Skip to main content

Selection of the Optimal Cord Blood Unit

  • Chapter
  • First Online:
  • 903 Accesses

Part of the book series: Stem Cell Biology and Regenerative Medicine ((STEMCELL))

Abstract

Over 30,000 umbilical cord blood transplants have been performed since the first umbilical cord blood transplant in France in 1988. Outcomes have improved with a better understanding of the importance of cell dose and human leukocyte antigen (HLA) matching. The selection of the appropriate umbilical cord blood unit is more challenging than choosing bone marrow or peripheral blood stem cell donors. In this section, we review the data on cell dose and HLA typing, including high resolution typing, killer immunoglobulin receptor (KIR) matching, HLA C matching, and HLA antibodies. We also analyze the importance of cord blood banking factors, ABO match, and racial/ethnic matching. Finally, we discuss the challenges of the future in cord blood selection.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Gluckman E, Broxmeyer HE, Auerbach AD, et al. Hematopoietic reconstitution in a patient with Fanconi anemia by means of umbilical-cord blood from an HLA-identical sibling. N Eng J Med. 1989;321(17):1174–8.

    Article  CAS  Google Scholar 

  2. Barker JN, Byam C, Scaradavou A, et al. Availability of cord blood extends allogeneic hematopoietic transplant access. Biol Blood Marrow Transplant. 2010;11:154–8.

    Google Scholar 

  3. Laughlin MJ, Barker J, Bambach B, et al. Hematopoietic engraftment and survival in adult recipients of umbilical-cord blood from unrelated donors. N Engl J Med. 2001;344(24):1815–22.

    Article  CAS  PubMed  Google Scholar 

  4. Gluckman E, Ruggeri A, Volt F, Rocha V, et al. Milestones in umbilical cord blood transplantation. Br J Hematol. 2011;154(4):441–7.

    Article  Google Scholar 

  5. Barker JN, Scaradavou A, Stevens C, et al. Combined effect of total nucleated cell dose and HLA match on transplantation outcome in 1061 cord blood recipients with hematologic malignancies. Blood. 2010;115(9):1843–9.

    Article  CAS  PubMed  Google Scholar 

  6. Barker JN, Byam C, Scaradavou A, et al. How I treat: the selection and acquisition of unrelated cord blood grafts. Blood. 2011;117(8):2332–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. Gluckman E, Rocha V. Improving outcomes of cord blood transplantation: HLA matching, cell dose, and other graft-and transplantation-related factors. Brit J Hematol. 2009;147:262–74.

    Article  Google Scholar 

  8. Avery S, Shi W, Lubin M, et al. Influence of infused cell dose and HLA match on engraftment after double-unit cord blood allografts. Blood. 2011;117(12):3277–85.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Eapen M, Klein JP, Ruggeri A, et al. Impact of allele-level HLA matching on outcomes after myeloablative single unit umbilical cord blood transplantation for hematologic malignancy. Blood. 2014;123(1):133–40. C or DRB1

    Article  CAS  PubMed  Google Scholar 

  10. Eapen M, Klein JP, Sanz GF, et al. Effect of donor-recipient matching at HLA A, B, C and DRB1 on outcomes after umbilical cord blood transplantation for leukemia and myelodysplastic syndrome: a retrospective analysis. Lancet Oncol. 2011;12(13):1214–21.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Garfall A, Kim H, Cutler C, et al. Allele level matching at HLA-is associated with improved survival after reduced intensity cord blood transplantation. Blood. 2012;120(21):2010a (abstract).

    Google Scholar 

  12. Cunha R, Loiseau P, Ruggeri A, et al. Impact of HLA mismatch direction on outcomes after umbilical cord blood transplantation for hematological malignant disorders: a retrospective Euro-EBMT analysis. Bone Marrow Transplant. 2014;49(1):24–9.

    Article  CAS  PubMed  Google Scholar 

  13. Matsuno N, Wake A, Uchida N, et al. Impact of HLA disparity in the graft-versus-host direction on engraftment in adult patients receiving reduced-intensity cord blood transplantation. Blood. 2009;114:1689–95.

    Article  CAS  PubMed  Google Scholar 

  14. Cutler C, Kim HT, Sun L, et al. Donor-specific anti-HLA antibodies predict outcome in double umbilical cord blood transplantation. Blood. 2011;118(25):6691–7.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  15. Ruggeri A, Rocha V, Masson E, et al. Impact of donor specific anti-HLA antibodies on graft failure and survival after reduced intensity conditioning-unrelated cord blood transplantation. Hematologica. 2013;98(7):1154–60.

