This study is designed to determine if stem and progenitor cells from umbilical cord blood units (UCBUs) are a clinically acceptable alternative to those from marrow or peripheral blood for unrelated-donor allogeneic transplantation. Questions to be answered about UCBU transplantation include: 1) can children unrelated to the neonate-donors be transplanted with a graft failure rate no greater than 5-10 percent? 2) can adults and larger children (>40 Kg) also be transplanted successfully (all successful matched sib and matched unrelated-donor cord blood transplants to date have been for patients weighing less than 40 Kg)? 3) is graft-vs-host disease (GvHD) usually mild and easily manageable? 4) how much and what kind of HLA disparity can be tolerated? 5) is there enough graft-vs-leukemia (GvL) effect to prevent relapse? 6) what is the course of immune reconstitution? To answer these and other questions about UCBU transplantation will require establishing: a) two to four collection and storage centers (Cord Blood Banks - CBBs) to provide the necessary resource by collecting, processing, cryopreserving and distributing human umbilical cord blood for transplantation to unrelated recipients; b) six to eight Cord Blood Transplant Centers (CBTCs) to follow common protocols for the transplantation of cord blood stem and progenitor cells; and c) a Medical Coordinating Center (MCC) to manage donor searches, facilitate the provision of cord blood units for transplants and collect and analyze data from these transplants. The purpose of this program is to accelerate and oversee clinical research in the rapidly emerging use of umbilical cord blood in place of marrow for transplantation.

Agency
National Institute of Health (NIH)
Institute
Division of Blood Diseases And Resources (NHLBI)
Type
Research and Development Contracts (N01)
Project #
N01HB067138-005
Application #
6331999
Study Section
Project Start
1996-09-30
Project End
2001-09-29
Budget Start
2000-07-13
Budget End
2000-09-30
Support Year
Fiscal Year
2000
Total Cost
$131,503
Indirect Cost
Name
Duke University
Department
Pediatrics
Type
Schools of Medicine
DUNS #
071723621
City
Durham
State
NC
Country
United States
Zip Code
27705
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Cohen, Geoff; Carter, Shelly L; Weinberg, Kenneth I et al. (2006) Antigen-specific T-lymphocyte function after cord blood transplantation. Biol Blood Marrow Transplant 12:1335-42
Martin, Paul L; Carter, Shelly L; Kernan, Nancy A et al. (2006) Results of the cord blood transplantation study (COBLT): outcomes of unrelated donor umbilical cord blood transplantation in pediatric patients with lysosomal and peroxisomal storage diseases. Biol Blood Marrow Transplant 12:184-94
Parkman, Robertson; Cohen, Geoff; Carter, Shelly L et al. (2006) Successful immune reconstitution decreases leukemic relapse and improves survival in recipients of unrelated cord blood transplantation. Biol Blood Marrow Transplant 12:919-27
Wall, Donna A; Carter, Shelly L; Kernan, Nancy A et al. (2005) Busulfan/melphalan/antithymocyte globulin followed by unrelated donor cord blood transplantation for treatment of infant leukemia and leukemia in young children: the Cord Blood Transplantation study (COBLT) experience. Biol Blood Marrow Transplant 11:637-46
Szabolcs, Paul; Park, Kyung-Duk; Reese, Melissa et al. (2003) Coexistent naive phenotype and higher cycling rate of cord blood T cells as compared to adult peripheral blood. Exp Hematol 31:708-14
Szabolcs, Paul; Park, Kyung-Duk; Reese, Melissa et al. (2003) Absolute values of dendritic cell subsets in bone marrow, cord blood, and peripheral blood enumerated by a novel method. Stem Cells 21:296-303
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