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Cord Blood Graft Assessment and Selection Criteria for Transplantation

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Best Practices in Processing and Storage for Hematopoietic Cell Transplantation

Abstract

Cord blood (CB) grafts extend the availability of allogeneic hematopoietic cell transplant (allo-HCT) to patients who do not have suitable adult donors, particularly those of ethnic minorities. With the growth of the worldwide CB Inventory, most patients will have several potential HLA-matched CB units (CBU); still, selection of the most appropriate CB graft for transplantation remains a complex decision since there are many considerations related to the CBU, the patient’s disease, and clinical condition as well as the type of transplant. This chapter aims to address the several aspects of CBU selection, including assays to evaluate the quality/potency of the graft, interactions between CBU total nucleated cell (TNC) dose and HLA mismatch, selection of CBU with “permissible” mismatches, and evaluation of other graft characteristics important for the safety and overall outcomes of CB transplantation. Since no selection algorithm “fits all,” transplant centers need to develop their own selection criteria based on their specific studies as well as their results of post-thaw CBU evaluation and outcomes.

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Acknowledgments

We thank the NYBC National Cord Blood Program staff who performs all the tasks needed to ensure the quality of the CBU and Dr. Pablo Rubinstein, Director of the National Cord Blood Program, for his support and constructive criticism. We are grateful to the obstetricians in the collaborating hospitals who support the National Cord Blood Program and to the mothers who generously donate their infant’s cord blood. We also thank Professor Jon J. van Rood for his insight and support.

We thank the MSKCC hospital staff, clinical teams, unrelated search coordinators, and laboratories for excellent patient care, detailed evaluation of CBU searches, and post-thaw CBU studies.

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Authors and Affiliations

  1. National Cord Blood Program, New York Blood Center, New York, NY, USA

    Andromachi Scaradavou M.D.

  2. Bone Marrow Transplant Service, Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Andromachi Scaradavou M.D.

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  1. Andromachi Scaradavou M.D.
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Correspondence to Andromachi Scaradavou M.D. .

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Editors and Affiliations

  1. Department of Pathology & Cell Biology, Columbia University, New York, New York, USA

    Joseph Schwartz

  2. New York Blood Center, New York, New York, USA

    Beth H. Shaz

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Scaradavou, A. (2018). Cord Blood Graft Assessment and Selection Criteria for Transplantation. In: Schwartz, J., Shaz, B. (eds) Best Practices in Processing and Storage for Hematopoietic Cell Transplantation . Advances and Controversies in Hematopoietic Transplantation and Cell Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-58949-7_10

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