Targeted drugs in concert with chemo: opposites

and therefore expected dominance of the manipulated unit. It is possible that the chimerism was transient and measurements were made too late, or that the fucosylated unit served to facilitate engraftment of the fucosylated and nonfucosylated HSPCs. This study represents an important advancement in the field ofUCB transplant. The strategy used is appealing because it is simple and could be performed in any institution with a cell manipulation laboratory. Previous cell expansion studies have shown similar improvements in engraftment but require complex and time-consuming manipulations in a good manufacturing practice facility. More rapid engraftment will be expected to reduce later infections, and perhaps reduce mortality, but these key end points require a larger study. Although an important advancement, this is an early-phase study of 22 patients, so future larger randomized studies will be needed to confirm these results in a larger data set and explore the mechanism of enhancement of engraftment. The technology use in this strategy appears simpler and more suited to a multicenter study than many approaches to improving engraftment. Conflict-of-interest disclosure: The author declares no competing financial interests. n