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Le Bourgeois A.,University of Nantes | Labopin M.,HOpitalSaint Antoine | Guillaume T.,University of Nantes | Delaunay J.,University of Nantes | And 17 more authors.
Experimental Hematology | Year: 2014

Our main objective was to determine new factors associated with engraftment and single-unit predominance after double umbilical cord blood (UCB) allogeneic stem-cell transplantation. Engraftment occurred in 78% of cases in this retrospective study including 77 adult patients. Three-year overall survival, disease-free survival, relapse incidence, and nonrelapse mortality were 55±6%, 44±6%, 33±5%, and 23±4%, respectively. In multivariate analysis, Human herpesvirus 6 reactivation during aplasia (hazard ratio [HR]=2.63; 95% confidence interval [CI]: 1.64-4.17; p<0.001), younger recipient age (<53years) (HR=1.97; 95% CI: 1.16-3.35; p = 0.012), and lower human leukocyte antigenmatching between the two units (3 of 6 or 4 of 6) (HR=2.09; 95% confidence interval: 1.22-3.59; p = 0.013) were the three factors independently associated with graft failure. Also, factors independently predicting the losing UCB unit were younger age of the UCB unit (odds ratio [OR]=1.01; 95% CI: 1-1.02; p = 0.035), lower CD34+ cell dose contained in the UCB unit (≤0.8×105/kg) (OR=2.55; 95% CI: 1.05-6.16; p= 0.04), and presence of an ABO incompatibility between the UCB unit and the recipient (OR=2.53; 95% CI: 1.15-5.53; p = 0.02). Thus, Human herpesvirus 6 reactivation during aplasia, lower unit-unit human leukocyte antigenmatching, and younger UCB unit age, as new unfavorable predictive factors, may represent new parameters to take into account afterdouble UCB allogeneic stem-cell transplantation in adults. These results need to beconfirmed prospectively, as they may influence unit selections and patient outcomes. © 2014 ISEH - International Society for Experimental Hematology. Source


Chevallier P.,University of Nantes | Robillard N.,Nantes University Hospital Center | Illiaquer M.,Nantes University Hospital Center | Illiaquer M.,University of Nantes | And 12 more authors.
Journal of Clinical Virology | Year: 2013

Background: Cord Blood (CB) are increasingly used as an alternative stem cells source in adults for allogeneic Stem Cell Transplantation (allo-SCT). The risk of human herpesvirus (HHV-6) reactivation is significantly higher after CB transplant vs unrelated peripheral blood stem cells (PBSC) allo-SCT. Higher HHV-6 cell receptor CD46 expression on progenitor cells in CB may explain this difference. Objectives: To prospectively compare the HHV-6 cell receptor CD46 expression on various cell subsets of three freshly harvested blood sources on one hand and of three graft sources on the other hand. Study design: 52 samples were used for the purpose of this study. They were issued from peripheral blood (PB, n=10), G-CSF mobilised PB (GCSF-PB, n=10), cord blood (CB, n=10), unmanipulated bone marrow (uBM, n=5), leukapheresis product (LP, n=10) and thawed CB graft (n=7). CD46 expression was assessed by FACS analysis on total lymphocytes, monocytes, NK cells, T and B cells subsets, plasmacytoid (pDCs) dendritic cells and stem cells. Results: As all cell subsets were found CD46 positive, CD46 mean fluorescence intensity (MFI) was then considered for comparison between the three blood sources and the three graft sources. The most impressive result observed was that HHV-6 cell receptor CD46 expression was significantly reduced in almost all cell components of thawed CB graft compared to other graft sources. Conclusions: This original study shows strong differences in term of quantitative CD46 expression between several blood and grafts samples. Our results suggest that other factors than the qualitative CD46 expression play a role in the higher HHV-6 reactivation observed after CB transplant in adults. © 2013 Elsevier B.V. Source


Thibaudeau C.,Unite dingenierie cellulaire | Flandrois G.,Unite dingenierie cellulaire | Piteux E.,Unite dingenierie cellulaire | Auffray F.,Unite dingenierie cellulaire | And 8 more authors.
Transfusion Clinique et Biologique | Year: 2011

Background: The freezing phase is a critical step of the freezing process of the hematopoietic stem cells. To standardize the decrease of the temperature, the use of a programmable freezer is recommended. There is no available protocol, neither to describe exactly the validation of a programmable freezer, nor to prove the performance of the freezing/thawing step of the grafts. Method: We describe a validation protocol with three phases: first a qualification of installation, then an operational qualification and finally, a qualification of performance. The validation is performed in tandem between the freezer which is routinely used (Nicool Plus) and a new one (Freezal). Results: With this protocol, we demonstrate the efficacy of the freezing program and its ability to assure the quality of the grafts reinjected to the patients, particularly in terms of cellular efficiency on CD34+. hematopoietic stem cells. On these cells, we measured a significant increase of cellular efficiency (+10%) after freezing with the Freezal. Conclusion: Here, we propose a validation protocol which is able to qualify a programmable freezer. This protocol can optimize the capability of the freezer and is able to prove its performance. © 2011 Elsevier Masson SAS. Source

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