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Donor selection for hematopoietic cell transplantation

INTRODUCTION

The selection of a donor is a critical element contributing to the success of a hematopoietic cell transplant (HCT). There are several possible sources for these cells:

  • An identical twin (syngeneic, HLA identical)
  • A sibling, relative, or unrelated donor (allogeneic, which can be HLA identical, haploidentical, or mismatched)
  • The patient (autologous, HLA identical)
  • Umbilical cord blood (allogeneic, which can be HLA identical, haploidentical, or mismatched)

This topic will provide an overview of the general issues involved in donor selection for HCT [1,2]. The decision as to which donor source to utilize depends to a large degree upon the clinical situation and the approaches employed at the individual transplant center. (See "Sources of hematopoietic stem cells".)

GENERAL CONSIDERATIONS

Transplant donors must be in generally good health without other comorbid conditions. The donor must have a performance status that will permit the safe collection of the cells, either by bone marrow (BM) or peripheral blood progenitor cell (PBPC) collection [3,4]. (See "Sources of hematopoietic stem cells".)

Thus, the donor must be able to tolerate anesthesia (either general or regional) and have adequate cardiac, pulmonary, hepatic and renal function. Pediatric donors are only utilized for autologous collection or donation to siblings. Donors with ongoing malignancies or a history of a malignant condition other than minor skin cancers (eg, basal cell carcinomas) are generally excluded from further consideration.

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Last literature review version 18.2: May 2010
This topic last updated: March 9, 2010
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References
Top
  1. Hough, R, Cooper, N, Veys, P. Allogeneic haemopoietic stem cell transplantation in children: what alternative donor should we choose when no matched sibling is available?. Br J Haematol 2009; 147:593.
  2. Godley, LA, van Besien, K. The next frontier for stem cell transplantation: finding a donor for all. JAMA 2010; 303:1421.
  3. Rowley, SD, Donaldson, G, Lilleby, K, et al. Experiences of donors enrolled in a randomized study of allogeneic bone marrow or peripheral blood stem cell transplantation. Blood 2001; 97:2541.
  4. Sacchi, N, Costeas, P, Hartwell, L, et al. Haematopoietic stem cell donor registries: World Marrow Donor Association recommendations for evaluation of donor health. Bone Marrow Transplant 2008; 42:9.
  5. Lau, GK, Lie, AK, Kwong, YL, et al. A case-controlled study on the use of HBsAg-positive donors for allogeneic hematopoietic cell transplantation. Blood 2000; 96:452.
  6. Strasser, SI, McDonald, GB. Hepatitis viruses and hematopoietic cell transplantation: A guide to patient and donor management. Blood 1999; 93:1127.
  7. Niederwieser, D, Gentilini, C, Hegenbart, U, et al. Transmission of donor illness by stem cell transplantation: should screening be different in older donors?. Bone Marrow Transplant 2004; 34:657.
  8. Glasser, L, Meloni-Ehrig, A, Greaves, W, et al. Synchronous development of acute myeloid leukemia in recipient and donor after allogeneic bone marrow transplantation: report of a case with comments on donor evaluation. Transfusion 2009; 49:555.
  9. Kiss, TL, Chang, H, Daly, A, et al. Bone marrow aspirates as part of routine donor assessment for allogeneic blood and marrow transplantation can reveal presence of occult hematological malignancies in otherwise asymptomatic individuals. Bone Marrow Transplant 2004; 33:855.
  10. Kollman, C, Howe, CW, Anasetti, C, et al. Donor characteristics as risk factors in recipients after transplantation of bone marrow from unrelated donors: the effect of donor age. Blood 2001; 98:2043.
  11. Davies, SM, Kollman, C, Anasetti, C, et al. Engraftment and survival after unrelated-donor bone marrow transplantation: a report from the national marrow donor program. Blood 2000; 96:4096.
  12. Gross, TG, Steinbuch, M, DeFor, T, et al. B cell lymphoproliferative disorders following hematopoietic stem cell transplantation: risk factors, treatment and outcome. Bone Marrow Transplant 1999; 23:251.
  13. Schultz, KR, Green, GJ, Wensley, D, et al. Obstructive lung disease in children after allogeneic bone marrow transplantation. Blood 1994; 84:3212.
  14. Thomas, ED, Clift, RA, Fefer, A, et al. Marrow transplantation for the treatment of chronic myelogenous leukemia. Ann Intern Med 1986; 104:155.
