Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Umbilical cord blood transplantation

  • Koo, Hong-Hoe (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Ahn, Hyo-Seop (Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine)
  • Received : 2012.03.21
  • Accepted : 2012.04.19
  • Published : 2012.07.15
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Abstract

Since the first umbilical cord blood transplantation (CBT) in 1998, cord blood (CB) has now become one of the most commonly used sources of hematopoietic stem cells for transplantation. CBT has advantages of easy procurement, no risk to donor, low risk of transmitting infections, immediate availability and immune tolerance allowing successful transplantation despite human leukocyte antigen disparity. Several studies have shown that the number of cells transplanted is the most important factor for engraftment in CBT, and it limits the wide use of CB in adult patients. New strategies for facilitating engraftment and reducing transplantation-related mortality are ongoing in the field of CBT and include the use of a reduced-intensity conditioning regimen, double-unit CBT, ex vivo expansion of CB, and co-transplantation of CB and mesenchymal stem cells. Recently, the results of two international studies with large sample sizes showed that CB is an acceptable alternative source of hematopoietic stem cells for adult recipients who lack human leukocyte antigen-matched adult donors. Along with the intensive researches, development in banking process of CB will amplify the use of CB and offer the chance for cure in more patients.

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References

  1. Broxmeyer HE, Douglas GW, Hangoc G, Cooper S, Bard J, English D, et al. Human umbilical cord blood as a potential source of transplantable hematopoietic stem/progenitor cells. Proc Natl Acad Sci U S A 1989;86: 3828-32. https://doi.org/10.1073/pnas.86.10.3828
  2. Gluckman E, Broxmeyer HA, Auerbach AD, Friedman HS, Douglas GW, Devergie A, et al. Hematopoietic reconstitution in a patient with Fanconi's anemia by means of umbilical-cord blood from an HLAidentical sibling. N Engl J Med 1989;321:1174-8. https://doi.org/10.1056/NEJM198910263211707
  3. Kurtzberg J, Laughlin M, Graham ML, Smith C, Olson JF, Halperin EC, et al. Placental blood as a source of hematopoietic stem cells for transplantation into unrelated recipients. N Engl J Med 1996;335:157-66. https://doi.org/10.1056/NEJM199607183350303
  4. Szabolcs P, Niedzwiecki D. Immune reconstitution after unrelated cord blood transplantation. Cytotherapy 2007;9:111-22. https://doi.org/10.1080/14653240701231014
  5. Gardiner CM, Meara AO, Reen DJ. Differential cytotoxicity of cord blood and bone marrow-derived natural killer cells. Blood 1998;91:207-13.
  6. Tse W, Laughlin MJ. Umbilical cord blood transplantation: a new alternative option. Hematology Am Soc Hematol Educ Program 2005:377-83.
  7. Rocha V, Wagner JE Jr, Sobocinski KA, Klein JP, Zhang MJ, Horowitz MM, et al. Graft-versus-host disease in children who have received a cord-blood or bone marrow transplant from an HLA-identical sibling. Eurocord and International Bone Marrow Transplant Registry Working Committee on Alternative Donor and Stem Cell Sources. N Engl J Med 2000;342:1846-54. https://doi.org/10.1056/NEJM200006223422501
  8. Eapen M, Rubinstein P, Zhang MJ, Stevens C, Kurtzberg J, Scaradavou A, et al. Outcomes of transplantation of unrelated donor umbilical cord blood and bone marrow in children with acute leukaemia: a comparison study. Lancet 2007;369:1947-54. https://doi.org/10.1016/S0140-6736(07)60915-5
  9. Atsuta Y, Suzuki R, Nagamura-Inoue T, Taniguchi S, Takahashi S, Kai S, et al. Disease-specific analyses of unrelated cord blood transplantation compared with unrelated bone marrow transplantation in adult patients with acute leukemia. Blood 2009;113:1631-8.. https://doi.org/10.1182/blood-2008-03-147041
