Biology of Blood and Marrow Transplantation最新文献

{"title":"Anaesthetic and Surgical Considerations in Post COVID-19 Patients Requiring Head and Neck Surgery.","authors":"Kritant Bhushan, Priya Jeyaraj, Rajnish Sahu, Mansi Luthra Sharma","doi":"10.1007/s12070-023-04040-5","DOIUrl":"10.1007/s12070-023-04040-5","url":null,"abstract":"<p><p>As the cases of COVID-19 have declined, the number of patients who have recovered from the dreaded disease is reporting for elective or emergency surgeries. Surgical planning in patients who have recovered from COVD-19 requires special considerations because of the morbidity and mortality associated with the infection and its devastating after-effects. There is a distinct paucity of literature on guidelines and protocols to follow in the perioperative management of these patients. With the help of experience gained over the past 2 years of the 'COVID-19 era', we have been able to establish important recommendations, guidelines and useful protocols during perioperative management of COVID-recovered patients. These protocols include important anesthetic and surgical considerations, which are both practical as well as implementable and are also in cognizance with government-laid down advisories. Although SARS-CoV-2 infection primarily affects the pulmonary and cardiac systems, it has the potential for serious and severely affect multiple organs and various other body systems in erratic and unpredictable manner. All of these factors can have significant implications that make the perioperative management of post-COVID-19 patients, difficult and challenging. Considering the far-reaching and long-lasting effects of this infection on the human body, the protocols and recommendations presented in this article can serve as a valuable guide for clinicians to effectively manage the surgical patient and help reduce perioperative complications attributable to COVID-19 infection.</p>","PeriodicalId":9165,"journal":{"name":"Biology of Blood and Marrow Transplantation","volume":"18 1","pages":"3602-3609"},"PeriodicalIF":0.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10645957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75714357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Membrane-bound D-mannose isomerase of acetic acid bacteria: finding, characterization, and application.","authors":"Osao Adachi, Naoya Kataoka, Kazunobu Matsushita, Yoshihiko Akakabe, Toshihiro Harada, Toshiharu Yakushi","doi":"10.1093/bbb/zbac049","DOIUrl":"10.1093/bbb/zbac049","url":null,"abstract":"<p><p>D-Mannose isomerase (EC 5.3.1.7) catalyzing reversible conversion between D-mannose and D-fructose was found in acetic acid bacteria. Cell fractionation confirmed the enzyme to be a typical membrane-bound enzyme, while all sugar isomerases so far reported are cytoplasmic. The optimal enzyme activity was found at pH 5.5, which was clear contrast to the cytoplasmic enzymes having alkaline optimal pH. The enzyme was heat stable and the optimal reaction temperature was observed at around 40 to 60˚C. Purified enzyme after solubilization from membrane fraction showed the total molecular mass of 196 kDa composing of identical four subunits of 48 kDa. Washed cells or immobilized cells were well functional at nearly 80% of conversion ratio from D-mannose to D-fructose and reversely 20-25% of D-fructose to D-mannose. Catalytic properties of the enzyme were discussed with respect to the biotechnological applications to high fructose syrup production from konjac taro.</p>","PeriodicalId":9165,"journal":{"name":"Biology of Blood and Marrow Transplantation","volume":"21 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75822028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human-induced pluripotent stem cells-derived retinal pigmented epithelium, a new horizon for cells-based therapies for age-related macular degeneration.","authors":"Samaneh Dehghan, Reza Mirshahi, Alireza Shoae-Hassani, Masood Naseripour","doi":"10.1186/s13287-022-02894-0","DOIUrl":"10.1186/s13287-022-02894-0","url":null,"abstract":"<p><p>Retinal pigment epithelium (RPE) degeneration is the hallmark of age-related