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Article ; Online: Distribution and determinants of QRS rotation of black and white persons in the general population.

Prineas, Ronald J / Zhang, Zhu-Ming / Stevens, Cladd E / Soliman, Elsayed Z

2017 Volume 51, Issue 2, Page(s) 316–322

Abstract: Background: The prevalence and determinants of QRS transition zones are not well established.: Methods: We examined the distributions of Normal, clockwise (CW) and counterclockwise (CCW)) QRS transition zones and their relations to disease, body size ...

Abstract	Background: The prevalence and determinants of QRS transition zones are not well established. Methods: We examined the distributions of Normal, clockwise (CW) and counterclockwise (CCW)) QRS transition zones and their relations to disease, body size and demographics in 4624 black and white men and women free of cardiovascular disease and major ECG abnormalities enrolled in the NHANES-III survey. Results: CW transition zones were least observed (6.2%) and CCW were most prevalent (60.1%) with Normal in an intermediate position (33.7%). In multivariable logistic regression analysis, the adjusted, significant predictors for CCW compared to Normal were a greater proportion of blacks and women, fewer thin people (BMI<20, thin), a greater ratio of chest depth to chest width, and an LVMass index <80g. By contrast, CW persons were older, had larger QRS/T angles, smaller ratio of chest depth to chest width, had a greater proportion of subjects with low voltage QRS, more pulmonary disease, a greater proportion with high heart rates, shorter QRS duration and were more obese (BMI≥30). Conclusions: Normal rather than being the most prevalent transition zone was intermediate in frequency between the most frequently encountered CCW and the least frequently encountered transition zone CW. Differences in the predictors of CW and CCW exist. This requires further investigation to examine how far these differences explain the differences in the published prognostic differences between CW and CCW.
MeSH term(s)	African Americans ; Body Size ; Demography ; Electrocardiography ; European Continental Ancestry Group ; Female ; Heart Conduction System/physiopathology ; Humans ; Male ; Middle Aged ; Nutrition Surveys ; United States
Language	English
Publishing date	2017-10-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	410286-1
ISSN	1532-8430 ; 0022-0736
ISSN (online)	1532-8430
ISSN	0022-0736
DOI	10.1016/j.jelectrocard.2017.10.004
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Article ; Online: Indirect evidence that maternal microchimerism in cord blood mediates a graft-versus-leukemia effect in cord blood transplantation.

van Rood, Jon J / Scaradavou, Andromachi / Stevens, Cladd E

Proceedings of the National Academy of Sciences of the United States of America

2012 Volume 109, Issue 7, Page(s) 2509–2514

Abstract: During pregnancy women can develop B- and T-cell immunity against the inherited paternal antigens (IPAs) of the fetus, such as HLA, peptides of minor histocompatibilty antigens, and possibly onco-fetal antigens. The biological and pathological role of ... ...

Abstract	During pregnancy women can develop B- and T-cell immunity against the inherited paternal antigens (IPAs) of the fetus, such as HLA, peptides of minor histocompatibilty antigens, and possibly onco-fetal antigens. The biological and pathological role of these pregnancy-induced immunological events is only understood in part. However, anti-IPA immunity in the mother persists for many decades after delivery and may reduce relapse in offspring with leukemia after HLA-haploidentical transplantation of maternal hematopoietic stem cells (HSC). We hypothesized that maternal anti-IPA immune elements cross the placenta and might confer a potent graft-versus-leukemia effect when cord blood (CB) is used in unrelated HSC transplantation. In a retrospective study of single-unit CB recipients with all grafts provided by the New York Blood Center, we show that patients with acute myeloid or lymphoblastic leukemia (n = 845) who shared one or more HLA-A, -B, or -DRB1 antigens with their CB donor's IPAs had a significant decrease in leukemic relapse posttransplantation [hazard ratio (HR) = 0.38, P < 0.001] compared with those that did not. Remarkably, relapse reduction in patients receiving CB with one HLA mismatch (HR = 0.15, P < 0.001) was not associated with an increased risk of severe acute graft-versus-host disease (HR = 1.43, P = 0.730). Our findings may explain the unexpected low relapse rate after CB transplantation, open new avenues in the study of leukemic relapse after HSC transplantation (possibly of malignancies in general), and have practical implications for CB unit selection.
MeSH term(s)	Female ; Fetal Blood/transplantation ; Graft vs Leukemia Effect/genetics ; Humans ; Retrospective Studies
Language	English
Publishing date	2012-01-09
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	209104-5
ISSN	1091-6490 ; 0027-8424
ISSN (online)	1091-6490
ISSN	0027-8424
DOI	10.1073/pnas.1119541109
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Article ; Online: Eradicating hepatitis B virus: The critical role of preventing perinatal transmission.