  15. Gale, RP, Horowitz, MM, Ash, RC, et al. Identical-twin bone marrow transplants for leukemia. Ann Intern Med 1994; 120:646.
  16. Bierman, PJ, Sweetenham, JW, Loberiza, FR Jr, et al. Syngeneic hematopoietic stem-cell transplantation for non-Hodgkin's lymphoma: a comparison with allogeneic and autologous transplantation--The Lymphoma Working Committee of the International Bone Marrow Transplant Registry and the European Group for Blood and Marrow Transplantation. J Clin Oncol 2003; 21:3744.
  17. Horowitz, MM, Gale, RP, Sondel, PM, et al. Graft-versus-leukemia reactions after bone marrow transplantation. Blood 1990; 75:555.
  18. Greaves, MF, Maia, AT, Wiemels, JL, et al. Leukemia in twins: lessons in natural history. Blood 2003; 102:2321.
  19. Broadfield, ZJ, Hain, RD, Harrison, CJ, et al. Complex chromosomal abnormalities in utero, 5 years before leukaemia. Br J Haematol 2004; 126:307.
  20. Rotta, M, Storer, BE, Storb, RF, et al. Donor statin treatment protects against severe acute graft-versus-host disease after related allogeneic hematopoietic cell transplantation. Blood 2010; 115:1288.
  21. Zeiser, R, Youssef, S, Baker, J, et al. Preemptive HMG-CoA reductase inhibition provides graft-versus-host disease protection by Th-2 polarization while sparing graft-versus-leukemia activity. Blood 2007; 110:4588.
  22. Hamadani, M, Awan, FT, Devine, SM. The impact of HMG-CoA reductase inhibition on the incidence and severity of graft-versus-host disease in patients with acute leukemia undergoing allogeneic transplantation. Blood 2008; 111:3901.
  23. Beatty, PG, Clift, RA, Mickelson, EM, et al. Marrow transplantation from related donors other than HLA-identical siblings. N Engl J Med 1985; 313:765.
  24. Kanda, Y, Chiba, S, Hirai, H, et al. Allogeneic hematopoietic stem cell transplantation from family members other than HLA-identical siblings over the last decade (1991-2000). Blood 2003; 102:1541.
  25. Xiao-Jun, H, Lan-Ping, X, Kai-Yan, L, et al. Partially matched related donor transplantation can achieve outcomes comparable with unrelated donor transplantation for patients with hematologic malignancies. Clin Cancer Res 2009; 15:4777.
  26. Dey, BR, Spitzer, TR. Current status of haploidentical stem cell transplantation. Br J Haematol 2006; 135:423.
  27. Aversa, F, Terenzi, A, Tabilio, A, et al. Addition of PBPCs to the marrow inoculum allows engraftment of mismatched T cell-depleted transplants for acute leukemia. Bone Marrow Transplant 1996; 17 Suppl 2:S58.
  28. Henslee-Downey, PJ, Abhyankar, SH, Parrish, RS, et al. Use of partially mismatched related donors extends access to allogeneic marrow transplant. Blood 1997; 89:3864.
  29. Lu, DP, Dong, L, Wu, T, et al. Conditioning including antithymocyte globulin followed by unmanipulated HLA-mismatched/haploidentical blood and marrow transplantation can achieve comparable outcomes with HLA-identical sibling transplantation. Blood 2006; 107:3065.
  30. Aversa, F, Tabilio, A, Velardi, A, et al. Transplantation for high-risk acute leukemia with high doses of T-cell-depeleted hematopoietic stem cells from full-haplotype incompatible donors. N Engl J Med 1998; 339:1186.
  31. Aversa, F, Terenzi, A, Tabilio, A, et al. Full haplotype-mismatched hematopoietic stem-cell transplantation: a phase II study in patients with acute leukemia at high risk of relapse. J Clin Oncol 2005; 23:3447.
  32. Amrolia, PJ, Muccioli-Casadei, G, Huls, H, et al. Adoptive immunotherapy with allodepleted donor T-cells improves immune reconstitution after haploidentical stem cell transplantation. Blood 2006; 108:1797.
  33. Ciceri, F, Bonini, C, Stanghellini, MT, et al. Infusion of suicide-gene-engineered donor lymphocytes after family haploidentical haemopoietic stem-cell transplantation for leukaemia (the TK007 trial): a non-randomised phase I-II study. Lancet Oncol 2009; 10:489.