macular degeneration (AMD). AMD, as one of the most common causes of irreversible visual impairment worldwide, remains in need of an appropriate approach to restore retinal function. Wet AMD, which is characterized by neovascular formation, can be stabilized by currently available therapies, including laser photocoagulation, photodynamic therapy, and intraocular injections of anti-VEFG (anti-vascular endothelial growth factor) therapy or a combination of these modalities. Unlike wet AMD, there is no effective therapy for progressive dry (non-neovascular) AMD. However, stem cell-based therapies, a part of regenerative medicine, have shown promising results for retinal degenerative diseases such as AMD. The goal of RPE cell therapy is to return the normal structure and function of the retina by re-establishing its interaction with photoreceptors, which is essential to vision. Considering the limited source of naturally occurring RPE cells, recent progress in stem cell research has allowed the generation of RPE cells from human pluripotent cells, both embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSC). Since iPSCs face neither ethical arguments nor significant immunological considerations when compared to ESCs, they open a new horizon for cell therapy of AMD. The current study aims to discuss AMD, review the protocols for making human iPSCs-derived RPEs, and summarize recent developments in the field of iPSC-derived RPEs cell therapy.</p>","PeriodicalId":9165,"journal":{"name":"Biology of Blood and Marrow Transplantation","volume":"11 1","pages":"217"},"PeriodicalIF":2.1,"publicationDate":"2022-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9137077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76159986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Goal-Oriented Monitoring of Cyclosporine Is Effective for Graft-versus-Host Disease Prevention after Hematopoietic Stem Cell Transplantation in Sickle Cell Disease and Thalassemia Major","authors":"Alexandra Gauthier ,&nbsp;Nathalie Bleyzac ,&nbsp;Nathalie Garnier ,&nbsp;Kamila Kebaili ,&nbsp;Philippe Joly ,&nbsp;Marie-Pierre Goutagny ,&nbsp;Isabelle Mollet ,&nbsp;Sylvain Goutelle ,&nbsp;Cécile Renard ,&nbsp;Yves Bertrand","doi":"10.1016/j.bbmt.2020.01.016","DOIUrl":"10.1016/j.bbmt.2020.01.016","url":null,"abstract":"<div><p>Graft-versus-host disease (GVHD) is an important challenge and a major cause of morbidity and mortality in children after hematopoietic stem cell transplant (HSCT). Herein we report our institution's experience of goal-oriented Bayesian monitoring for cyclosporine (CsA) used alone as GVHD prophylaxis during the post-transplant period in pediatric patients with thalassemia major (TM) or sickle cell anemia (SCA) undergoing HLA-matched HSCT. We also studied evolution of chimerism. Twenty-six consecutive patients (SCA, 14; TM, 12) underwent matched sibling donor (MSD) HSCT from 2004 to 2014. All patients received a myeloablative conditioning regimen. GVHD prophylaxis consisted of 20 mg/kg antithymocyte globulin in the conditioning regimens and then CsA alone in the post-transplant period. Target CsA trough blood concentration (TBC) was 150 ± 20 ng/mL. At last follow-up, all patients were alive and free of disease, even in cases of mixed chimerism. Engraftment occurred in all patients. No patient developed grades II to IV acute GVHD, 4 patients developed acute grade I skin GVHD, and only 1 presented with chronic pulmonary GVHD. A better control of GVHD and immunosuppression by a strict monitoring of CsA TBC as described herein is promising and could play a crucial role. Further investigations are required, but this study opens new perspectives to improve survival and safety of HSCT from alternative donors in TM and SCA to levels compatible with that obtained with MSDs.</p></div>","PeriodicalId":9165,"journal":{"name":"Biology of Blood and Marrow Transplantation","volume":"26 12","pages":"Pages 2285-2291"},"PeriodicalIF":4.