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Updated: May 7, 2026
Isolation of Precursor B-cell Subsets from Umbilical Cord Blood
Published on: April 16, 2013
Analysis of risk factors of cord blood transplantation for children
Gal Goldstein1, Bella Bielorai, Jerry Stein
1Department of Pediatric Hemato-Oncology and Bone Marrow Transplantation, The Edmond and Lily Safra Children's Hospital, Ramat Gan, Israel.
Insights
ABO blood group matching improves myeloid engraftment in cord blood transplantation. Rh matching also impacts overall survival, a factor not previously highlighted in cord blood stem cell transplants.
Area of Science:
- Hematology
- Transplantation Medicine
- Immunology
Background:
- Cord blood (CB) is a frequent source for hematopoietic stem cell transplantation.
- Identifying risk factors for transplantation outcomes is crucial.
Purpose of the Study:
- To investigate risk factors influencing myeloid engraftment, event-free survival (EFS), and overall survival (OS) in pediatric cord blood transplant recipients.
Main Methods:
- Retrospective analysis of single-unit cord blood transplant data from Israel (1992-2011).
- Studied 87 children undergoing transplantation for hematological malignancies or non-malignant diseases.
- Evaluated factors including ABO and Rh blood group matching, donor type, and graft-versus-host disease.
Main Results:
- Neutrophil recovery occurred in 78.3% (median 26 days), and platelet engraftment in 53% (median 36 days).
- ABO blood group matching was linked to better myeloid engraftment.
- One-year EFS was 45% and OS was 57%. Rh mismatch and unrelated donor transplantation were associated with inferior OS.
Conclusions:
- ABO blood group matching is a significant factor for engraftment in cord blood transplantation.
- Rh matching appears to influence overall survival, a novel finding in this context.
- These findings emphasize the importance of careful donor selection for optimizing cord blood transplant outcomes.
Background:
As cord blood (CB) is being used frequently as a source for heamtopoetic stem cell transplantation defining risk factors for transplantation outcome is an important issue.
Procedure:
The data of all single unit CB transplantation preformed in Israel from 1992 to 2011 were collected. The risk factors for myeloid engraftment, event free survival (EFS) and overall survival (OS) were studied in 87 children.
Results:
There were 49 children with hematological malignancies and 38 with non-malignant diseases. Cumulative rate of neutrophil recovery was 78.3%, while median time to myeloid recovery was 26 days. The incidence of platelet engraftment at 150 days was 53%, and the median time to platelet recovery was 36 days. ABO blood group matching between CB unit and recipient was associated with superior myeloid engraftment. Acute graft versus host disease of grades II-IV occurred in 33% of the patients. Chronic graft versus host disease occurred in 16% of patients. Probabilities of EFS and OS at 1 year were 45% and 57%, respectively. Factors associated with inferior OS were Rh major mismatch versus matched Rh and transplantation from unrelated donor versus related donor.
Conclusions:
These results indicate that matching of ABO blood groups is an important factor that affects engraftment, and also that Rh matching seem to have an impact on OS, which was not previously described in the setting of CB transplantation.
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