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Clinical challenges and cord blood transplantation: are we asking the right questions?

P A Lowry1

  • 1Saint Barnabas Hospital, Livingston, NJ 07039, USA.

Cord blood offers an exciting alternative to traditional sources of stem cells for clinical transplantation, but its use will test traditional limits on minimal cell numbers required for engraftment as well as other aspects of the stem cell model of hematopoiesis. There is great interest in stem cell selection and ex vivo expansion techniques as they apply to cord blood. Although provocative, these approaches in their emphasis on the quantitative should not be allowed to obscure the important qualitative differences of cord blood with respect both to hematopoietic reconstitution per se and in the larger context to the unique immunologic status of that product. Whereas the momentum of cord blood transplantation may arise from the explosion in animal model-based stem cell biology, its direction must be determined by the clinical end points we week.

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