Use of Cord Blood Cells for Banking and Transplant

Abstract

Allogeneic hematopoietic stem cell (HSC) transplantation has been used to treat thousands of patients, both adults and children, who have life- threatening hematological diseases. The principal limitations of allogeneic bone marrow transplantation (BMT) are, for the majority of patients, the lack of suitable HLA-matched donors and the complications of graft-versus-host disease (GVHD) associated with HLA mismatches. The lack of an HLA-identical sibling donor in 70% of the cases has been overcome through the establishment of registries of potential marrow donors. These registries, however, often are restricted in terms of HLA polymorphism and ethnic diversity. Despite a bone marrow donor registry which contains >3.7 million donors worldwide, some patients cannot be transplanted because of the lack of a suitable HLA-identical donor. New approaches have been investigated, including the use of HLA partially mismatched, T cell-depleted, mobilized peripheral blood HSC or umbilical cord HSC.