Table 1.

Advantages of umbilical cord blood (UCB) as hematopoietic stem cells for allogeneic transplantation.

  1. Umbilical cord blood is an abundantly available source of stem cells, which can be harvested at no risk to the mother or infant.

  2. Since collection occurs after birth of a full term normal infant, UCB is not associated with current ethical concerns raised in use of embryonic stem cells.

  3. Ethnic balance in a cord blood repository can be maintained automatically in heterogeneous populations or can be controlled via collection from birthing centers representing targeted minority populations.

  4. There is low viral contamination of UCB including cytomegalovirus and Epstein-Barr virus.

  5. UCB, cryopreserved and banked, is available on demand particularly for patients with unstable disease, eliminating delays and uncertainties that now complicate marrow collection from unrelated donors.

  6. To date, no malignant transformation of infused UCB has been observed in any transplant recipient.

  7. The amplification of allogeneic responses including Th1- associated cytokine production by neonatal T lymphocytes has been shown to be less than that of adult T cells, which may underlie UCB reduced graft-versus-host reactivity compared with adult-derived marrow grafts.

  8. Frozen UCB can be easily shipped and thawed for use when needed, compared to freshly donated bone marrow, which has a limited shelf-life, necessitating coordination between harvesting physicians, transportation personnel, and transplantation teams.

  9. There is an undistorted accumulation of HLA genotypes acquired in a UCB bank because stored UCB suffers no attrition except by clinical use, unlike volunteer unrelated adult donor registries in which donors are lost due to advancing age, new medical conditions, or geographic relocation.

  10. As yet to be determined, although intriguing given the emerging understanding of age-dependent telomerase activity and important contributions of genetic HSC regulation with advancing age of the donor to hematopoietic and immune function in the recipient; pediatric patients trans- planted with newborn HSC would expectedly maintain normal hematopoietic and immune function during advancing decades, compared with HSC grafts received from adult donors.

 

  1. Umbilical cord blood is an abundantly available source of stem cells, which can be harvested at no risk to the mother or infant.

  2. Since collection occurs after birth of a full term normal infant, UCB is not associated with current ethical concerns raised in use of embryonic stem cells.

  3. Ethnic balance in a cord blood repository can be maintained automatically in heterogeneous populations or can be controlled via collection from birthing centers representing targeted minority populations.

  4. There is low viral contamination of UCB including cytomegalovirus and Epstein-Barr virus.

  5. UCB, cryopreserved and banked, is available on demand particularly for patients with unstable disease, eliminating delays and uncertainties that now complicate marrow collection from unrelated donors.

  6. To date, no malignant transformation of infused UCB has been observed in any transplant recipient.

  7. The amplification of allogeneic responses including Th1- associated cytokine production by neonatal T lymphocytes has been shown to be less than that of adult T cells, which may underlie UCB reduced graft-versus-host reactivity compared with adult-derived marrow grafts.

  8. Frozen UCB can be easily shipped and thawed for use when needed, compared to freshly donated bone marrow, which has a limited shelf-life, necessitating coordination between harvesting physicians, transportation personnel, and transplantation teams.

  9. There is an undistorted accumulation of HLA genotypes acquired in a UCB bank because stored UCB suffers no attrition except by clinical use, unlike volunteer unrelated adult donor registries in which donors are lost due to advancing age, new medical conditions, or geographic relocation.

  10. As yet to be determined, although intriguing given the emerging understanding of age-dependent telomerase activity and important contributions of genetic HSC regulation with advancing age of the donor to hematopoietic and immune function in the recipient; pediatric patients trans- planted with newborn HSC would expectedly maintain normal hematopoietic and immune function during advancing decades, compared with HSC grafts received from adult donors.

 
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