How to increase hematopoietic stem cell engraftment and transplant outcome?

by Alexey Bersenev on May 18, 2009 · 3 comments

in business, educational

 
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



2. BioE PrepaCyte-CB

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

2. Pluristem PLX-I

1. phase I



2. preclinical – phase I

co-transplantation with few HSC sources
1. double (multiple) unit CB

2. CB + MB of BM from 3rd party donors

1. NCT00514579



2. Bone Marrow Transplant 2009; 43: 365

1. phase II-III



2. phase I

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



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{ 3 comments… read them below or add one }

Denis May 18, 2009 at 5:32 am

it was writen to test new option – ‘tweet this’
:)

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Jim H May 18, 2009 at 1:50 pm

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

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Alex May 18, 2009 at 2:00 pm

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 –
no, not only because of that :)) I had this post in mind for a long while.

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