The most significant limitation of using of hematopoietic stem cell transplantation for treatment hematological and non-hematological diseases is a low number of progenitor/stem cells in the graft. For sufficient engraftment and good clinical outcome 2-5 millions of CD34+ cells should be transplanted. Unfortunately, many cell products, especially cord blood samples contain less number of stem cells than required.
Here I was trying to summarize some approaches used for improvement of engraftment by mostly increasing stem cell number per graft. The top part of the table represents approaches which have a potential to be commercialized.
| approach |
examples |
references |
phase |
| Increase yield of HSC by isolation procedure |
1. cord + placental blood HSC
2. improving CB processing |
1. HemaCell Perfusion system | preclinical – phase I |
| HSC expansion ex vivo |
using cytokine cocktails or “artificial niche” bioreactors | StemEx Gamida Cell | phase II-III |
| co-transplantation with cells increasing engraftment |
1. myeoid progenitors
2. mesenchymal cells |
1. Cellerant CLT-08 |
1. phase I
|
| co-transplantation with few HSC sources |
1. double (multiple) unit CB
2. CB + MB of BM from 3rd party donors |
1. NCT00514579 | 1. phase II-III
|
| new conditioning regiments |
making more niches available in host BM | Science 2007; 5854: 1296 | preclinical |
| new routes to transplantation of HSC | intra-bone bone marrow transplant | Lancet Oncology 2008;9:831 | phase I-II |
CB – cord blood; BM – bone marrow; MB – mobilized blood
Let me know if I missed something.
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it was writen to test new option – ‘tweet this’
Alex,
Actually, LifeBankUSA (a subsidiary of Celgene) is in Clinical trial (I believe phase I) with their combined placenta + CB transplants: see http://www.lifebankusa.com/moretreatment-success.html and http://www.celgene.com/pdfs/product_pipeline.pdf
thanks Jim,
I’ve heard that Cryo-Cell proposed to mix CB with menstrual blood, I don’t know how that’s going to work.
to Denis –
) I had this post in mind for a long while.
no, not only because of that