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bbmt.2020.01.016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37601574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Hematopoietic Stem Cell Transplantation Lung Computed Tomography as an Alternative to the Pulmonary Function Test during the COVID-19 Pandemic","authors":"Masaharu Tamaki ,&nbsp;Hideki Nakasone ,&nbsp;Tadao Aikawa ,&nbsp;Yuhei Nakamura ,&nbsp;Masakatsu Kawamura ,&nbsp;Shunto Kawamura ,&nbsp;Junko Takeshita ,&nbsp;Nozomu Yoshino ,&nbsp;Yukiko Misaki ,&nbsp;Kazuki Yoshimura ,&nbsp;Shinpei Matsumi ,&nbsp;Ayumi Gomyo ,&nbsp;Aki Tanihara ,&nbsp;Machiko Kusuda ,&nbsp;Yu Akahoshi ,&nbsp;Shun-ichi Kimura ,&nbsp;Shinichi Kako ,&nbsp;Noriko Oyama-Manabe ,&nbsp;Yoshinobu Kanda","doi":"10.1016/j.bbmt.2020.08.025","DOIUrl":"10.1016/j.bbmt.2020.08.025","url":null,"abstract":"<div><p>The pulmonary function test (PFT) is an important test for risk stratification before allogeneic transplantation (allo-HCT). However, it might be preferable to avoid PFT as much as possible in the recent era of coronavirus disease 2019 (COVID-19), because PFT requires forced expirations and might produce aerosols, increasing the risk of COVID-19 transmission. Therefore, we tried to predict normal PFT results before allo-HCT based on computed tomography (CT) findings. This study included 390 allo-HCT recipients at our center for whom lung CT images and PFT results before allo-HCT were available. Abnormal CT findings were less likely to be observed in the normal PFT group (47.0% versus 67.4%, <em>P</em> = .015), with a high negative predictive value of 92.9%. In a multivariate analysis, normal CT was significantly associated with normal PFT (odds ratio, 2.47; 95% confidence interval, 1.22 to 4.97; <em>P</em> = .012). A model for predicting normal PFT was constructed based on the results of a multivariate analysis, and the area under the curve of the receiver operating characteristic analysis was 0.656, which gave a sensitivity of 45.5% and a specificity of 86.0%. The relatively high specificity of the model suggested that PFT can be omitted in patients with normal CT findings before allo-HCT.</p></div>","PeriodicalId":9165,"journal":{"name":"Biology of Blood and Marrow Transplantation","volume":"26 12","pages":"Pages 2318-2322"},"PeriodicalIF":4.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bbmt.2020.08.025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38323566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Officers and Directors of ASTCT","authors":"","doi":"10.1016/S1083-8791(20)30705-9","DOIUrl":"https://doi.org/10.1016/S1083-8791(20)30705-9","url":null,"abstract":"","PeriodicalId":9165,"journal":{"name":"Biology of Blood and Marrow Transplantation","volume":"26 12","pages":"Page A3"},"PeriodicalIF":4.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1083-8791(20)30705-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136816042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonmyeloablative Conditioning Regimen before T Cell Replete Haploidentical Transplantation with Post-Transplant Cyclophosphamide for Advanced Hodgkin and Non-Hodgkin Lymphomas","authors":"Catalina Montes de Oca ,&nbsp;Luca Castagna ,&nbsp;Chiara De Philippis ,&nbsp;Stefania Bramanti ,&nbsp;Jean Marc Schiano ,&nbsp;Thomas Pagliardini ,&nbsp;Aude Collignon ,&nbsp;Samia Harbi ,&nbsp;Jacopo Mariotti ,&nbsp;Angela Granata ,&nbsp;Valerio Maisano ,&nbsp;Sabine Furst ,&nbsp;Faezeah Legrand ,&nbsp;Christian Chabannon ,&nbsp;Carmelo Carlo-Stella ,&nbsp;Armando Santoro ,&nbsp;Didier Blaise ,&nbsp;Raynier Devillier","doi":"10.1016/j.bbmt.2020.08.014","DOIUrl":"10.1016/j.bbmt.2020.08.014","url":null,"abstract":"<div><p>Allogeneic hematopoietic stem cell transplantation (allo-SCT) is a valid option in patients with refractory lymphomas. HLA haploidentical stem cell transplantation (haplo-SCT) expanded the accessibility to allogeneic hematopoietic cell transplantation. The aims of study were to retrospectively assess the toxicity and efficacy of haplo-SCT using nonmyeloablative conditioning in patients with advanced lymphoma. In total, 147 patients with advanced lymphoma at 2 partner institutions were included. Patients received a uniform nonmyeloablative conditioning regimen and graft-versus-host disease (GVHD) prophylaxis. The primary endpoints