  34. Ruggeri, L, Capanni, M, Casucci, M, et al. Role of natural killer cell alloreactivity in HLA-mismatched hematopoietic stem cell transplantation. Blood 1999; 94:333.
  35. Ruggeri, L, Mancusi, A, Capanni, M, et al. Donor natural killer cell allorecognition of missing self in haploidentical hematopoietic transplantation for acute myeloid leukemia: challenging its predictive value. Blood 2007; 110:433.
  36. Davies, SM, Ruggieri, L, DeFor, T, et al. Evaluation of KIR ligand incompatibility in mismatched unrelated donor hematopoietic transplants. Killer immunoglobulin-like receptor. Blood 2002; 100:3825.
  37. Farag, SS, Bacigalupo, A, Eapen, M, et al. The effect of KIR ligand incompatibility on the outcome of unrelated donor transplantation: a report from the center for international blood and marrow transplant research, the European blood and marrow transplant registry, and the Dutch registry. Biol Blood Marrow Transplant 2006; 12:876.
  38. Giebel, S, Locatelli, F, Lamparelli, T, et al. Survival advantage with KIR ligand incompatibility in hematopoietic stem cell transplantation from unrelated donors. Blood 2003; 102:814.
  39. Ruggeri, L, Capanni, M, Urbani, E, et al. Effectiveness of donor natural killer cell alloreactivity in mismatched hematopoietic transplants. Science 2002; 295:2097.
  40. Guinan, EC, Boussiotis, VA, Neuberg, D, et al. Transplantation of anergic histoincompatible bone marrow allografts. N Engl J Med 1999; 340:1704.
  41. Ball, LM, Bernardo, ME, Roelofs, H, et al. Cotransplantation of ex vivo expanded mesenchymal stem cells accelerates lymphocyte recovery and may reduce the risk of graft failure in haploidentical hematopoietic stem-cell transplantation. Blood 2007; 110:2764.
  42. Ichinohe, T, Uchiyama, T, Shimazaki, C, et al. Feasibility of HLA-haploidentical hematopoietic stem cell transplantation between noninherited maternal antigen (NIMA)-mismatched family members linked with long-term fetomaternal microchimerism. Blood 2004; 104:3821.
  43. Aoyama, K, Koyama, M, Matsuoka, K, et al. Improved outcome of allogeneic bone marrow transplantation due to breastfeeding-induced tolerance to maternal antigens. Blood 2009; 113:1829.
  44. Weiden, PL, Flournoy, N, Thomas, ED, Prentice, R, et al. Antileukemic effect of graft-versus-host disease in human recipients of allogeneic-marrow grafts. N Engl J Med 1979; 300:1068.
  45. Verdijk, RM, Kloosterman, A, Pool, J, et al. Pregnancy induces minor histocompatibility antigen-specific cytotoxic T cells: implications for stem cell transplantation and immunotherapy. Blood 2004; 103:1961.
  46. van Halteren, AG, Jankowska-Gan, E, Joosten, A, et al. Naturally acquired tolerance and sensitization to minor histocompatibility antigens in healthy family members. Blood 2009; 114:2263.
  47. van Rood, JJ, Loberiza, FR Jr, Zhang, MJ, et al. Effect of tolerance to noninherited maternal antigens on the occurrence of graft-versus-host disease after bone marrow transplantation from a parent or an HLA-haploidentical sibling. Blood 2002; 99:1572.
  48. Stern, M, Ruggeri, L, Mancusi, A, et al. Survival after T cell-depleted haploidentical stem cell transplantation is improved using the mother as donor. Blood 2008; 112:2990.
  49. Veys, P, Amrolia, P, Rao, K. The role of haploidentical stem cell transplantation in the management of children with haematological disorders. Br J Haematol 2003; 123:193.
  50. Rocha, V, Franco, RF, Porcher, R, et al. Host defense and inflammatory gene polymorphisms are associated with outcomes after HLA-identical sibling bone marrow transplantation. Blood 2002; 100:3908.
  51. Grumet, FC, Hiraki, DD, Brown, BWM, et al. CD31 mismatching affects marrow transplantation outcome. Biol Blood Marrow Transplant 2001; 7:503.
  52. Shimazaki, C, Ochiai, N, Uchida, R, et al. Non-T-cell-depleted HLA haploidentical stem cell transplantation in advanced hematologic malignancies based on the feto-maternal michrochimerism. Blood 2003; 101:3334.