Stevens, Cladd E / Toy, Pearl / Kamili, Saleem / Taylor, Patricia E / Tong, Myron J / Xia, Guo-Liang / Vyas, Girish N

Biologicals : journal of the International Association of Biological Standardization

2017 Volume 50, Page(s) 3–19

Abstract: Prevention of hepatitis B virus (HBV) transmission from infected mothers to their newborns is critical to HBV control and eventual eradication. Mother-to-child perinatal transmission causes the highest chronic carrier rate (>85%) with a high rate of ... ...

Abstract	Prevention of hepatitis B virus (HBV) transmission from infected mothers to their newborns is critical to HBV control and eventual eradication. Mother-to-child perinatal transmission causes the highest chronic carrier rate (>85%) with a high rate of subsequent chronic liver disease and hepatocellular carcinoma. This risk is reduced by 90% with HBV vaccine given along with hepatitis B immune globulin (HBIG) starting at birth. New analyses of our data from US trials of HBIG and HBV vaccine in high-risk infants revealed better efficacy with yeast-recombinant vaccine than plasma-derived vaccine, especially in preventing late onset infections, with evidence that vaccine prevented transmission of maternal HBV infection with the glycine to arginine mutation in surface antigen codon 145 (sG145R). Most late infections with sG145R were in vaccine non-responders, suggesting escape from HBIG rather than from vaccine-induced antibody. Our findings also help explain survey results from Taiwan following universal childhood immunization implemented in the mid-1980s. We conclude that current vaccines will remain effective against surface antigen mutants. Anti-viral drugs in high-risk pregnant women, in combination with newborn HBIG and vaccine, show promise for eliminating residual breakthrough neonatal infections, critical to meeting WHO 2030 goals and for eradicating HBV.
MeSH term(s)	Adult ; Female ; Hepatitis B/immunology ; Hepatitis B/transmission ; Hepatitis B/virology ; Hepatitis B Vaccines/immunology ; Hepatitis B Vaccines/therapeutic use ; Hepatitis B virus/drug effects ; Hepatitis B virus/immunology ; Hepatitis B virus/physiology ; Humans ; Infant, Newborn ; Infectious Disease Transmission, Vertical/prevention & control ; Pregnancy ; Pregnancy Complications, Infectious/immunology ; Pregnancy Complications, Infectious/prevention & control ; Pregnancy Complications, Infectious/virology
Chemical Substances	Hepatitis B Vaccines
Language	English
Publishing date	2017-11
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1017370-5
ISSN	1095-8320 ; 1045-1056
ISSN (online)	1095-8320
ISSN	1045-1056
DOI	10.1016/j.biologicals.2017.08.008
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Article ; Online: Combined effect of total nucleated cell dose and HLA match on transplantation outcome in 1061 cord blood recipients with hematologic malignancies.

Barker, Juliet N / Scaradavou, Andromachi / Stevens, Cladd E

Blood

2009 Volume 115, Issue 9, Page(s) 1843–1849

Abstract: Both total nucleated cell (TNC) dose and human leukocyte antigen (HLA)-match affect the outcome of cord blood (CB) transplantation. However, how to prioritize these characteristics in unit selection is not established. Therefore, we analyzed the outcomes ...