were progression-free survival (PFS), overall survival (OS), GVHD, nonrelapse mortality, and GVHD, relapse-free survival (GRFS). Median follow-up was 39 months (range, 6 to 114 months). The median age was 46 years (range, 19 to 71 years). Sixty-five percent of patients were in complete remission (CR) at transplantation. Cumulative incidence of grade II to IV acute GVHD was 30% (95% confidence interval [Cl], 23% to 38%). Two-year cumulative incidence of all grades of chronic GVHD was 13% (95% CI, 8% to 20%). Two-year cumulative incidence of disease relapse was 19% (95% CI, 14% to 27%), with a higher incidence in patients not being in CR at allo-HCT (CR versus not CR: 12% versus 33%, <em>P</em> = .006). Two-year PFS, OS, and GRFS were 66% (95% CI, 59-75), 73% (95% CI, 66-81), and 56% (95% CI, 48-65), respectively. Haplo-SCT with post-transplantation cyclophosphamide may be considered a valid option for patients with aggressive lymphoma and deserves further evaluation.</p></div>","PeriodicalId":9165,"journal":{"name":"Biology of Blood and Marrow Transplantation","volume":"26 12","pages":"Pages 2299-2305"},"PeriodicalIF":4.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bbmt.2020.08.014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38296340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Propylene Glycol-Free Melphalan versus PG-Melphalan as Conditioning for Autologous Hematopoietic Cell Transplantation for Myeloma","authors":"Kathleen Monahan ,&nbsp;Ariel Kleman ,&nbsp;Bicky Thapa ,&nbsp;Aniko Szabo ,&nbsp;Anita D'Souza ,&nbsp;Binod Dhakal ,&nbsp;James H. Jerkins ,&nbsp;Marcelo C. Pasquini ,&nbsp;Mehdi Hamadani ,&nbsp;Parameswaran N. Hari ,&nbsp;Saurabh Chhabra","doi":"10.1016/j.bbmt.2020.08.030","DOIUrl":"10.1016/j.bbmt.2020.08.030","url":null,"abstract":"<div><p>High-dose melphalan (Mel) conditioning before autologous hematopoietic cell transplantation (autoHCT) is standard of care for patients with transplantation-eligible multiple myeloma. The traditional lyophilized Mel formulation has inadequate solubility and stability after reconstitution, leading to the use of propylene glycol (PG) as a solubilizing agent. A newer PG-free Mel preparation (Evomela) uses beta cyclodextrin captisol as a solubilizing agent and was approved by the United States Food and Drug Administration as a conditioning agent based on a single-phase IIb study showing bioequivalence. We compared the outcomes of consecutive patients with myeloma undergoing autoHCT using the 2 formulations of Mel for conditioning as our center switched from using the older formulation (PG-Mel) to the newer one (PGF-Mel). Of 294 autoHCT recipients, 162 received PG-Mel conditioning and 132 received PGF-Mel conditioning. The PGF-Mel group was older and had a lower average Karnofsky Performance Status score. PGF-Mel was associated with faster neutrophil recovery (median, 12 days versus 13 days; <em>P</em> &lt; .001), fewer grade 3-4 infections within 30 days of autoHCT (1.5% versus 8.0%; <em>P</em> = .048), and a lower 30-day rehospitalization rate (6.8% versus 17.9%; <em>P</em> = .04), as confirmed by propensity-weighted analysis. No significant between-group differences were detected in mucositis, organ toxicity, myeloma response, or 100-day mortality.</p></div>","PeriodicalId":9165,"journal":{"name":"Biology of Blood and Marrow Transplantation","volume":"26 12","pages":"Pages 2229-2236"},"PeriodicalIF":4.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bbmt.2020.08.030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38372974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Neuroimaging Correlates of Post-Transplant Delirium","authors":"Patrick Smith ,&nbsp;Jillian C. Thompson ,&nbsp;Elena Perea ,&nbsp;Brian Wasserman ,&nbsp;Lauren Bohannon ,&nbsp;Alessandro Racioppi ,&nbsp;Taewoong Choi ,&nbsp;Cristina Gasparetto ,&nbsp;Mitchell E. Horwitz ,&nbsp;Gwynn Long ,&nbsp;Richard Lopez ,&nbsp;David A. Rizzieri ,&nbsp;Stefanie Sarantopoulos ,&nbsp;Keith M. Sullivan ,&nbsp;Nelson J. Chao ,&nbsp;Anthony D. Sung","doi":"10.1016/j.bbmt.2020.09.016","DOIUrl":"10.1016/j.bbmt.2020.09.016","url":null,"abstract":"<div><p>Delirium