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Umbilical cord blood transplantation

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Abstract

Over the past decade umbilical cord blood has been established as a viable source of hematopoietic stem cells for allogeneic transplantation. Early experience with umbilical cord blood transplantation (CBT) demonstrated a lower incidence of graft-versus-host disease even though the procedure was performed with HLA-disparate grafts. The overall outcome of CBT appears similar to that of allogeneic bone marrow transplantation. The expansion of the donor selection is particularly beneficial to ethnic minorities, whose representation in the marrow registries is relatively small. The major drawbacks of CBT are slow hematopoietic recovery and a high incidence of graft failure, as a result of a lower number of progenitors infused. This paper reviews the current results of CBT and ongoing investigations to increase its availability to a larger number of recipients.

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References and Recommended Reading

  1. Rocha V, Wagner JE, Sobocinski K, et al.: Comparison of graft-versus-host disease in children transplanted with HLA identical sibling umbilical cord blood versus HLA identical sibling bone marrow transplant. N Engl J Med 2000, 342:1846–1854.

    Article  PubMed  CAS  Google Scholar 

  2. Rocha V, Cornish J, Sievers E, et al.: Comparison of outcomes of unrelated bone marrow and umbilical cord blood transplants in children with acute leukemia. Blood 2001, 97:2962–2971.This retrospective study compared the outcome of cord blood transplantation with that of unmanipulated and T-cell-depleted unrelated-donor marrow transplantation. Despite differences in the problems encountered among the three groups, the overall survival was similar.

    Article  PubMed  CAS  Google Scholar 

  3. Rubinstein P, Kurtzberg J, Loberiza FR, et al.: Comparison of unrelated cord blood and unrelated bone marrow transplants for leukemia in children: a collaborative study of the New York Blood Center and the International Bone Marrow Transplant Registry [abstract]. Blood 2001, 98:814a.This comparative study showed that the degree of HLA disparity affected the outcome of children undergoing unrelated-donor cord blood and marrow transplantation. Survival with a one-HLA-antigen-mismatched cord blood transplant was similar to that with a fully HLA-identical marrow graft.

    Article  Google Scholar 

  4. Hurley CK, Baxter Lowe LA, Logan B, et al.: National Marrow Donor Program HLA-matching guidelines for unrelated marrow transplants. Biol Blood Marrow Transplant 2003, 9:610–615.

    Article  PubMed  Google Scholar 

  5. Dalle JH, Duval M, Moghrabi A, et al.: Results of an unrelated transplant search strategy using partially HLAmismatched cord blood as an immediate alternative to HLA-matched bone marrow. Bone Marrow Transplant 2004, 33:605–611.

    Article  PubMed  CAS  Google Scholar 

  6. Gluckman E, Rocha V, Arcese W, et al.: Factors associated with outcomes of unrelated cord blood transplant: guidelines for donor choice. Exp Hematol 2004, 32:397–407. A large series comparing the relative contribution of cell dose and HLA disparity in the outcome of cord blood transplantation.

    Article  PubMed  CAS  Google Scholar 

  7. Michel G, Rocha V, Chevret S, et al.: Unrelated cord blood transplantation for childhood acute myeloid leukemia: a Eurocord group analysis. Blood 2003, 102:4290–4297. In a retrospective study, the authors showed that unrelateddonor cord blood transplants were efficacious for advanced childhood AML.

    Article  PubMed  CAS  Google Scholar 

  8. Gluckman E, Rocha V: Cord blood transplantation for children with acute leukemia: a Eurocord registry analysis. Blood Cells Mol Dis 2004, 33:271–273.A general overview of the results of a large cohort of children undergoing umbilical cord blood transplants for leukemia. The outcome of acute lymphoblastic leukemia was analyzed in detail.

    Article  PubMed  Google Scholar 

  9. Jacobsohn DA, Hewlett B, Ranalli M, et al.: Outcomes of unrelated cord blood transplants and allogeneic-related hematopoietic stem cell transplants in children with high-risk acute lymphocytic leukemia. Bone Marrow Transplant 2004, 34:901–907.

    Article  PubMed  CAS  Google Scholar 

  10. Parikh SH, Martin PL, Szabolcs P, et al.: Outcomes of unrelated umbilical cord blood transplantation in pediatric patients with myelodysplastic syndrome [abstract]. Biol Blood Marrow Transplant 2005, 11(Suppl 1):80.

    Article  Google Scholar 

  11. Kurtzberg J, Carter SL, Baxter-Lowe LA, et al.: Results of the Cord Blood Transplantation Study (COBLT): clinical outcomes of 193 unrelated donor umbilical cord blood transplantation in pediatric patients with malignant conditions [abstract]. Biol Blood Marrow Transplant 2005, 11(Suppl 1):2.