Abstract	Both total nucleated cell (TNC) dose and human leukocyte antigen (HLA)-match affect the outcome of cord blood (CB) transplantation. However, how to prioritize these characteristics in unit selection is not established. Therefore, we analyzed the outcomes of 1061 patients who received single-unit myeloablative CB transplantation for leukemia or myelodysplasia. TNC dose and HLA-match each affected survival via their effect on transplant-related mortality (TRM); neither was associated with relapse. Therefore, TRM was the focus of multivariate analyses combining dose and HLA-match. Compared with our 1 HLA-mismatch (MM) reference group with TNC 2.5 to 4.9 x 10(7)/kg, recipients of 0 MM units had the lowest TRM regardless of dose (relative risk [RR] = 0.4, P = .019). TRM for recipients of 1- or 2-MM units with TNC 5.0 x 10(7)/kg or greater was similar to the reference group (RR = 0.8, P = .391 and RR = 1.0, P = .847) despite their greater dose. Recipients of 2 MM units with TNC 2.5 to 4.9 x 10(7)/kg had a greater TRM (RR = 1.5, P = .014), and those with 1 or 2 MM and TNC less than 2.5 x 10(7)/kg or 3 MM did substantially worse. These findings support new unit selection criteria that take into account both TNC dose and HLA-match and have important implications for the size of the global CB inventory needed to find an optimum CB graft.
MeSH term(s)	Adolescent ; Adult ; Blood Cell Count ; Child ; Child, Preschool ; Cord Blood Stem Cell Transplantation/adverse effects ; Female ; Fetal Blood/cytology ; Fetal Blood/immunology ; Graft Survival ; Graft vs Host Disease/etiology ; Hematologic Neoplasms/blood ; Hematologic Neoplasms/immunology ; Hematologic Neoplasms/mortality ; Hematologic Neoplasms/therapy ; Histocompatibility Testing ; Humans ; Infant ; Infant, Newborn ; Leukocyte Count ; Male ; Middle Aged ; Neutrophils ; Platelet Count ; Survival Analysis ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2009-12-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	80069-7
ISSN	1528-0020 ; 0006-4971
ISSN (online)	1528-0020
ISSN	0006-4971
DOI	10.1182/blood-2009-07-231068
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Article: Eradicating hepatitis B virus: The critical role of preventing perinatal transmission

Stevens, Cladd E / Girish N. Vyas / Guo-Liang Xia / Myron J. Tong / Patricia E. Taylor / Pearl Toy / Saleem Kamili

Biologicals. 2017 Nov., v. 50

2017

Abstract	Prevention of hepatitis B virus (HBV) transmission from infected mothers to their newborns is critical to HBV control and eventual eradication. Mother-to-child perinatal transmission causes the highest chronic carrier rate (>85%) with a high rate of subsequent chronic liver disease and hepatocellular carcinoma. This risk is reduced by 90% with HBV vaccine given along with hepatitis B immune globulin (HBIG) starting at birth. New analyses of our data from US trials of HBIG and HBV vaccine in high-risk infants revealed better efficacy with yeast-recombinant vaccine than plasma-derived vaccine, especially in preventing late onset infections, with evidence that vaccine prevented transmission of maternal HBV infection with the glycine to arginine mutation in surface antigen codon 145 (sG145R). Most late infections with sG145R were in vaccine non-responders, suggesting escape from HBIG rather than from vaccine-induced antibody. Our findings also help explain survey results from Taiwan following universal childhood immunization implemented in the mid-1980s. We conclude that current vaccines will remain effective against surface antigen mutants. Anti-viral drugs in high-risk pregnant women, in combination with newborn HBIG and vaccine, show promise for eliminating residual breakthrough neonatal infections, critical to meeting WHO 2030 goals and for eradicating HBV.
Keywords	antibodies ; antiviral agents ; arginine ; childhood ; hepatitis B ; Hepatitis B virus ; hepatoma ; immunization ; immunoglobulins ; mothers ; mutants ; mutation ; neonates ; pregnant women ; risk ; surface antigens ; surveys ; vaccines ; Taiwan
Language	English
Dates of publication	2017-11
Size	p. 3-19.
Publishing place	Elsevier Ltd
Document type	Article
ZDB-ID	1017370-5
ISSN	1095-8320 ; 1045-1056
ISSN (online)	1095-8320
ISSN	1045-1056
DOI	10.1016/j.biologicals.2017.08.008
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Article: Indirect evidence that maternal microchimerism in cord blood mediates a graft-versus-leukemia effect in cord blood transplantation

van Rood, Jon J / Scaradavou, Andromachi / Stevens, Cladd E

Proceedings of the National Academy of Sciences of the United States of America. 2012 Feb. 14, v. 109, no. 7

