Abstract
Cord blood as the source of hematopoietic stem cells has several advantages over bone marrow cells for transplant purpose. It is readily available, and causes no physical harm or inconveniences to the donor in the processing of harvesting cells. Waiting time between initiating the search and the time to transplant from an unrelated donor is much shorter with cord blood than with unrelated donor bone marrow. The incidence of graft-versus-host diseases is much less. Because of these advantages, cord blood has been increasingly used as the source of stem cells. As of this writing, more than 200 cord blood transplants have been done in patients with hematological malignancies, solid tumors, hematological diseases, immunodeficiency syndromes, and metabolic diseases. One of the limitations inherent in the cord blood is its limited number of hematopoietic stem cells. Thus it has been primarily used for pediatric patients, though more recently, adult patients also have been transplanted with cord blood as people have become more experienced in harvesting cord blood thus yielding a large number of stem cells in a given specimen. Efforts have been made to amplify stem cellsin vitro following harvesting cord blood stem cells, so that adult recipients also would routinely benefit from this resource. Cord blood lymphocytes are functionally “naive”, do not generate vigorous mixed lymphocyte culture reactivities. The low incidence of graft-versus-host disease in the recipients of cord blood is due to this particular property. It is highly desirable that the world wide cord blood registry, similar to the international bone marrow registry would be instituted, but there are logistic, ethical and financial problems that need to be resolved. Cord blood is one of the best stem cell sources, and its application is quite wide.
Similar content being viewed by others
References
Weber-Nordt RM, Schott E, Finke J,et al. Umbilical cord blood: an alternative to the transplantation of bone marrow stem cells.Cancer Treatment Reviews 1996; 22: 381–391
Kogler G, Callejas J, Hakenberg P,et al. Hematopoietic transplant potential of unrelated cord blood:Critical issues. J Hematotherapy 1996; 5: 105–116
Gluckman E. European organization for cord blood banking.Blood Cells 1994; 20: 601–608.
Kurtzberg J, Laughlin M, Graham ML,et al. Placental blood as a source of hematopoietic stem cells for transplantation into unrelated recipients.N Engl J Med 1996; 335; 157–166
Harris DT. Experience in autologous and allogeneic cord blood banking.J Hematotherapy 1996; 5: 123–128
Denning-Kendall P, Donaldson C, Nicol A,et al. Optimal processing of human umbilical cord blood for clinical banking.Experiment Hematol. 1996; 24: 1394–1401
Fritsch G, Stimpel M, Buchinger P,et al. Does cord blood contain enough progenitor cells for transplatation?J Hematopathology 1994; 3: 291–298
Bertolini F, Lazzari L, Laluri E,et al. Comparative study of different procedures for the collection and banking of umbilical cord blood.J Hematotherapy 1995; 4: 29–36
Pahwa RN, Fleischer A, Shih S,et al. Erythrocyte-depleted allogeneic human umbilical cord blood transplantation.Blood Cells 1994; 20: 267–274
Bruno A, Adorno G, Ballatore G,et al. Cryopreservation of umbilical cord blood using dimethy sulfoxide and hydroxyethyl starch without rate-controlled freezing (abstr).Experimental Hematol 1997; 25: 827
Hakenberg P, Sirchia G, Garcia J,et al. Allocation conflict in cord blood transplantation: An evaluation of matching criteria of cord blood specimen and its impact on the work flow within an international CB network (abstr).Experimental Hematol 1997; 25: 827
Gluckman E: Umbilical cord blood transplant in human.Bone Marrow Transplant 1996; 18: 166–170
Gluckman E, Rocha V, Boyer-Chammard A,et al. Outcome of cord-blood transplantation from related and unrelated donors.N Engl J Med 1997; 337: 373–381
Lasky LC. Hematopoietic reconstitution using progenitors recovered from blood (review).Transfusion 1989; 29: 552.
Laporte Jph, Lesage S, Portnol MF,et al. Unrelated mismatched cord blood (CB) transplant in patients with hematological malignancies: A single institution experience (abstr).Experimental Hematol 1997; 25: 827.
