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a Department of Pediatrics, University of Tokushima, Tokushima, Japan;
b Nakayama Maternity Clinic, Tokushima, Japan;
c Stem Cell Transplantation Unit, National Cancer Center Hospital, Tokyo, Japan
Key Words. Megakaryocyte progenitors • Cord blood • Hematopoietic cell transplantation
Yoshifumi Kawano, M.D., Department of Pediatrics, University of Tokushima, 2-50-1 Kuramoto-cho, 770-8503 Tokushima, Japan. Telephone: +81-88-633-7135; Fax: +81-88-631-8697; e-mail: ykawano{at}clin.med.tokushima-u.ac.jp
Delayed platelet recovery is an inherent problem with cord blood cell transplantation (CBCT). To investigate this problem, the number of human megakaryocyte (MK) progenitor cells in cord blood (CB; n = 24) was measured and compared with that in G-CSF-mobilized peripheral blood stem cells (PBSC; n = 25). The median numbers of colony-forming units for MK (CFU-MK) that were detected by a serum-free assay system in CB and peripheral blood (PB) were 26 (range, 6-102)/105 nucleated cells (NC) and 37 (2-540)/105 mononuclear cells (MNC), respectively. The numbers of colony-forming units for granulocyte/macrophage (CFU-GM) were 88 (33-241)/105 NC in CB and 138 (6.3-1,250)/105 MNC in PB. The frequencies of CD34+ cells in CB and PB were, respectively, 0.44% (0.10-1.07) and 0.98% (0.05-20.8). The numbers of CFU-MK in CB and PBSC were correlated with those of CD34+ cells. The estimated number of infused CFU-MK in CBCT was 1/15 that of PBSC transplantation (PBSCT), based upon the above data and the widely used standard doses for both types of transplants. Further, the numbers of infused CFU-MK in patients who received allogeneic PBSCT at our institute were inversely correlated with the speed of platelet recovery. These data indicate that delayed platelet recovery after CBCT is simply due to the low number of CFU-MK contained in grafts.
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