    Article  Google Scholar 

  12. Barker JN, Weisdorf DJ, DeFor TE, et al.: Rapid and complete donor chimerism in adult recipients of unrelated donor umbilical cord blood transplantation after reduced-intensity conditioning. Blood 2003, 102:1915–1919.A large cohort of cord blood recipients of reduced-intensity conditioning was reported. A minor variation of the preparative regimen was shown to affect the transplant outcome.

    Article  PubMed  CAS  Google Scholar 

  13. Chao NJ, Koh LP, Long GD, et al.: Adult recipients of umbilical cord blood transplants after nonmyeloablative preparative regimens. Biol Blood Marrow Transplant 2004, 10:569–575.

    Article  PubMed  Google Scholar 

  14. Del Toro G, Satwani P, Harrison L, et al.: A pilot study of reduced intensity conditioning and allogeneic stem cell transplantation from unrelated cord blood and matched family donors in children and adolescent recipients. Bone Marrow Transplant 2004, 33:613–622.

    Article  Google Scholar 

  15. Petropoulos D, Worth LL, Mullen CA, et al.: Total body irradiation, fludarabine, melphalan and allogeneic hematopoietic stem cell transplantation for advanced pediatric hematologic malignancies [abstract]. Blood (ASH Annual Meeting Abstracts) 2004, 104:506a, Abstract 1827.

    Google Scholar 

  16. Miyakoshi S, Yuji K, Kami M, et al.: Successful engraftment after reduced-intensity umbilical cord blood transplantation for adult patients with advanced hematological diseases. Clin Cancer Res 2004, 10:3586–3592.

    Article  PubMed  Google Scholar 

  17. Hows JM: Status of umbilical cord blood transplantation in the year 2001. J Clin Pathol 2001, 54:428–434.

    Article  PubMed  CAS  Google Scholar 

  18. Shpall EJ, Quinones R, Giller R, et al.: Transplantation of ex vivo expanded cord blood. Biol Blood Marrow Transplant 2002, 8:368–376.This is the first report of the feasibility of clinical-scale umbilical cord blood expansion for transplantation.

    Article  PubMed  Google Scholar 

  19. Peled T, Landau E, Mandel J, et al.: Linear polyamine copper chelator tetraethylenepentamine augments long-term ex vivo expansion of cord blood derived CD34+ cells and increases their engraftment potential in NOD/SCID mice. Exp Hematol 2004, 32:547–555.

    Article  PubMed  CAS  Google Scholar 

  20. Shpall E, de Lima M, Chan KW, et al.: Transplantation of cord blood expanded ex vivo with copper chelator [abstract]. Blood (ASH Annual Meeting Abstracts) 2004, 104:281a, Abstract 982.

    Google Scholar 

  21. Barker JN, Weisdorf DJ, DeFor TE, et al.: Transplantation of 2 partially HLA-matched umbilical cord blood units to enhance engraftment in adults with hematologic malignancy. Blood 2005, 105:1343–1447.The first report of a significant number of patients given double cord blood transplants. The high success rate may change the approach in the treatment of heavier recipients.

    Article  PubMed  CAS  Google Scholar 

  22. Fernandez MN, Regidor C, Cabrera R, et al.: Unrelated umbilical cord blood transplants in adults: Early recovery of neutrophils by supportive co-transplantation of a low number of highly purified peripheral blood CD34+ cells from an HLA-haploidentical donor. Exp Hematol 2003, 31:535–544.This is an entirely different concept to facilitate cord blood engraftment. Its safety and efficacy await further confirmatory studies.

    Article  PubMed  Google Scholar 

  23. Ballen KK, Kurtzberg J, Lane TA, et al.: Racial diversity with high nucleated cell counts and CD34 counts achieved in a national network of cord blood banks. Biol Blood Marrow Transplant 2004, 10:269–275.

    Article  PubMed  Google Scholar 

  24. Davey S, Armitage S, Rocha V, et al.: The London Cord Blood Bank: analysis of banking and transplantation outcome. Br J Haematol 2004, 125:358–365.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Pediatrics, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 87, 77030, Houston, TX, USA

    Demetrios Petropoulos MD

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  1. Demetrios Petropoulos MD
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  2. Ka Wah Chan MD
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Correspondence to Demetrios Petropoulos MD.

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Petropoulos, D., Chan, K.W. Umbilical cord blood transplantation. Curr Hematol Malig Rep 1, 197–200 (2006). https://doi.org/10.1007/s11899-996-0008-5

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  • DOI: https://doi.org/10.1007/s11899-996-0008-5

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