Laporte Jph, Gorin NC, Lesage S,et al. Unrelated cord blood transplantation for chronic myelocytic leukemia (CML) in adult patients (abstr).Experimental Hematol 1997; 25: 828
Hirao A, Kawano Y, Takaue Y,et al. Engrafment potential of peripheral and cord blood stem cells evaluated by a long term culture system.Experimental Hematol 1994; 22: 521–526
Nimagaonkar MT, Roscoe R, Persichetti J.et al. A unique population of CD 34+ cells in cord blood.Stem Cells 1995; 13: 158–166
Steen R, Tjonnfjord GE, Egeland T. Comparison of the phenotype and clonogenicity of normal CD 34+ cells from umbilical cord blood, granulocyte colony-stimulating factor-mobilized peripheral blood, and adult human bone marrow.J Hematotherapy 1994; 3: 253–262
Sato J, Kawano Y, Takaue Y,et al. Quantitative and qualitative comparative analysis of gradient-separated hematopoietic cells from cord blood and chemotherapy-mobilized peripheral blood.Stem Cells 1995; 13: 548–555
Traycoff CM, Abboud MR, Laver J,et al. Evaluation of the in vitro behavior of phenotypically defined subpopulation in human umbilical cord blood hematopoietic progenitor cells.Experimental Hematol 1994; 22: 215–22
Newburger PE, Quesenberry PJ. Umbilical cord blood as a new and promising source of unrelated-donor hematopoietic stem cells for transplantation (editorial review).Current Opinions in Pediatrics 1996; 8: 29–32
Keever CA, Abu-Hajir M, Graf W,et al. Characterization of the alloreactivity and anti-leukemia reactivity of cord blood mononuclear cells.Bone Marrow Transplant 1995; 15: 407–419
Harris DT, LoCascio, Besencon FJ. Analysis of the alloreactive capacity of human umbilical cord blood: Implications for graft-versus-host disease.Bone Marrow Transplant 1994; 14: 545–553
Gaddy J, Risdon G, Broxmeyer HE. Cord blood natural killer cells are functionally and phenotypically immature but readily respond to Interleukin-2 and Interleukin-12.J Interferon Cytokine Res 1995; 15: 527–536
Wagner JE, Kernan NA, Steinbuch M,et al. Allogeneic sibling umbilical-cord-blood transplantation in children with malignant and non-malignant disease.Lancet 1995; 346: 214–219
Sanders J. Bone Marrow Transplantation in pediatric oncology. In: Pizzo PA, Poplack DZ, eds.Principles and Practices of Pediatric Oncology 3rd edn. Philadelphia: Lippincott-Raven, 1997; 359
Stary J, Bartunkova J, Kobylka P,et al. Case report: Sucessful HLA-identical sibling cord blood transplantation in a 6 year old boy with leukocyte adhesion deficiency syndrome.Bone Marrow Transplant 1996; 18: 249–252
Auerbach AD. Umbilical cord blood transplants for genetic disease: Diagnsotic and ethical issues in fetal studies.Blood Cells 1994; 20: 303–309
Kernan NA, Schroeder ML, Ciavarella D,et al. Umbilical cord blood infusion in a patient for correction of Wiskott-Aldrich syndrome.Blood Cells 1994; 20: 245–248
Shen B-J, Hou H-S, Zhang H-Q,et al. Unrelated, HLA-mismatched multiple human umbilical cord blood transfusion in four cases with advanced solid tumors: Intitial studies.Blood Cells 1994; 20: 285–292.
Kohn DB, Weinberg KI, Nolta JA,et al. Engrafment of gene-modified umbilical cord blood cells in neonates with adenosine deaminase deficiency.Nature Med 1995; 1: 1017–1023.
Koller MR, Manchel I, Maher RJ,et al. Clinical scale human umbilical cord blood cell expansion in an automated perfusion culture system (abstr).Experimental Hematol 1997; 25: 826
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Inoue, S. Cord blood transplant: Current and future issues. Indian J Pediatr 65, 163–171 (1998). https://doi.org/10.1007/BF02752291
Issue Date:
DOI: https://doi.org/10.1007/BF02752291