Umbilical cord blood transplants

Abstract

With the establishment of cord blood banks, the number of related and unrelated umbilical cord blood transplants is increasing worldwide. Close links have been established with the cord blood banks. Available data showed that umbilical cord blood transplants offer overall results comparable to those obtained with related or unrelated bone marrow transplants. Several differences were found: engraftment with cord blood was delayed, resulting in an increased incidence of early transplant complications, and the incidence of acute and chronic graft-versus-host disease was significantly reduced with cord blood grafts, even in HLA-mismatched transplants and in adults. In patients with leukemia, the rate of relapse appeared to be similar to that documented in bone marrow transplant recipients. These data confirm the potential benefit of using umbilical cord blood hematopoietic stem cells for allogeneic transplants.

Co-infusion of ex vivo-expanded, parental MSCs prevents life-threatening acute GVHD, but does not reduce the risk of graft failure in pediatric patients undergoing allogeneic umbilical cord blood transplantation

“…[8][9][10][11][12][13][14] with hematological disorders were enrolled in this study and received co-transplantation of UCB cells and parental-derived MSCs between May 2006 and January 2008. The results of these 13 patients were compared with those obtained in a group of 39 historical controls (median age 4 years, range 0.…”

“…The results of these 13 patients were compared with those obtained in a group of 39 historical controls (median age 4 years, range 0. [8][9][10][11][12][13][14][15][16][17] transplanted in one of the three centers (Pavia, Leiden and Stockholm) and matched as closely as possible for original disease and type of UCB donor used. Details on the study population and controls are reported in Table 1.…”

“…In both groups, GVHD prophylaxis was based on the use of CYA alone in case of transplantation from an HLA-identical sibling, and CYA together with steroids for patients receiving UCBT from an UD, 14 with the exception of three patients in the control group who received CYA and MTX. Pre-transplantation antithymocyte globulin was administered to all recipients of an UD UCBT.…”

“…2,3,[8][9][10][11][12] Results of UCBT from either an HLA-compatible sibling or from a UD have been reported to be comparable with those obtained in children transplanted with BM cells. 1,[13][14][15] However, in comparison with pediatric patients transplanted with BM cells from a matched UD, children receiving an unrelated UCBT, most being HLA disparate, have both delayed kinetics of hematopoietic recovery and increased risk of TRM in the early post transplantation period, mainly attributable to a higher risk of infectious complications. 16,17 Strategies aimed at improving engraftment and reducing TRM in UCBT recipients, such as infusion of two units in the same recipient, ex vivo expansion of UCB HSCs and intrabone injection of cord blood cells, have been recently proposed.…”

Outcomes of unrelated cord blood transplantation in pediatric recipients

“…2,3,11 The majority of reports of UCBT are from cord blood bank registries or cord blood banks. 5,12,13 However, in a large single center experience at the University of Minnesota, Wagner et al reported results of transplantation of unrelated donor umbilical cord blood in 102 patients with malignant and nonmalignant diseases. 2 The main objective of this study is to report the outcomes, namely, hematological recovery, GVHD, transplantation-related mortality and overall survival (OS) of unrelated cord blood transplants in children performed in one center over the last 5 years.…”