  53. Keen, LJ, DeFor, TE, Bidwell, JL, et al. Interleukin-10 and tumor necrosis factor alpha region haplotypes predict transplant-related mortality after unrelated donor stem cell transplantation. Blood 2004; 103:3599.
  54. Wirk, B, Klumpp, TR, Ulicny, J, et al. Lack of effect of donor-recipient Rh mismatch on outcomes after allogeneic hematopoietic stem cell transplantation. Transfusion 2008; 48:163.
  55. Rowley, SD, Liang, PS, Ulz, L. Transplantation of ABO-incompatible bone marrow and peripheral blood stem cell components. Bone Marrow Transplant 2000; 26:749.
  56. Bolan, CD, Childs, RW, Procter, JL, et al. Massive immune haemolysis after allogeneic peripheral blood stem cell transplantation with minor ABO incompatibility. Br J Haematol 2001; 112:787.
  57. Bolan, CD, Leitman, SF, Griffith, LM, et al. Delayed donor red cell chimerism and pure red cell aplasia following major ABO-incompatible nonmyeloablative hematopoietic stem cell transplantation. Blood 2001; 98:1687.
  58. Worel, N, Greinix, HT, Schneider, B, et al. Regeneration of erythropoiesis after related- and unrelated-donor BMT or peripheral blood HPC transplantation: a major ABO mismatch means problems. Transfusion 2000; 40:543.
  59. Lee, JH, Lee, KH, Kim, S, et al. Anti-A isoagglutinin as a risk factor for the development of pure red cell aplasia after major ABO-incompatible allogeneic bone marrow transplantation. Bone Marrow Transplant 2000; 25:179.
  60. Mielcarek, M, Zaucha, JM, Sandmaier, B, et al. Type of post-grafting immunosuppression after non-myeloablative blood cell transplantation may influence risk of delayed haemolysis due to minor ABO incompatibility. Br J Haematol 2002; 116:500.
  61. Mijovic, A, Abdallah, A, Pearce, L, et al. Effects on erythropoiesis of alemtuzumab-containing reduced intensity and standard conditioning regimens. Br J Haematol 2008; 142:444.
  62. Kanda, J, Ichinohe, T, Matsuo, K, et al. Impact of ABO mismatching on the outcomes of allogeneic related and unrelated blood and marrow stem cell transplantations for hematologic malignancies: IPD-based meta-analysis of cohort studies. Transfusion 2009; 49:624.
  63. Mijovic, A. Alloimmunization to RhD antigen in RhD-incompatible haemopoietic cell transplants with non-myeloablative conditioning. Vox Sang 2002; 83:358.
  64. Cid, J, Lozano, M, Fernandez-Aviles, F, et al. Anti-D alloimmunization after D-mismatched allogeneic hematopoietic stem cell transplantation in patients with hematologic diseases. Transfusion 2006; 46:169.
  65. Maciej Zaucha, J, Mielcarek, M, Takatu, A, et al. Engraftment of early erythroid progenitors is not delayed after non-myeloablative major ABO-incompatible haematopoietic stem cell transplantation. Br J Haematol 2002; 119:740.
  66. Canals, C, Muniz-Diaz, E, Martinez, C, et al. Impact of ABO incompatibility on allogeneic peripheral blood progenitor cell transplantation after reduced intensity conditioning. Transfusion 2004; 44:1603.
  67. Wang, Z, Sorror, ML, Leisenring, W, et al. The impact of donor type and ABO incompatibility on transfusion requirements after nonmyeloablative haematopoietic cell transplantation. Br J Haematol 2010; 149:101.
  68. Worel, N, Kalhs, P, Keil, F, et al. ABO mismatch increases transplant-related morbidity and mortality in patients given nonmyeloablative allogeneic HPC transplantation. Transfusion 2003; 43:1153.
  69. Stussi, G, Seebach, L, Muntwyler, J, et al. Graft-versus-host disease and survival after ABO-incompatible allogeneic bone marrow transplantation: a single-centre experience. Br J Haematol 2001; 113:251.
  70. Worel, N, Greinix, HT, Keil, F, et al. Severe immune hemolysis after minor ABO-mismatched allogeneic peripheral blood progenitor cell transplantation occurs more frequently after nonmyeloablative than myeloablative conditioning. Transfusion 2002; 42:1293.
  71. Erker, CG, Steins, MB, Fischer, RJ, et al. The influence of blood group differences in allogeneic hematopoietic peripheral blood progenitor cell transplantation. Transfusion 2005; 45:1382.
