Haematopoietic Transplant Potential of Unrelated and Related Cord Blood: The first six Years of the EUROCORD/NETCORD Bank Germany

Abstract

To date, human umbilical cord blood (CB) has been employed successfully in well over 1000 allogeneic (unrelated and sibling) stem cell transplantations. Because of primary limitations in volume and cell numbers, over 90% of these transplantations were performed in children. Therefore requests for well standardised cord blood units of high quality are now increasing constantly. Examination and standardisation of unrelated and related cord blood stem cell preparations and banking as well as their biological characterisation was already initiated in Düsseldorf in 1992. Hitherto a total of 3236 CB samples with a mean volume of 89 +/- 25 ml, a mean total number of nucleated cells (NC) of 10 +/- 5 x 10(8) and a mean number of CFU-GM of 6 +/- 5 x 10(5) have also been validated by haematological, immunological and microbiological criteria. In addition to that, 97 directed CB donations of siblings with a clinical indication have been characterised and banked along the same lines. All CB units were collected from the umbilical cord vein immediately after vaginal full term delivery or caesarean section, then frozen and stored in liquid nitrogen. 1940 CB units were stored unseparated, the other 1296 were volume reduced using Hetastarch (HES) with a mean recovery of 85 +/- 13% of the nucleated cells, 86 +/- 12% and 84 +/- 13% for CFC and CD34+ cells, respectively. Only 5.0 ml of a CB sample is required for routine laboratory testing as there are HLA-class I typing, HLA-class II typing by sequence specific oligonucleotide probes (PCR-SOP), ABO typing, sterility control, assessment of progenitor and stem cells by colony forming assays, and CD34+ status as well as certain viral infections such as CMV, Hepatitis B, C, HIV, Parvo B19 by PCR technology before releasing the CB unit for transplantation. For apparent viral infections, maternal sera obtained at birth were tested for HBsAg, anti-HBc, anti-HCV, -HAV-(IgG, IgM), -HIV-1-2, -EBV- (IgG, IgM), -HTLVI-II, -CMV (IgM, IgG), toxoplasmosis and syphilis. Within the last three years a total of 4860 preliminary searches and 680 extended unit reports were submitted to the CB bank Düsseldorf by fax or World Wide Web. So far 68 unrelated and 3 related CB units were delivered. From these 70 have been transplanted in 30 different transplant centres world-wide. Until now the evaluation of the first 53 unrelated CB-transplantations was performed together with the EUROCORD transplant registry. Three patients were excluded from the analysis, since they received an unrelated CB-transplant for non-engraftment after previous allotransplants. The median patient age of these 50 patients was 5.0 years (range 0.3-44), the median weight 18 kg (range 4-70 kg). The majority of the patients transplanted for malignancies (66%) suffered from ALL (n = 19), AML (n = 7), CML (n = 4) and lymphoma (n = 2) with two third (75%) in an intermediate (2nd CR) or advanced stage of disease (> 2nd CR); 13 patients had metabolic diseases and immunodeficiencies and three had aplastic anaemia. All CB samples as well as th...

Effects of preeclampsia on the yield of hematopoietic stem cells obtained from umbilical cord blood at delivery

“…4,7 In accordance with these findings, many UCB banks have established a policy of selecting units with high numbers of total nucleated and CD34 + cells. 8,9 Studies performed on healthy pregnancies have shown that gestational and obstetric factors, including maternal age, parity, gestational age, length of labor, stress during labor, route of delivery, technique of UCB collection and positioning of the newborn after delivery can influence the numbers of HSC in UCB obtained after delivery.…”

Impact of Selection of Cord Blood Units from the United States and Swiss Registries on the Cost of Banking Operations

“…In 1989, the first CB transplantation was reported in a boy suffering from Fanconi anemia; the first two series of CB transplantation from related and unrelated donors were reported in 1994 and 1995 [for review see 5]. The first unrelated CB banking programs were started in 1992 at the Eurocord/Netcord Bank in Düsseldorf [6] and in 1993 at the New York Blood Center [7].…”

Stammzelltransplantationen aus Nabelschnurblut verwandter und nicht verwandter Spender bei Kindern und Erwachsenen - eine Übersicht zum Stammzelltransplantationswesen aus Nabelschnurblut

“…In Deutschland vertritt die Nabelschnurblutbank Düsseldorf NETCORD. Im Zeitraum von 1996 ± 1999 erhielt sie 4860 vorläufige Suchanfragen [5].…”