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Uses
DUCORD, HPC (Hematopoietic Progenitor Cell), Cord Blood, is an allogeneic cord blood hematopoietic progenitor cell therapy indicated for use in unrelated donor hematopoietic progenitor stem cell transplantation procedures in conjunction with an appropriate preparative regimen for hematopoietic and immunologic reconstitution in patients with disorders affecting the hematopoietic system that are inherited, acquired, or result from myeloablative treatment.
The risk benefit assessment for an individual patient depends on the patient characteristics, including disease, stage, risk factors, and specific manifestations of the disease, on characteristics of the graft, and on other available treatments or types of hematopoietic progenitor cells.
History
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Other Information
DUCORD consists of hematopoietic progenitor cells, monocytes, lymphocytes, and granulocytes from human cord blood for intravenous infusion. Blood recovered from umbilical cord and placenta is volume reduced and partially depleted of red blood cells and plasma.
The active ingredient is hematopoietic progenitor cells which express the cell surface marker CD34. The potency of cord blood is determined by measuring the numbers of total nucleated cells (TNC) and CD34+ cells, and cell viability. Each unit of DUCORD contains a minimum of 9 × 108 total nucleated cells with at least 1.25 × 106 viable CD34+ cells at the time of cryopreservation. The cellular composition of DUCORD depends on the composition of cells in the blood recovered from the umbilical cord and placenta of the donor. The actual nucleated cell count, the CD34+ cell count, the ABO group, and the HLA typing are listed on the container label and/or accompanying records sent with each individual unit.
DUCORD has the following inactive ingredients: dimethyl sulfoxide (DMSO), citrate phosphate dextrose (CPD), hydroxyethylstarch, and Dextran 40. When prepared for infusion according to instructions, the infusate contains the following inactive ingredients: Dextran 40, human serum albumin, residual DMSO, and CPD.
Sources
Vazculep Manufacturers
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éclat Pharmaceuticals, Llc
Vazculep | Duke University School Of Medicine, Carolinas Cord Blood Bank
For intravenous use only. Do not irradiate.Unit selection and administration of DUCORD should be done under the direction of a physician experienced in hematopoietic progenitor cell transplantation.
2.1 DosingThe recommended minimum dose is 2.5 × 107 nucleated cells/kg at cryopreservation. Multiple units may be required in order to achieve the appropriate dose.
Matching for at least 4 of 6 HLA-A antigens, HLA-B antigens, and HLA-DRB1 alleles is recommended. The HLA typing and nucleated cell content for each individual unit of DUCORD are documented on the container label and/or in accompanying records.
2.2 Preparation for InfusionDUCORD should be prepared by a trained healthcare professional.
Do not irradiate DUCORD. See the appended detailed instructions for preparation of DUCORD for infusion. Once prepared for infusion, DUCORD may be stored at 4 to 8 °C for up to 30 minutes if product is thawed and DMSO is not removed, at 4 to 8 °C for up to 1 hour if DUCORD is thawed and diluted to reduce DMSO concentration, and at 4 to 8 °C for up to 4 hours if DMSO is removed in a washing procedure [see Instructions for Preparation for Infusion]. The recommended limit on DMSO administration is 1 gram per kg body weight per day. [See Warnings and Precautions (5.2) and Overdosage (10 ] 2.3 AdministrationDUCORD should be administered under the supervision of a qualified healthcare professional experienced in hematopoietic progenitor cell transplantation.
Confirm the identity of the patient for the specified unit of DUCORD prior to administration. Confirm that emergency medications are available for use in the immediate area. Ensure the patient is hydrated adequately. Premedicate the patient 30 to 60 minutes before the administration of DUCORD. Premedication should include any or all of the following: antipyretic, histamine antagonists, and corticosteroids. Inspect the product for any abnormalities, such as unusual particulates, and for breaches of container integrity prior to administration. Prior to infusion, discuss all such product irregularities with the laboratory issuing the product for infusion. Administer DUCORD by intravenous infusion. Do not administer in the same tubing concurrently with products other than 0.9% Sodium Chloride, Injection (USP). DUCORD may be filtered through a 170 to 260 micron filter designed to remove clots. Do NOT use a filter designed to remove leukocytes. DUCORD should be infused over 15 to 60 minutes depending on the volume of the product and the weight of the patient. The rate of infusion should not exceed a maximum of 5 milliliters per kilogram per hour. The infusion rate should be reduced if the fluid load is not tolerated. The infusion should be discontinued in the event of an allergic reaction or if the patient develops a moderate to severe infusion reaction. [See Warnings and Precautions (5.2) and Adverse Reactions (6)] Monitor the patient for adverse reactions during, and for at least six hours after, administration. Because DUCORD contains lysed red cells that may cause renal failure, careful monitoring of urine output is also recommended.NOTE: If product is being prepared for a multi-unit infusion, infuse units independently.
Should a reaction occur, appropriately manage the reaction before the second unit is thawed for infusion.
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