Impact of hyperbaric oxygen on post-UCB transplant blood transfusion and growth factor support.

OBJECTIVES

This study seeks to evaluate time to packed red blood cell (PRBC) and platelet independence and growth factor use for the HBO study population in comparison to historic UCB transplant data from the same institution.

BACKGROUND

Umbilical cord blood (UCB) transplantation is limited by low stem/progenitor cell numbers and impaired homing, causing delayed engraftment and higher rates of engraftment failure, which increase post-transplant transfusion needs. Hyperbaric oxygen (HBO) therapy has shown to improve engraftment and blood count recovery in animal models and initial human trials.

METHODS/MATERIALS: Fifteen subjects underwent HBO therapy at the Univrsity of Kansas Cancer Center (KUCC) after reduced intensity conditioning (RIC) or myeloablative conditioning (MAC) regimens in preparation for UCB transplantation. Six hours following HBO therapy, they received single or double UCB units. Patient records were reviewed for post-transplant PRBC and platelet transfusion requirements and for growth factor use. One HBO patient was excluded from this analysis due to graft rejection and autologous recovery. These were compared to standard UCB recipient requirements from previous KUCC patients.

RESULTS

In the first 100 days post-transplant, HBO patients required fewer consecutive days of G-CSF support and achieved PRBC and platelet independence significantly faster than standard group patients. By days 66 and 74, 100 % of HBO patients were PRBC and platelet independent, respectively, compared to 67.4 % and 65.1 % in the standard group by day 100.

CONCLUSION

HBO-therapy may offer a potential improvement in growth factor support and TTI in adult patients undergoing UCB transplantation.