Umbilical cord blood banking

Characteristics of stem cells -

These pluripotent stem cells can differentiate to form lymphoid precursors, which then produce B-lymphocytes, T-lymphocytes, natural killer cells, and plasma cells, as well as myeloid stem cells that give rise to the erythrocytes, platelets, neutrophils, monocytes, eosinophils, basophils, and macrophages. Cord blood stem cells have been used to treat many patients worldwide with different malignant and nonmalignant diseases and to treat patients with severe combined immunodeficiency syndrome through gene therapy techniques.

The premise for umbilical cord blood banking is the fact that cord blood stem cells are the progenitor cells that can reconstitute the blood and immune systems. These cells are particularly abundant in cord blood with concentrations nearly 10 times greater than that found in bone marrow and are more proliferative. Unlike the risks inherent in bone marrow transplants, they can be collected safely without maternal or neonatal risk following delivery.

Advantages of cord blood banking

Umbilical cord blood banking offers many advantages over unrelated donor-derived bone marrow as a source of stem cells for an affected sibling, including a higher likelihood of an HLA match and its availability. Moreover, when used by unrelated third-party recipients, umbilical cord blood-derived stem cells seem to confer advantages in rates of engraftment and reduced graft-versus-host (GVH) disease even if there are one or two HLA loci mismatches. The latter phenomena may reflect the cells’ relative immunological immaturity and the higher proportion of stem cells in an umbilical cord specimen than in bone marrow.

Benefits of Cord Blood Transplantation

1. Greater HLA mismatch tolerance

2. Significantly reduced risk of graft-versus-host disease

3. Painless, noninvasive, risk-free retrieval

4. Technically simple collection process

5. Immediate availability for clinical use

6. Superior proliferative capacity

7. Significantly lower cost

8. Lower risk of infectious complications

References:

1. Wagner JE, Kernan NA, Steinbuch M, Braxmeyer HE, Gluckman E.

2. Allogeneic sibling umbilical-cord-blood transplation in children with malignant and nonmalignant disease. Lancet 1995;346:214–9. 2. Perlow J

3. Cord blood banking: an ob’s perspective. Contemp Ob/Gyn 2002;11:31–43. 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;325:157–66

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