2012

Abstract	During pregnancy women can develop B- and T-cell immunity against the inherited paternal antigens (IPAs) of the fetus, such as HLA, peptides of minor histocompatibilty antigens, and possibly onco-fetal antigens. The biological and pathological role of these pregnancy-induced immunological events is only understood in part. However, anti-IPA immunity in the mother persists for many decades after delivery and may reduce relapse in offspring with leukemia after HLA-haploidentical transplantation of maternal hematopoietic stem cells (HSC). We hypothesized that maternal anti-IPA immune elements cross the placenta and might confer a potent graft-versus-leukemia effect when cord blood (CB) is used in unrelated HSC transplantation. In a retrospective study of single-unit CB recipients with all grafts provided by the New York Blood Center, we show that patients with acute myeloid or lymphoblastic leukemia (n = 845) who shared one or more HLA-A, -B, or -DRB1 antigens with their CB donor's IPAs had a significant decrease in leukemic relapse posttransplantation [hazard ratio (HR) = 0.38, P < 0.001] compared with those that did not. Remarkably, relapse reduction in patients receiving CB with one HLA mismatch (HR = 0.15, P < 0.001) was not associated with an increased risk of severe acute graft-versus-host disease (HR = 1.43, P = 0.730). Our findings may explain the unexpected low relapse rate after CB transplantation, open new avenues in the study of leukemic relapse after HSC transplantation (possibly of malignancies in general), and have practical implications for CB unit selection.
Keywords	blood ; fetus ; histocompatibility antigens ; immunity ; lymphocytic leukemia ; patients ; peptides ; placenta ; pregnancy ; progeny ; relapse ; retrospective studies ; risk ; stem cells ; women ; New York
Language	English
Dates of publication	2012-0214
Size	p. 2509-2514.
Publishing place	National Academy of Sciences
Document type	Article
ZDB-ID	209104-5
ISSN	1091-6490 ; 0027-8424
ISSN (online)	1091-6490
ISSN	0027-8424
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Article ; Online: Association between Nondominant Unit Total Nucleated Cell Dose and Engraftment in Myeloablative Double-Unit Cord Blood Transplantation.

Purtill, Duncan / Stevens, Cladd E / Lubin, Marissa / Ponce, Doris / Hanash, Alan / Giralt, Sergio / Scaradavou, Andromachi / Young, James W / Barker, Juliet N

Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation

2015 Volume 21, Issue 11, Page(s) 1981–1984

Abstract: Sustained hematopoiesis after double-unit cord blood transplantation (dCBT) is mediated by 1 unit in nearly all patients. To investigate the associations between nondominant unit characteristics and neutrophil engraftment, we studied 129 consecutive ... ...

Abstract	Sustained hematopoiesis after double-unit cord blood transplantation (dCBT) is mediated by 1 unit in nearly all patients. To investigate the associations between nondominant unit characteristics and neutrophil engraftment, we studied 129 consecutive myeloablative dCBT recipients. Ninety-five percent (95% confidence interval, 90 to 98) of patients engrafted. Detection of the nondominant unit 21 to 28 days after dCBT was not associated with improved neutrophil engraftment. In univariate analyses, nondominant unit characteristics (infused total nucleated cell [TNC] and viable CD3(+) cell doses) were significantly associated with speed and success of neutrophil engraftment as were dominant unit characteristics (infused TNC; viable CD34(+), viable CD3(+), and viable CD3-56(+)16(+) cell doses; and post-thaw CD34(+) cell viability). In multivariate analysis, higher infused TNC dose of the nondominant unit was independently associated with improved neutrophil engraftment, even when this unit did not contribute to donor hematopoiesis. In further subgroup analysis, this association was only evident when the infused viable CD34(+) cell dose of the dominant unit was low (<1.20 × 10(5)/kg). These findings suggest nondominant units mediate a dose-dependent facilitation of engraftment in myeloablative dCBT and support continued investigation of dCBT biology and the clinical practice of dCBT in adults in whom low cell dose grafts are common.
MeSH term(s)	Adolescent ; Adult ; Aged ; Cell Nucleus/immunology ; Child ; Child, Preschool ; Cord Blood Stem Cell Transplantation/methods ; Female ; Graft Survival ; Hematologic Neoplasms/immunology ; Hematologic Neoplasms/mortality ; Hematologic Neoplasms/pathology ; Hematologic Neoplasms/therapy ; Hematopoiesis/drug effects ; Hematopoiesis/immunology ; Histocompatibility Testing ; Humans ; Infant ; Male ; Middle Aged ; Myeloablative Agonists/therapeutic use ; Neutrophils/cytology ; Neutrophils/immunology ; Retrospective Studies ; Survival Analysis ; Tissue Donors ; Transplantation Conditioning
Chemical Substances	Myeloablative Agonists
Language	English
Publishing date	2015-11
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1474865-4
ISSN	1523-6536 ; 1083-8791
ISSN (online)	1523-6536
ISSN	1083-8791
DOI	10.1016/j.bbmt.2015.07.015
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Zs.A 5082: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Extracellular DNA in cord blood plasma and applications in cord blood banking for sample identification.

