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Umbilical cord blood transplantation: current practice and future innovations
Juliet N Barker1, John E Wagner
1Department of Medicine, Blood and Marrow Transplant Program of the University of Minnesota School of Medicine, University of Minnesota, MMC 480 UMHC, 420 Delaware Street, SE, Minneapolis, MN 55455, USA. barker014@tc.umn.edu
Abstract:
As a source of hematopoietic stem cells (HSCs), umbilical cord blood (UCB) has the advantages of speed of availability, tolerance of 1-2 antigen HLA mismatch, and a low incidence of severe GVHD. Thus, UCB represents a highly convenient HSC source that may significantly extend the HSC donor pool. UCB transplantation (UCBT) has become a standard practice in the treatment of pediatric malignancies. Now, UCBT is being investigated in adults using both conventional and non-myeloablative preparative regimens. As graft cell dose is the major factor determining hematopoietic recovery and survival in URD UCBT, methods to increase cell dose such as multiple-unit transplant and ex vivo expansion are being pursued. This review outlines the current status of UCBT with emphasis on current and future innovations.