Cord blood banking for clinical transplantation

Abstract

Cord blood (CB) stem and progenitor cells from related donors have been transplanted for past 20 years and from unrelated donors issued by public CB banks for 16 years. This brief look at public CB banking highlights aspects of its current status to suggest that accomplishing the currently required tasks, though no small undertaking, is not enough: much remains to be contributed. CB banking started in the 1930s, collecting blood for transfusion and showed that CB could be effectively collected, stored and administered intravenously without negative consequences. The realization that it contains hematopoietic 'stem' cells (actually, colony-forming units) followed discoveries elsewhere in hematopoiesis research, while HLA and unrelated BMT were being investigated. Progress in the exploration of ethnically stratified HLA allele frequencies, together with plausible neonatal (partial) immunological tolerance, seemed to predict initially frequent, unavoidable, but sufficiently tolerable HLA mismatching with CB grafts. Gluckman et al. and Boyse et al. proved that HLA-identical sibling CB grafts led to definitive engraftment. Technical developments in processing and freezing enabled public banks to accumulate large inventories and to supply grafts that could succeed despite major HLA incompatibility and low cell doses and provide hope for universal access to unrelated-donor transplantation. Public CB banking has thrived worldwide. Regulation and accreditation defined Good Tissue Practice in the CB banking environment and provided accepted do's, don't's and how to's. Startling advances continue to be made, not only technical, but including the description of molecular regulation in the function of natural killer and other cells involved in allogeneic recognition that will have dramatic effects and will permit further improvement in CB selection and use.

Umbilical cord blood banking: an update

“…For the vast majority of families, due to cost or other reasons, public cord blood banking represents the only option to obtain a suitable graft in case of a need. Thus, it is important to educate prospective parents on the advantages and disadvantages of private versus public cord blood banking before the third trimester of pregnancy [21]. The donor process should be clear and simple with ample time to ask questions and to have the opportunity to become informed regarding the issues related to cord blood banking for their family.…”

“…Cord blood may not be collected if there are known hereditary diseases specifically involving hematopoiesis in the family or if severe disabilities or diseases are identified in the donor fetus before birth. Additional exclusion criteria include infectious diseases (e.g., HIV, hepatitis) in the mother, severe pregnancy complications or premature delivery with birth weight less than 1,500 g or if perinatal asphyxia is present in the fetus and cell counts [8,21,32]. These factors would impact on the quality and quantity of cord blood collected.…”

“…The cord blood is then labeled, weighed and the volume recorded. The blood cell counts for nucleated, mononucleated and CD34+ cells are recorded before the blood units are stored in liquid nitrogen or in the vapor phase of liquid nitrogen (≤150°C) [8,21]. The cell count and volume are known to be key parameters for selection and eligibility of cord blood units for transplantation.…”

“…The results, to date, are encouraging and appear at least comparable to bone marrow or peripheral blood progenitor cells as the donor source for transplants [12,13]. Later, Rubenstein and others were the first to establish an unrelated cord blood bank from voluntary donors and then used the blood units from the bank for unrelated cord blood transplantation [19][20][21]. These events further emphasize the importance of umbilical cord blood banking for transplantation in the medical field and the growing interest with 330 published articles retrieved by online searching of the PubMED website (www.ncbi.nlm.nih.gov/pubmed) on January 11, 2011 using the term "umbilical cord blood banking".…”

Cryopreservation of Cord Blood Hematopoietic Progenitor Cells in Cryoprotective Media Containing Various Concentrations of DMSO and Antioxidants

“…Щорічно кіль-кість проведених трансплантацій збільшується, а показання до даного виду терапії розширюються. Все це призвело до створення мережі кріобанків та розробці специфічних для даних клітин протоколів низькотемпературної консервації [10]. Однак неве-ликі об'єми кожної дози КК і неможливість повтор-ного забору викликають необхідність вибору най-більш ефективних технологій кріоконсервування.…”