Albano, Maria S / Scaradavou, Andromachi / Stevens, Cladd E / Rubinstein, Pablo

Transfusion

2009 Volume 49, Issue 8, Page(s) 1685–1691

Abstract: Background: Human cord blood (CB) units donated for transplantation require testing for various markers in blood and plasma aliquots. Although the identity link between the CB unit and the labeled aliquots with the same identifiers can be confirmed by ... ...

Abstract	Background: Human cord blood (CB) units donated for transplantation require testing for various markers in blood and plasma aliquots. Although the identity link between the CB unit and the labeled aliquots with the same identifiers can be confirmed by HLA-DNA assays, these methods have not been used for CB plasma. We have previously reported that viral DNA sequences are present in the CB plasma of carrier babies and now hypothesize that human genomic DNA may also be present in CB plasma. Study design and methods: The aim of the study was to determine whether human genomic DNA is also present in CB plasma in quality and quantity able to support human genetic identification by short tandem repeat analysis (STR). Results: The presence of extracellular DNA (EC-DNA) in CB and adult peripheral blood plasma was confirmed by HLA-DR polymerase chain reaction (PCR) and real-time PCR of Alu (SB2) genes. High concentrations were seen in CB plasma (0.131 ng/mL vs. adult 0.005 ng/mL; p < 0.001). EC-DNA increased over time while CB was stored at room temperature; this increase was associated with decreasing cell viability. STR-PCR of EC-DNA showed good signal strength and accurate allele calling so that linkage between the infant donor, the collected CB unit, and CB plasma aliquots could be established. Conclusion: This study demonstrates that infant-derived EC-DNA is present in CB plasma and provides a useful tool for the unambiguous confirmation of plasma aliquot identity, as routinely used in CB banking, by the use of a sensitive and highly accurate DNA assay.
MeSH term(s)	Adult ; Alu Elements/genetics ; Blood Banking/methods ; DNA/blood ; DNA/genetics ; Female ; Fetal Blood ; HLA Antigens/genetics ; Humans ; Male ; Plasma ; Specimen Handling/methods
Chemical Substances	HLA Antigens ; DNA (9007-49-2)
Language	English
Publishing date	2009-04-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	208417-x
ISSN	1537-2995 ; 0041-1132
ISSN (online)	1537-2995
ISSN	0041-1132
DOI	10.1111/j.1537-2995.2009.02168.x
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Article ; Online: HLA mismatch direction in cord blood transplantation: impact on outcome and implications for cord blood unit selection.

Stevens, Cladd E / Carrier, Carmelita / Carpenter, Carol / Sung, Dorothy / Scaradavou, Andromachi

Blood

2011 Volume 118, Issue 14, Page(s) 3969–3978

Abstract: Donor-recipient human leukocyte antigen mismatch level affects the outcome of unrelated cord blood (CB) transplantation. To identify possible "permissive" mismatches, we examined the relationship between direction of human leukocyte antigen mismatch (" ... ...