  72. Sniecinski, IJ, Oien, L, Petz, L, Blume, KG. Immunohematologic consequences of major ABO-mismatched bone marrow transplantation. Transplantation 1988; 45:530.
  73. Worel, N, Greinix, HT, Supper, V, et al. Prophylactic red blood cell exchange for prevention of severe immune hemolysis in minor ABO-mismatched allogeneic peripheral blood progenitor cell transplantation after reduced-intensity conditioning. Transfusion 2007; 47:1494.
  74. Izumi, N, Fuse, I, Furukawa, T, et al. Long-term production of pre-existing alloantibodies to E and c after allogenic BMT in a patient with aplastic anemia resulting in delayed hemolytic anemia. Transfusion 2003; 43:241.
  75. Griffith, LM, McCoy, JP Jr, Bolan, CD, et al. Persistence of recipient plasma cells and anti-donor isohaemagglutinins in patients with delayed donor erythropoiesis after major ABO incompatible non-myeloablative haematopoietic cell transplantation. Br J Haematol 2005; 128:668.
  76. van Tol, MJ, Gerritsen, EJ, de Lange, GG, et al. The origin of IgG production and homogeneous IgG components after allogeneic bone marrow transplantation. Blood 1996; 87:818.
  77. Ang, HA, Apperley, JF, Ward, KN. Persistence of antibody to human parvovirus B19 after allogeneic bone marrow transplantation: role of prior recipient immunity. Blood 1997; 89:4646.
  78. Stroncek, D, Bartsch, G, Perkins, HA, et al. The National Marrow Donor Program. Transfusion 1993; 33:567.
  79. Oudshoorn, M, van Leeuwen, A, van der Zanden, HG, van Rood, JJ. Bone Marrow Donors Worldwide: A successful exercise in international cooperation. Bone Marrow Transplant 1994; 14:3.
  80. Gratwohl, A, Baldomero, H, Frauendorfer, K, et al. Results of the EBMT activity survey 2005 on haematopoietic stem cell transplantation: focus on increasing use of unrelated donors. Bone Marrow Transplant 2007; 39:71.
  81. Beatty, PG, Mori, M, Milford, E. Impact of racial genetic polymorphism on the probability of finding an HLA-matched donor. Transplantation 1995; 60:778.
  82. Mori, M, Beatty, PG, Graves, M, et al. HLA gene and haplotype frequencies in the North American population: the National Marrow Donor Program Donor Registry. Transplantation 1997; 64:1017.
  83. Szydlo, R, Goldman, JM, Klein, JP, et al. Results of allogeneic bone marrow transplants for leukemia using donors other than HLA-identical siblings. J Clin Oncol 1997; 15:1767.
  84. Speiser, DE, Tiercy, JM, Rufer, M, et al. High resolution HLA matching associated with decreased mortality after unrelated bone marrow transplantation. Blood 1996; 87:4455.
  85. Sasazuki, Juji, T, Morishima, Y, et al. Effect of matching class I HLA alleles on clinical outcome after transplantation of hematopoietic stem cells from an unrelated donor. N Engl J Med 1998; 339:1177.
  86. Prasad, VK, Kernan, NA, Heller, G, et al. DNA typing for HLA-A and HLA-B identifies disparities between patients and unrelated donors matched by HLA-A and HLA-B serology and HLA-DRß1. Blood 1999; 93:399.
  87. Petersdorf, EW, Longton, GM, Anasetti, C, et al. Association of HLA-C disparity with graft failure after marrow transplantation from unrelated donors. Blood 1997; 89:1818.
  88. Petersdorf, EW, Hansen, JA, Martin, PJ, et al. Major-histocompatibility-complex class I alleles and antigens in hematopoietic-cell transplantation. N Engl J Med 2001; 345:1794.
  89. Flomenberg, N, Baxter-Lowe, LA, Confer, D, et al. Impact of HLA class I and class II high-resolution matching on outcomes of unrelated donor bone marrow transplantation: HLA-C mismatching is associated with a strong adverse effect on transplantation outcome. Blood 2004; 104:1923.
  90. Lee, SJ, Klein, J, Haagenson, M, et al. High-resolution donor-recipient HLA matching contributes to the success of unrelated donor marrow transplantation. Blood 2007; 110:4576.
  91. Shaw, BE, Gooley, TA, Malkki, M, et al. The importance of HLA-DPB1 in unrelated donor hematopoietic cell transplantation. Blood 2007; 110:4560.