  10. Eapen M, Rocha V, Sanz G, Scaradavou A, Zhang MJ, Arcese W, et al. Effect of graft source on unrelated donor haemopoietic stem-cell transplantation in adults with acute leukaemia: a retrospective analysis. Lancet Oncol 2010;11:653-60. https://doi.org/10.1016/S1470-2045(10)70127-3
  11. Lee YH, Cho NC, Je KH, Han H, Han JY, Kim JS, et al. Successful sibling cord blood stem cell transplantation for relapsed acute mixed lineage leukemia. Korean J Hematol 1999;34:471-6.
  12. Kang HJ, Yoo KH, Lee JW, Kim H, Lee SH, Sung KW, et al. Double umbilical cord blood transplantation for children and adolescents. Ann Hematol 2010;89:1035-44. https://doi.org/10.1007/s00277-010-0985-2
  13. Yoo KH, Lee SH, Sung KW, Koo HH, Chung NG, Cho B, et al. Current status of pediatric umbilical cord blood transplantation in Korea: a multicenter retrospective analysis of 236 cases. Am J Hematol 2011;86:12-7. https://doi.org/10.1002/ajh.21886
  14. Barker JN, Weisdorf DJ, DeFor TE, Blazar BR, McGlave PB, Miller JS, et al. Transplantation of 2 partially HLA-matched umbilical cord blood units to enhance engraftment in adults with hematologic malignancy. Blood 2005;105:1343-7.
  15. Yoo KH, Lee SH, Kim HJ, Sung KW, Jung HL, Cho EJ, et al. The impact of post-thaw colony-forming units-granulocyte/macrophage on engraftment following unrelated cord blood transplantation in pediatric recipients. Bone Marrow Transplant 2007;39:515-21. https://doi.org/10.1038/sj.bmt.1705629
  16. Kelly SS, Sola CB, de Lima M, Shpall E. Ex vivo expansion of cord blood. Bone Marrow Transplant 2009;44:673-81. https://doi.org/10.1038/bmt.2009.284
  17. Pecora AL, Stiff P, Jennis A, Goldberg S, Rosenbluth R, Price P, et al. Prompt and durable engraftment in two older adult patients with high risk chronic myelogenous leukemia (CML) using ex vivo expanded and unmanipulated unrelated umbilical cord blood. Bone Marrow Transplant 2000;25:797-9. https://doi.org/10.1038/sj.bmt.1702222
  18. Lee MW, Jang IK, Yoo KH, Sung KW, Koo HH. Stem and progenitor cells in human umbilical cord blood. Int J Hematol 2010;92:45-51. https://doi.org/10.1007/s12185-010-0619-4
  19. Devine SM, Bartholomew AM, Mahmud N, Nelson M, Patil S, Hardy W, et al. Mesenchymal stem cells are capable of homing to the bone marrow of non-human primates following systemic infusion. Exp Hematol 2001;29:244-55. https://doi.org/10.1016/S0301-472X(00)00635-4
  20. Nauta AJ, Fibbe WE. Immunomodulatory properties of mesenchymal stromal cells. Blood 2007;110:3499-506. https://doi.org/10.1182/blood-2007-02-069716
  21. Ball LM, Bernardo ME, Roelofs H, Lankester A, Cometa A, Egeler RM, et al. Cotransplantation of ex vivo expanded mesenchymal stem cells accelerates lymphocyte recovery and may reduce the risk of graft failure in haploidentical hematopoietic stem-cell transplantation. Blood 2007;110:2764-7. https://doi.org/10.1182/blood-2007-04-087056
  22. Lee SH, Cheuh HW, Yoo KH, Sung KW, Koo HH, Kim JY, et al. Cotransplantation of third party umbilical cord blood mesenchymal stem cells to promote engraftment in pediatric recipients of unrelated donor umbilical cord blood. Biol Blood Marrow Trnansplant 2011;17:S169-70.
  23. Cutler C, Ballen K. Reduced-intensity conditioning and umbilical cord blood transplantation in adults. Bone Marrow Transplant 2009;44:667-71. https://doi.org/10.1038/bmt.2009.283
  24. Grewal SS, Kahn JP, MacMillan ML, Ramsay NK, Wagner JE. Successful hematopoietic stem cell transplantation for Fanconi anemia from an unaffected HLA-genotype-identical sibling selected using preimplantation genetic diagnosis. Blood 2004;103:1147-51.

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  1. New strategies in cord blood cells transplantation : New strategies in cord blood cells transplantation vol.37, pp.9, 2012, https://doi.org/10.1002/cbin.10114