is common among adults undergoing hematopoietic stem cell transplantation (HCT), although the clinical and neuroimaging correlates of post-HCT delirium have not been adequately delineated. We therefore examined the frequency of delirium and neuroimaging correlates of post-transplant delirium in a retrospective cohort of 115 adults undergoing neuroimaging after allogeneic HCT. Delirium was established using previously validated methods for retrospective identification of chart-assessed postprocedural delirium. Chart reviews were independently conducted by a multidisciplinary team with expertise in HCT, psychiatry, and psychology on consecutive allogeneic HCT patients who underwent neuroimaging assessments and transplantation at a single center between January 2009 and December 2016. Neuroimaging markers of white matter damage and brain volume loss were also recorded. In total, 115 patients were included, ranging in age from 20 to 74 years (mean [SD] age, 49 [13]). Fifty-three patients (46%) developed post-HCT delirium. In an adjusted model, delirium incidence was associated with older age (odds ratio [OR], 1.92 [1.28, 2.87] per decade, <em>P</em> = .002), greater severity of white matter hyperintensities (OR, 1.95 [1.06, 3.57], <em>P</em> = .031), and conditioning intensity (OR, 6.37 [2.20, 18.45], <em>P</em> &lt; .001) but was unrelated to cortical atrophy (<em>P</em> = .777). Delirium was associated with fewer hospital-free days (<em>P</em> = .023) but was not associated with overall survival (hazard ratio, 0.95 [0.56, 1.61], <em>P</em> = .844). Greater incidence of delirium following HCT was associated with greater age, microvascular burden, and conditioning intensity. Pre-HCT consideration of microvascular burden and other neuroimaging biomarkers of risk may be warranted.</p></div>","PeriodicalId":9165,"journal":{"name":"Biology of Blood and Marrow Transplantation","volume":"26 12","pages":"Pages 2323-2328"},"PeriodicalIF":4.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bbmt.2020.09.016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38503565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines for Cord Blood Unit Selection","authors":"Ioannis Politikos ,&nbsp;Eric Davis ,&nbsp;Melissa Nhaissi ,&nbsp;John E. Wagner ,&nbsp;Claudio G. Brunstein ,&nbsp;Sandra Cohen ,&nbsp;Elizabeth J. Shpall ,&nbsp;Filippo Milano ,&nbsp;Andromachi Scaradavou ,&nbsp;Juliet N. Barker ,&nbsp;American Society for Transplantation and Cellular Therapy Cord Blood Special Interest Group","doi":"10.1016/j.bbmt.2020.07.030","DOIUrl":"10.1016/j.bbmt.2020.07.030","url":null,"abstract":"<div><p>Optimal cord blood (CB) unit selection is critical to maximize the likelihood of successful engraftment and survival after CB transplantation (CBT). However, unit selection can be complex because multiple characteristics must be considered including unit cell dose, donor-recipient human leukocyte antigen (HLA) match, and unit quality. This review provides evidence-based and experience-based comprehensive guidelines for CB unit selection. Topics addressed include the use of both the TNC and the CD34⁺ cell dose, as well as the CD34⁺ cell to TNC content ratio to evaluate unit progenitor cell content and engraftment potential, the acceptable TNC and CD34⁺ cell dose criteria that define an adequate single-unit graft, and the indication and acceptable cell dose criteria for double-unit grafts. The acceptable criteria for 6-loci (HLA-A, -B antigen, -DRB1 allele) and 8-allele (HLA-A, -B, -C, -DRB1) donor-recipient HLA match, the evaluation of patients with donor-specific HLA antibodies, and the multiple determinants of unit quality are also reviewed in detail. Finally, a practical step-by-step guide to CB searches and the principles that guide ultimate graft selection are outlined.</p></div>","PeriodicalId":9165,"journal":{"name":"Biology of Blood and Marrow Transplantation","volume":"26 12","pages":"Pages 2190-2196"},"PeriodicalIF":4.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bbmt.2020.07.030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38212626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}