Antenatal predictors of stem cell content for successful umbilical cord blood donation

Abstract

Purpose The most important HLA-independent factor for the selection of cord blood units (CBU) for hematopoietic stem cell transplantation is the total nucleated cell (TNC) count over 150 × 107 as a surrogate marker for stem cell content. The purpose of this prospective study was to define prenatal clinical predictors for TNC count that would help to identify successful CBU donors before the onset of active labor. Methods This was a prospective analysis of 594 CBUs, collected from all eligible term singleton pregnancies at Basel University Hospital between 4/2015 and 9/2016 analyzing several maternal and fetal factors. The impact of these factors on TNC count (< 150 × 107 cells vs. ≥ 150 × 107 cells) of the CBUs was modeled in a multivariate analysis. Results A total of 114 (19.2%) CBUs had a TNC count of ≥ 150 × 107. In a ROC analysis there was no significant difference between the AUC of all prenatal factors (AUC 0.62) and estimated fetal birth weight by ultrasound alone (AUC 0.62). For women planning a trial of labor a recruitment cut-off at an estimated birth weight of 3300 g would allow 72.6% of all donors with sufficient TNC count to be recruited and 22.8% of all collected CBUs would have a sufficient TNC count for banking. For women planning for elective CS a cut-off of 3400 g would allow 71.4% of all donors with sufficient TNC count to be recruited and 22.7% of all collected CBUs would have sufficient TNC count for banking. Conclusion The estimated fetal birth weight within 2 weeks of delivery by ultrasound as single parameter can be considered at the time of recruitment to estimate the chances of a successful CBU donation.

Increasing the Efficacy of Umbilical Cord Blood Banking Using Machine Learning Algorithms: A Case Study from Royan Cord Blood Bank

“…In this article, three cut-offs are examined. The three cutoffs are 0.7 × 10 9 , 1 × 10 9 , 1.5 × 10 9 , which have been used in the literature and international cord blood banks [3,4,5,8,9].…”

“…The most relevant advantages of UCB as a source of HSCs are readily available once collected and stored, less-precise matching of the donor's human leukocyte antigen (HLA) type to the recipient's HLA type, no risk or pain to the mother or baby, availability, and lower risk of GVHD infection than adult sources [3,4]. The most crucial disadvantage of umbilical cord blood is the limited number of stem cells in the cord blood unit (CBU), which is typically around ten times lower than bone marrow [5]. Two types of banks have been created to collect and store cord blood units: 1) private banks and 2) public banks.…”

“…They demonstrated that the Lasso method has the best performance. Funk et al [5] predicted samples with a cell dose of more than 1.5 × 10 9 using the logistic regression method and using maternal and neonatal factors. They indicated that the fetal weight factor has the most significant effect o n the TNC of the samples.…”