Hematologic Neoplasms Clinical Trial
Official title:
Intra-bone Cord Blood Transplantation for Hematological Malignancies Lacking a HLA Suitable Donor
For the great majority of hematological malignancies, hemopoietic stem cell (HSC) transplant
is the only possible cure. The source of HSC is usually bone marrow (BM) or peripheral blood
cell (PBSC) mobilized by granulocyte growth factor. Transplant needs a HLA compatible donor
weather related or unrelated. A suitable compatible donor can be found in at least 70% of the
patients. Thus, at least 30% of patients with indication for allogeneic HSC transplant are
not able to undergo the procedure because of the lack of a HLA compatible donor. Cord blood
(CB) cells represent another possible source, that needs a lower degree of HLA compatibility.
CB transplant, however, offers a lower number of HSC. Thus, adult patient rarely may benefit
from this source of stem cells, mainly beacuse thie body weight is too high to have ad
adequate number of cell per kg. Recently, experimental animal models confirmed that an
adequate recovery of allogeneic hemopoiesis can be achieved via intrabone injection, using a
1Log lower number of cells compared to the intravenous way (Yahata 2003, Castello 2004).
Safety and feasibility of intrabone infusion was verified by two clinical studies on humans:
the first was conducted by Ringden O. et al. in 18 patients using BM as a source of SC. No
side effects and complete engraftment of donor hemopoiesis was observed; the second one was
conducted by Frassoni et al. (Frassoni 2008) with CB as the source of HSC.
The aim of this study is to evaluate the intrabone infusion of compatible CB in patients with
haematological malignancies lacking a HLA matched donor.
We will perform:
evaluation of the engraftment kinetics; evaluation of the chimerism degree at 30, 60, 100
days, 6 months and 1 year after transplant; studies on immunological reconstitution and the
role of the NK compartment.
n/a
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