cells infused. The number of nucleated cells in umbilical cord blood to be infused and requir...Clinical analysis shows that the most cr itical factor pr edicting the stem cell engraftment is the high dose of progenitor cells infused. The number of nucleated cells in umbilical cord blood to be infused and require d to obtain a successful engraftment is superior to 3.7×107/kg including 10 5/kg of CD34(+) cells or even more than 1×108/kg containing 106/kg of CD34( + ) cells as the most ideal dose for high engraftment. A ‘megadose’ of purified CD34(+) cells of 107/kg along with depleted CD3(+) cells from mobilized periph eral blood is recommended for allo-transplant to achieve a high rate of engraft ment and very low rate of GvHD. The problem for CD3(+) depleted allo-transplant is higher frequency of malignancy relapse. In that case, the cellular immunother apy of post-transplantation as donor-lymphocyte-infusion is efficacious. As H LA genotyping is increasingly defined to higher degree of resolution by DNA prob es, it is recommended to sheck by means of genotyping when matching for the dono r/host couples especially the unrelated couples before use. It is worthy to adop t the unrelated donors matched or mismatched for those high-risk acute leukemia patients who don’t have proper donor and need transplant urgently.展开更多
文摘Clinical analysis shows that the most cr itical factor pr edicting the stem cell engraftment is the high dose of progenitor cells infused. The number of nucleated cells in umbilical cord blood to be infused and require d to obtain a successful engraftment is superior to 3.7×107/kg including 10 5/kg of CD34(+) cells or even more than 1×108/kg containing 106/kg of CD34( + ) cells as the most ideal dose for high engraftment. A ‘megadose’ of purified CD34(+) cells of 107/kg along with depleted CD3(+) cells from mobilized periph eral blood is recommended for allo-transplant to achieve a high rate of engraft ment and very low rate of GvHD. The problem for CD3(+) depleted allo-transplant is higher frequency of malignancy relapse. In that case, the cellular immunother apy of post-transplantation as donor-lymphocyte-infusion is efficacious. As H LA genotyping is increasingly defined to higher degree of resolution by DNA prob es, it is recommended to sheck by means of genotyping when matching for the dono r/host couples especially the unrelated couples before use. It is worthy to adop t the unrelated donors matched or mismatched for those high-risk acute leukemia patients who don’t have proper donor and need transplant urgently.
