by Juliet Barker, MD
July 2017
The cord blood (CB) SIG has been created to provide a national and international forum to promote the use of CB for the transplantation of patients with diseases of the blood and bone marrow as well as to support the development of CB-derived cellular therapies and regenerative medicine applications. The SIG is led by Dr Juliet Barker (Co-Chair, MSKCC) and Dr EJ Shpall (Co-Chair, MDACC) and includes Dr Claudio Brunstein (University of MN), Dr Colleen Delaney (FHCRC), Dr Joanne Kurtzberg (Duke University), Dr Filippo Milano (FHCRC) and Dr Ioannis Politikos (MSKCC) as Steering Committee members. The SIG has a wide membership from the U.S. and other countries and its website can be found at here. Any member of ASBMT is invited to join. The SIG had a lively and well attended in person meeting at this years 2017 Tandem conference (Orlando, Florida). Speakers included MDs from transplant centers in the US, England and Europe and CB banks as well as representatives of the NMDP and the CIBMTR.
The SIG’s first major initiative has been a state of the art review describing optimal practices in CB transplantation (CBT) for hematologic malignancies. This manuscript outlines specific detailed guidelines concerning patient and unit selection, conditioning regimens, immune suppression, unit thaw and infusion, infection prophylaxis and therapy and other aspects of supportive care from the perspective of 6 U.S. centers with a major interest in CBT. The paper, “Optimal Practices in Unrelated Donor Cord Blood Transplantation for Hematologic Malignancies,” has recently been published in BBMT and is available on the SIG website.
Planned goals for 2017-2018 are numerous and include:
- Communicating with the U.S. Advisory Council on Blood Stem Cell Transplantation to support the continued funding of public CB banks in the U.S.
- To work with the NMDP to develop improved strategies to enhance CB unit selection and develop webinars concerning unit selection and thaw and infusion and disseminate CBT guidelines via the NMDP Network.
- To encourage collaborations between centers to perform high quality retrospective analyses studying CBT outcomes, complications and correlative laboratory studies. There is a major interest in studies of long-term survival ideally including GVHD burden and quality of life measurements. One such analysis concerning outcomes of pediatric CBT for the treatment of AML is underway.
- To collaborate on the development of and participate in prospective multi-center trials. While governmental funding is ideal, Foundation, biotech and pharmaceutical funding will be needed given the challenges in the current funding environment. One such study investigating letermovir for CMV prophylaxis in adult CMV seropositive CBT recipients is in planning in collaboration with the ASBMT Infectious Diseases SIG.
- To further develop the CB SIG website and enhance ongoing communications with SIG membership. Further publications concerning CBT practices could be considered through the ASBMT Practice Guidelines Committee.
- To participate in cost effectiveness analyses of CBT.
- To collaborate with other organizations involved in hematopoietic stem cell transplantation. Collaboration with ISCT is already underway and the CB SIG hosted a session at the Cord Blood Series Workshop at the May ISCT annual meeting concerning CBT as a platform for cellular therapy.
A question remains as to what SIG activities would be the most useful for the field. While a search of ClinicalTrials.gov reveals a multitude of ongoing trials in CBT, further collaboration amongst investigators interested in CBT is critically important to the future of the field. Moreover, while research in advanced technologies such as ex vivo expansion, for example, are important, publications concerning high quality retrospective analyses and more detailed guidelines to guide graft selection and management of all aspects of CBT and its associated complications are also important. Comments from SIG members concerning what would be considered most valuable are welcome and can be submitted through the email listserv. Email addresses for the SIG co-chairs can also be found on the CB SIG website.
Read the entire July 2017 ASBMT eNews here.