RESUMO
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.
Assuntos
Armazenamento de Sangue , Bancos de Sangue , Transplante de Células-Tronco de Sangue do Cordão Umbilical , Sangue Fetal , Programas Nacionais de Saúde , Adolescente , Adulto , Idoso , Bancos de Sangue/estatística & dados numéricos , Bancos de Sangue/tendências , Transtornos da Insuficiência da Medula Óssea/epidemiologia , Transtornos da Insuficiência da Medula Óssea/terapia , Criança , Pré-Escolar , Transplante de Células-Tronco de Sangue do Cordão Umbilical/normas , Transplante de Células-Tronco de Sangue do Cordão Umbilical/estatística & dados numéricos , Transplante de Células-Tronco de Sangue do Cordão Umbilical/tendências , Intervalo Livre de Doença , Feminino , Transplante de Células-Tronco Hematopoéticas/normas , Transplante de Células-Tronco Hematopoéticas/estatística & dados numéricos , História do Século XXI , Humanos , Lactente , Recém-Nascido , Leucemia/epidemiologia , Leucemia/terapia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Programas Nacionais de Saúde/organização & administração , Programas Nacionais de Saúde/normas , Programas Nacionais de Saúde/tendências , Gravidez , Estudos Retrospectivos , Taxa de Sobrevida , Adulto Jovem , Armazenamento de Sangue/métodosRESUMO
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.