  92. Crocchiolo, R, Zino, E, Vago, L, et al. Nonpermissive HLA-DPB1 disparity is a significant independent risk factor for mortality after unrelated hematopoietic stem cell transplantation. Blood 2009; 114:1437.
  93. Petersdorf, EW, Anasetti, C, Martin, PJ, et al. Limits of HLA mismatching in unrelated hematopoietic cell transplantation. Blood 2004; 104:2976.
  94. Hansen, JA, Gooley, TA, Martin, PJ, et al. Bone marrow transplants from unrelated donors for patients with chronic myeloid leukemia. N Engl J Med 1998; 338:962.
  95. Finke, J, Schmoor, C, Lang, H, et al. Matched and mismatched allogeneic stem-cell transplantation from unrelated donors using combined graft-versus-host disease prophylaxis including rabbit anti-T lymphocyte globulin. J Clin Oncol 2003; 21:506.
  96. Yakoub-Agha, I, Mesnil, F, Kuentz, M, et al. Allogeneic marrow stem-cell transplantation from human leukocyte antigen-identical siblings versus human leukocyte antigen-allelic-matched unrelated donors (10/10) in patients with standard-risk hematologic malignancy: a prospective study from the French Society of Bone Marrow Transplantation and Cell Therapy. J Clin Oncol 2006; 24:5695.
  97. Oudshoorn, M, Cornelissen, JJ, Fibbe, WE, et al. Problems and possible solutions in finding an unrelated bone marrow donor: Results of consecutive searches for 240 Dutch patients. Bone Marrow Transplant 1997; 20:1011.
  98. Hurley, CK, Wagner, JE, Setterholm, MI, Confer, DL. Advances in HLA: Practical implications for selecting adult donors and cord blood units. Biol Blood Marrow Transplant 2006; 12:28.
  99. Kurtzberg, J, Laughlin, M, Graham, ML, et al. Placental blood as a source of hematopoietic stem cells for transplantation into unrelated recipients. N Engl J Med 1996; 335:157.
  100. Takahashi, S, Iseki, T, Ooi, J, et al. SIngle-institute comparative analysis of unrelated bone marrow transplantation and cord blood transplantation for adult patients with hematological malignancies. Blood 2004; 104:3813.
  101. Rubinstein, P, Carrier, C, Scaradavou, A, et al. Outcomes among 562 recipients of placental-blood transplants from unrelated donors. N Engl J Med 1998; 339:1565.
  102. Gluckman, E, Rocha, V, Boyer-Chammard, A, et al. Outcome of cord-blood transplantation from related and unrelated donors. Eurocord Transplant Group and the European Blood and Marrow Transplantation Group. N Engl J Med 1997; 337:373.
  103. Kurtzberg, J, Prasad, VK, Carter, SL, et al. Results of the Cord Blood Transplantation Study (COBLT): clinical outcomes of unrelated donor umbilical cord blood transplantation in pediatric patients with hematologic malignancies. Blood 2008; 112:4318.
  104. de Lima, M, McMannis, J, Gee, A, et al. Transplantation of ex vivo expanded cord blood cells using the copper chelator tetraethylenepentamine: a phase I/II clinical trial. Bone Marrow Transplant 2008; 41:771.
  105. Delaney, C, Varnum-Finney, B, Aoyama, K, et al. Dose-dependent effects of the Notch ligand Delta1 on ex vivo differentiation and in vivo marrow repopulating ability of cord blood cells. Blood 2005; 106:2693.
  106. Hippen, KL, Harker-Murray, P, Porter, SB, et al. Umbilical cord blood regulatory T-cell expansion and functional effects of tumor necrosis factor receptor family members OX40 and 4-1BB expressed on artificial antigen-presenting cells. Blood 2008; 112:2847.
  107. Kogler, G, Callejas, J, Hakenberg, P, et al. Hematopoietic transplant potential of unrelated cord blood: Critical issues. J Hematother 1996; 5:105.
  108. Karanes, C, Confer, D, Walker, T, et al. Unrelated donor stem cell transplantation: The role of the National Marrow Donor Program. Oncology (Huntingt) 2003; 17:1036.
  109. Stelljes, M, van Biezen, A, Slavin, S, et al. The harvest and use of autologous back-up grafts for graft failure or severe GVHD after allogeneic hematopoietic stem cell transplantation: a survey of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant 2008; 42:739.
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