Abstract	Donor-recipient human leukocyte antigen mismatch level affects the outcome of unrelated cord blood (CB) transplantation. To identify possible "permissive" mismatches, we examined the relationship between direction of human leukocyte antigen mismatch ("vector") and transplantation outcomes in 1202 recipients of single CB units from the New York Blood Center National Cord Blood Program treated in United States Centers from 1993-2006. Altogether, 98 donor/patient pairs had only unidirectional mismatches: 58 in the graft-versus-host (GVH) direction only (GVH-O) and 40 in the host-versus-graft or rejection direction only (R-O). Engraftment was faster in patients with GVH-O mismatches compared with those with 1 bidirectional mismatch (hazard ratio [HR] = 1.6, P = .003). In addition, patients with hematologic malignancies given GVH-O grafts had lower transplantation-related mortality (HR = 0.5, P = .062), overall mortality (HR = 0.5, P = .019), and treatment failure (HR = 0.5, P = .016), resulting in outcomes similar to those of matched CB grafts. In contrast, R-O mismatches had slower engraftment, higher graft failure, and higher relapse rates (HR = 2.4, P = .010). Based on our findings, CB search algorithms should be modified to identify unidirectional mismatches. We recommend that transplant centers give priority to GVH-O-mismatched units over other mismatches and avoid selecting R-O mismatches, if possible.
MeSH term(s)	Adolescent ; Child ; Child, Preschool ; Cord Blood Stem Cell Transplantation/methods ; Cord Blood Stem Cell Transplantation/mortality ; Female ; Fetal Blood/immunology ; Fetal Blood/transplantation ; Graft vs Host Disease/immunology ; HLA Antigens/immunology ; Hematologic Neoplasms/mortality ; Hematologic Neoplasms/surgery ; Hematologic Neoplasms/therapy ; Histocompatibility Testing ; Humans ; Infant ; Infant, Newborn ; Male ; Treatment Outcome ; Young Adult
Chemical Substances	HLA Antigens
Language	English
Publishing date	2011-07-12
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	80069-7
ISSN	1528-0020 ; 0006-4971
ISSN (online)	1528-0020
ISSN	0006-4971
DOI	10.1182/blood-2010-11-317271
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Article ; Online: Reexposure of cord blood to noninherited maternal HLA antigens improves transplant outcome in hematological malignancies.

van Rood, Jon J / Stevens, Cladd E / Smits, Jacqueline / Carrier, Carmelita / Carpenter, Carol / Scaradavou, Andromachi

Proceedings of the National Academy of Sciences of the United States of America

2009 Volume 106, Issue 47, Page(s) 19952–19957

Abstract: Cord blood (CB) hematopoietic stem cell transplantation can be successful even if donor and recipient are not fully matched for human leukocyte antigens (HLA). This may result from tolerance-inducing events during pregnancy but to date this concept has ... ...

Abstract	Cord blood (CB) hematopoietic stem cell transplantation can be successful even if donor and recipient are not fully matched for human leukocyte antigens (HLA). This may result from tolerance-inducing events during pregnancy but to date this concept has not been tested in CB transplantation. Hence we analyzed the impact of fetal exposure to noninherited maternal antigens (NIMA) of the HLA-A, -B antigens, or -DRB1 alleles on the outcome of CB transplants. The 1,121 patients studied were transplanted for hematological malignancy with a single CB unit: 1,059 received grafts mismatched for one or two HLA antigens. Of these patients, 79 patients had a mismatched antigen that was identical to a donor NIMA, 25 with one HLA mismatch (MM), and 54 with two. If there was a NIMA match, transplant-related mortality (TRM) was improved, especially in patients >or=10 years (P = 0.012) as were overall mortality and treatment failure (P = 0.022 and 0.020, respectively, in the older subset), perhaps related to improved neutrophil recovery, especially in patients who received a low total nucleated cell (TNC) dose (P = 0.031). Posttransplant relapse rate also tended to be reduced, especially in patients with myelogenous malignancies given units with a single HLA mismatch (P = 0.074). These findings represent unique evidence that donor exposure to NIMA can improve survival in unrelated CB transplantation and might reduce relapse, indicating that cord blood cells can mount an antileukemic effect. By matching for donor NIMAs in search algorithms of CB inventories, the probability of selecting a graft with an optimal outcome will increase significantly.
MeSH term(s)	Adolescent ; Child ; Cord Blood Stem Cell Transplantation/mortality ; Female ; Fetal Blood/immunology ; Fetus/immunology ; Graft Survival/immunology ; HLA Antigens/immunology ; Hematologic Neoplasms/immunology ; Hematologic Neoplasms/therapy ; Humans ; Immune Tolerance/immunology ; Pregnancy/immunology ; Recurrence ; Treatment Outcome
Chemical Substances	HLA Antigens
Language	English
Publishing date	2009-11-09
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	209104-5
ISSN	1091-6490 ; 0027-8424
ISSN (online)	1091-6490
ISSN	0027-8424
DOI	10.1073/pnas.0910310106
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