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.

National Institute of Health (NIH)
Division of Blood Diseases And Resources (NHLBI)
Research and Development Contracts (N01)
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Duke University
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Park, Kyung-Duk; Marti, Luciana; Kurtzberg, Joanne et al. (2006) In vitro priming and expansion of cytomegalovirus-specific Th1 and Tc1 T cells from naive cord blood lymphocytes. Blood 108:1770-3
Ayello, Janet; van de Ven, Carmella; Fortino, Weiwei et al. (2006) Characterization of cord blood natural killer and lymphokine activated killer lymphocytes following ex vivo cellular engineering. Biol Blood Marrow Transplant 12:608-22
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Cairo, Mitchell S; Wagner, Elizabeth L; Fraser, John et al. (2005) Characterization of banked umbilical cord blood hematopoietic progenitor cells and lymphocyte subsets and correlation with ethnicity, birth weight, sex, and type of delivery: a Cord Blood Transplantation (COBLT) Study report. Transfusion 45:856-66
Szabolcs, Paul; Park, Kyung-Duk; Marti, Luciana et al. (2004) Superior depletion of alloreactive T cells from peripheral blood stem cell and umbilical cord blood grafts by the combined use of trimetrexate and interleukin-2 immunotoxin. Biol Blood Marrow Transplant 10:772-83
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
Sugarman, Jeremy; Kurtzberg, Joanne; Box, Tamara L et al. (2002) Optimization of informed consent for umbilical cord blood banking. Am J Obstet Gynecol 187:1642-6
Szabolcs, P; Reese, M; Yancey, K B et al. (2002) Combination treatment of bullous pemphigoid with anti-CD20 and anti-CD25 antibodies in a patient with chronic graft-versus-host disease. Bone Marrow Transplant 30:327-9
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