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Prepublished online as a Blood First Edition Paper on February 20, 2003; DOI 10.1182/blood-2001-12-0290. This Article Full Text Full Text (PDF) All Versions of this Article: 2001-12-0290v1 101/12/5061    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Jaroscak, J. Articles by Kurtzberg, J. Search for Related Content PubMed PubMed Citation Articles by Jaroscak, J. Articles by Kurtzberg, J. Related Collections Hematopoiesis and Stem Cells Neoplasia Transplantation Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 15 June 2003, Vol. 101, No. 12, pp. 5061-5067 TRANSPLANTATION Augmentation of umbilical cord blood (UCB) transplantation with ex vivo–expanded UCB cells: results of a phase 1 trial using the AastromReplicell System Jennifer Jaroscak, Kristin Goltry, Alan Smith, Barbara Waters-Pick, Paul L. Martin, Timothy A. Driscoll, Richard Howrey, Nelson Chao, Judy Douville, Sue Burhop, Pingfu Fu, and Joanne Kurtzberg From the Pediatric and Adult Bone Marrow Transplant Programs at Duke University Medical Center, Durham, NC; Aastrom Biosciences, Ann Arbor, MI; and Rainbow Babies and Childrens Hospital, Cleveland, OH. Allogeneic stem cell transplantation with umbilical cord blood (UCB) cells is limited by the cell dose a single unit provides recipients. Ex vivo expansion is one strategy to increase the number of cells available for transplantation. Aastrom Biosciences developed an automated continuous perfusion culture device for expansion of hematopoietic stem cells (HSCs). Cells are expanded in media supplemented with fetal bovine serum, horse serum, PIXY321, flt-3 ligand, and erythropoietin. We performed a phase 1 trial augmenting conventional UCB transplants with ex vivo–expanded cells. The 28 patients were enrolled on the trial between October 8, 1997 and September 30, 1998. UCB cells were expanded in the device, then administered as a boost to the conventional graft on posttransplantation day 12. While expansion of total cells and colony-forming units (CFUs) occurred in all cases, the magnitude of expansion varied considerably. The median fold increase was 2.4 (range, 1.0-8.5) in nucleated cells, 82 (range, 4.6-266.4) in CFU granulocyte-macrophages, and 0.5 (range, 0.09-2.45) in CD34+ lineage negative (lin–) cells. CD3+ cells did not expand under these conditions. Clinical-scale ex vivo expansion of UCB is feasible, and the administration of ex vivo–expanded cells is well tolerated. Augmentation of UCB transplants with ex vivo–expanded cells did not alter the time to myeloid, erythroid, or platelet engraftment in 21 evaluable patients. Recipients of ex vivo–expanded cells continue to have durable engraftment with a median follow-up of 47 months (range, 41-51 months). A randomized phase 2 study will determine whether augmenting UCB transplants with ex vivo–expanded UCB cells is beneficial. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: K. Vanheusden, S. Van Coppernolle, M. De Smedt, J. Plum, and B. Vandekerckhove In Vitro Expanded Cells Contributing to Rapid Severe Combined Immunodeficient Repopulation Activity Are CD34+38-33+90+45RA- Stem Cells, January 1, 2007; 25(1): 107 - 114. [Abstract] [Full Text] [PDF] H. 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