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1.
Arch Med Res ; 51(1): 54-62, 2020 01.
Article in English | MEDLINE | ID: mdl-32086109

ABSTRACT

BACKGROUND: The umbilical cord blood bank at the Mexican Institute of Social Security (IMSS-CBB) was established in January 2005. This lead to the development of the UCB transplantation program. Herein, we describe the experience generated during these 13 years. STUDY DESIGN AND METHODS: Donor selection, as well as UCB collection, processing, and banking were performed under good manufacturing practices and standard operating procedures. UCB units were thawed, processed, and released for transplantation based on HLA and nucleated cell content. RESULTS: From January 2005-December 2017, 1,298 UCB units were banked; 164 of them were released for transplantation, and 118 UCB transplants were performed. Ninety-four transplants were performed in pediatric patients and 24 in adults. Sixty percent of them corresponded to patients with leukemia, 19% were patients with marrow failure, and the rest had immunodeficiency, hemoglobinopathy, metabolic disorders, or solid tumors. Engraftment was observed in 67 patients (57% of transplanted patients) and 64% of them were still alive when writing this article. In contrast, only 13 of the 51 (25%) non-engrafting patients were alive. At the time of writing this article, the disease-free survival rate was 37%, and the overall survival rate was 47%, with survival periods of 161-3,721 days. CONCLUSION: The IMSS UCB banking and transplantation program has had a significant impact for many IMSS patients. The hematopoietic transplantation program at our institution has benefited from the use of UCB as a source of transplantable cells.


Subject(s)
Blood Banking , Blood Banks , Cord Blood Stem Cell Transplantation , Fetal Blood , National Health Programs , Adolescent , Adult , Aged , Blood Banks/statistics & numerical data , Blood Banks/trends , Bone Marrow Failure Disorders/epidemiology , Bone Marrow Failure Disorders/therapy , Child , Child, Preschool , Cord Blood Stem Cell Transplantation/standards , Cord Blood Stem Cell Transplantation/statistics & numerical data , Cord Blood Stem Cell Transplantation/trends , Disease-Free Survival , Female , Hematopoietic Stem Cell Transplantation/standards , Hematopoietic Stem Cell Transplantation/statistics & numerical data , History, 21st Century , Humans , Infant , Infant, Newborn , Leukemia/epidemiology , Leukemia/therapy , Male , Mexico/epidemiology , Middle Aged , National Health Programs/organization & administration , National Health Programs/standards , National Health Programs/trends , Pregnancy , Retrospective Studies , Survival Rate , Young Adult , Blood Banking/methods
2.
Transfusion ; 51(2): 328-32, 2011 Feb.
Article in English | MEDLINE | ID: mdl-21309778

ABSTRACT

BACKGROUND: In January 2005, the Cord Blood Bank (CBB) at the Mexican Institute of Social Security initiated activities. Herein, we describe the experience generated during this period (January 1, 2005-December 31, 2009). STUDY DESIGN AND METHODS: Good manufacturing practices and standard operating procedures were used to address donor selection, as well as umbilical cord blood (UCB) collection, processing, and cryopreservation. Based mainly on HLA and nucleated cell content, specific UCB units were thawed, processed, and released for transplantation. RESULTS: A total of 589 UCB units were stored, representing 54% of the total number of units collected. Forty-eight units (8.14% of the stored units) were released for transplantation of 36 patients. Twenty-six patients (72% of cases) corresponded to patients with acute leukemia, five (14%) to patients with marrow failure, and the rest (five; 14%) to patients with hemoglobinopathies and other syndromes. The median number of nucleated cells infused per patient was 6.71 × 10(7) /kg and the median number of CD34+ cells was 4.8 × 10(5) /kg. Current engraftment data indicate that engraftment occurred in 56%, and no engraftment in 44%, of cases. Engraftment was more frequent (59%) in patients that received more than 3 × 10(7) total nucleated cells (TNCs)/kg body weight, than in those receiving fewer than 3 × 10(7) TNCs/kg (40%). Myeloid engraftment was observed 7 to 54 days posttransplant (median, 23 days), whereas platelet engraftment was detected on Days 12 to 87 posttransplant (median, 38 days). To date, the disease-free survival rate was 41% and the overall survival was 47%, with survival periods of 126 to 1654 days. CONCLUSION: Although the experience presented herein is still limited and the period of analysis is still short, the results obtained during these 5 years are encouraging.


Subject(s)
Blood Banks/statistics & numerical data , Cord Blood Stem Cell Transplantation/statistics & numerical data , Fetal Blood , Anemia, Aplastic/therapy , Blood Cell Count , Cell Nucleus , Disease-Free Survival , Graft Survival , Hematopoietic Stem Cells/cytology , Hematopoietic Stem Cells/ultrastructure , Hemoglobinopathies/therapy , Humans , Infant, Newborn , Leukemia/therapy , Mexico , Retrospective Studies , Social Security , Treatment Outcome
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