    Article  Google Scholar 

  16. Takanashi M, Atsuta Y, Fujiwara K, et al. The impact of anti-HLA antibodies on unrelated cord blood transplantations. Blood. 2010;116(15):2839–46.

    Article  CAS  PubMed  Google Scholar 

  17. Rocha V, Spellman S, Zhang MJ, et al. Effect of HLA-matching recipients to donor noninherited maternal antigens on outcomes after mismatched umbilical cord blood transplantation for hematologic malignancy. Biol Blood Marrow Transplant. 2012;18(12):1890–6.

    Article  PubMed  Google Scholar 

  18. van Rood JJ, Smits J, et al. Reexposure of cord blood to noninterited maternal HLA antigens improves transplant outcomes in hematological malignancies. Proc Natl Acad Sci U S A. 2009;106(47):19952–7.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Willemze R, Rodrigues CA, Labopin M, et al. KIR-ligand incompatibility in the graft-versus-host direction improves outcomes after umbilical cord blood transplantation for acute leukemia. Leukemia. 2009;23(3):492–500.

    Article  CAS  PubMed  Google Scholar 

  20. Brunstein CG, Wagner JE, Weisdorf D, et al. Negative effect of KIR alloreactivity in recipients of umbilical cord blood transplants depends on transplantation conditioning intensity. Blood. 2009;113(22):5628–34.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Tanaka J, Morishima Y, Takahashi Y, et al. Effects of KIR ligand incompatibility on clinical outcomes of umbilical cord blood transplantation without ATG for acute leukemia in remission. Blood Cancer J. 2013;3:e164.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Garfall A, Kim HT, Sun L, et al. KIR ligand incompatibility is not associated with relapse reduction after double umbilical cord blood transplantation. Bone Marrow Transplant. 2013;48(7):1000–2.

    Article  CAS  PubMed  Google Scholar 

  23. 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.

    Article  CAS  PubMed  Google Scholar 

  24. Delaney M, Ballen KK. The role of HLA in umbilical cord blood transplantation. Best Pract Res Clin Hematol. 2010;23:179–87.

    Article  CAS  Google Scholar 

  25. Rubinstein P, Dobrila L, Rosenfield R, et al. Processing and cryopreservation of placental/umbilical cord blood for unrelated bone marrow reconstitution. Proc Natl Acad Sci U S A. 1995;92:10119–22.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Petz L, Jaing TH, Rosenthal J, et al. Analysis of 120 pediatric patients with nonmalignant disorders transplanted using unrelated plasma-depleted or-reduced cord blood. Transfusion. 2012;52:1311–20.

    Article  PubMed  Google Scholar 

  27. Nikiforow S, Li S, Coughlin E, et al. Impact of cord blood processing conditions on outcomes after double cord blood transplantation. Blood. 2013;695a (abstract).

    Google Scholar 

  28. Guttridge MG, Soh TG, Belfield H, et al. Storage time affects umbilical cord blood viability. Transfusion. 2014;54:1278–85.

    Article  CAS  PubMed  Google Scholar 

  29. Page KM, Mendizibal A, Betz-Shablein R, et al. Optimizing donor selection for public cord blood banking: influence of maternal, infant, and collection characteristics on cord blood unit quality. Transfusion. 2013;54(2):340–52.

    PubMed  Google Scholar 

  30. Page KM, Zhang L, Mendizibal A, et al. Total colony-forming units are a strong, independent predictor of neutrophil and platelet engraftment after unrelated cord blood transplantation: a single center analysis of 435 cord blood transplants. Biol Blood Marrow Transplant. 2011;17:1362–74.

    Article  PubMed  Google Scholar 

  31. Romee R, Weisdorf DJ, Brunstein C, et al. Impact of ABO-mismatch on risk of GVHD after umbilical cord blood transplantation. Bone Marrow Transplant. 2013;48(8):1046–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  32. Ballen KK, Klein JP, Pedersen TL, et al. Relationship of race/ethnicity and survival after single umbilical cord blood transplantation for adults and children with leukemia and myelodysplastic syndromes. Biol Blood Marrow Transplant. 2012;18(6):903–12.

    Article  PubMed  Google Scholar 

  33. Ustun C, Bachonova V, Shanley R, et al. Importance of donor ethnicity/race matching in unrelated adult and cord blood allogeneic hematopoietic cell transplantation. Leuk Lymphoma. 2014;55(2):358–64.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Karen K. Ballen MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Ballen, K. (2014). Selection of the Optimal Cord Blood Unit. In: Ballen, K. (eds) Umbilical Cord Blood Banking and Transplantation. Stem Cell Biology and Regenerative Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-06444-4_20

Download citation

Publish with us

Policies and ethics