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Kondo AT, Alvarez KCA, Cipolletta ANF, Sakashita AM, Kutner JM. Nucleated red blood cell: a feasible quality parameter of cord blood units. Hematol Transfus Cell Ther 2024; 46:221-227. [PMID: 36935342 PMCID: PMC11221323 DOI: 10.1016/j.htct.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 01/20/2023] [Indexed: 03/06/2023] Open
Abstract
INTRODUCTION Umbilical cord blood is an alternative source of hematopoietic progenitor cells for bone marrow transplantation; however, it is associated with a higher graft failure rate. The presence of a high rate of nucleated red blood cells (NRBCs) seems to be related to a greater capacity for engraftment, although is also associated with fetal distress conditions. We analyzed the correlation of the NRBC with quality parameters and its association with the utilization score of a cord blood unit. STUDY DESIGN AND METHOD Data of 3346 units collected in a public cord blood bank from May 2010 to December 2017 were analyzed, retrospectively, to identify factors associated with an increased number of nucleated red blood cells and its correlation with the engraftment capacity measured through total nucleated cells (TNCs) and CD34 positive cells. We also evaluated the utilization score of these units and identified an NRBC cutoff associated with a higher score. RESULTS The median volume collected was 104 mL (42-255), the pre-processing TNC count was 144.77 × 107 (95.46-477.18), the post-processing TNC count was 119.44 × 107 (42.7-477.18), the CD34 count was 4.67 × 106 (0.31-48.01), the NRBC count was 5 (0-202) and the utilization score was 0.0228 (0.00143-0.9740). The NRBC showed a correlation with the collected volume, TNC and CD34 positive cells and a higher utilization score and the receiver operating characteristic (ROC) curve analysis identified the five NRBC/100 leukocytes cutoff that correlates better with the probability of use. No association with pathological conditions and the NRBC rate was observed. CONCLUSIONS The NRBC is a feasible parameter for the screening of the cord blood unit (CBU) and the minimum cutoff of five NRBC/100 leukocytes can be a strategy in conjunction with the TNC to identify better units for cord blood bank sustainability.
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Pucci G, Foti G, Surace R, Monteleone R, Princi D, Fabrizi E, Quattrone G, Miniero R, Liverani A, Talarico V. Evaluation of factors affecting total nucleated cells in umbilical cord blood collected for the Calabria Cord Blood Bank. Minerva Pediatr (Torino) 2024; 76:363-371. [PMID: 33305918 DOI: 10.23736/s2724-5276.20.06096-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
BACKGROUND Total nucleated cell (TNC) count is the most important biological feature to consider in assessing the quality of umbilical cord blood (UCB) for hematopoietic stem cell (HSC) transplantation. Certain obstetric factors have been reported to increase TNC count in UCB units collected for transplantation. The aim of our study was to analyze how various maternal, neonatal and obstetric factors affected TNC count in the UCBs we collected for our cord blood bank in southern Italy. METHODS We performed a retrospective analysis of 634 medical records of UCBs collected by Calabria Cord Blood Bank (CCBB), Reggio Calabria, Italy, between January 1, 2010, and December 31, 2016. We analyzed various maternal, neonatal and obstetric variables factors and related this factor with the characteristic of TNC. RESULTS We found that the average number of TNCs was significantly greater in vaginal delivery than in caesarean delivery. We also found that TNCs were higher in the 40th week of pregnancy and when Apgar 1' scores were ≤9. The effect of a newborn's gender was less evident on TNC count. CONCLUSIONS Knowledge of factors predictive of a higher TNC count would help cord blood banks more efficiently identify donors likely to yield high-quality UCBs for transplantation.
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Affiliation(s)
- Giulia Pucci
- Calabria Cord Blood Bank, Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy
| | - Giovanni Foti
- Calabria Cord Blood Bank, Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy
| | - Rosangela Surace
- Calabria Cord Blood Bank, Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy
| | - Renza Monteleone
- Calabria Cord Blood Bank, Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy
| | - Domenica Princi
- Calabria Cord Blood Bank, Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy
| | - Enrico Fabrizi
- Department of Economic and Social Sciences (DISES), Sacro Cuore University of Piacenza, Piacenza, Italy
| | - Giuseppe Quattrone
- Department of Economic and Social Sciences (DISES), Sacro Cuore University of Piacenza, Piacenza, Italy
| | - Roberto Miniero
- Department of Pediatrics, Pugliese-Ciaccio Hospital of Catanzaro, Catanzaro, Italy
| | | | - Valentina Talarico
- Department of Pediatrics, Pugliese-Ciaccio Hospital of Catanzaro, Catanzaro, Italy -
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Mohd Idris MR, Nordin F, Mahdy ZA, Abd Wahid SF. Gestational Diabetes Mellitus in Pregnancy Increased Erythropoietin Level Affecting Differentiation Potency of Haematopoietic Stem Cell of Umbilical Cord Blood. Front Med (Lausanne) 2021; 8:727179. [PMID: 34490314 PMCID: PMC8416672 DOI: 10.3389/fmed.2021.727179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 07/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The in utero environment has many factors that can support cell differentiation. Cytokines, chemokines and growth factors play big roles in haematopoietic mechanisms. Some diseases like gestational diabetes mellitus (GDM) might affect the environment and haematopoietic stem cell (HSC) quality. The aim of this study is to investigate the adverse effects of GDM on umbilical cord blood (UCB) HSC in terms of differentiation potency including the UCB parameters used for banking and transplantation purposes. Methods: UCB-HSC was collected from 42 GDM and 38 normal pregnancies. UCB-HSC was isolated and further enriched using immuno-magnetic separation beads (MACS). The UCB-HSC were cultured in methylcellulose media to investigate the differentiation potency. The level of erythropoietin (EPO) and insulin in the UCB plasma was measured using enzyme linked immunoassay (ELISA) technique. Result: The UCB parameters; volume, total nucleated count (TNC) and total CD34+ cells were significantly reduced in the GDM group compared to the control group. The number of HSC progenitors' colonies were significantly reduced in the GDM group except for progenitor BFU-E, which was significantly increased (GDM = 94.19 ± 6.21, Control = 73.61 ± 2.73, p = 0.010). This data was associated with higher EPO level in GDM group. However, the insulin level in the GDM group was comparable to the Control group. Conclusion: Our results suggest that the changes in the in utero environment due to abnormalities during pregnancy such as GDM might affect the differentiation potency of UCB-HSC. These findings can be considered as an additional parameter for the inclusion and exclusion criteria for UCB banking, particularly for mothers with GDM.
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Affiliation(s)
- Mohd Razif Mohd Idris
- Cell Therapy Centre, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Fazlina Nordin
- Centre for Tissue Engineering and Regenerative Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Zaleha Abdullah Mahdy
- Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - S. Fadilah Abd Wahid
- Cell Therapy Centre, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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4
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Nordin F, Idris MRM, Mahdy ZA, Wahid SFA. Preeclampsia in pregnancy affecting the stemness and differentiation potency of haematopoietic stem cell of the umbilical cord blood. BMC Pregnancy Childbirth 2020; 20:399. [PMID: 32650736 PMCID: PMC7350629 DOI: 10.1186/s12884-020-03084-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 07/01/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Umbilical cord blood (UCB) has been proposed as the potential source of haematopoietic stem cells (HSC) for allogeneic transplantation. However, few studies have shown that a common disease in pregnancy such as preeclampsia would affect the quality of UCB-HSC. Total nucleated cell count (TNC) is an important parameter that can be used to predict engraftment including UCB banking. Colony forming unit (CFU) assay is widely used as an indicator to predict the success of engraftment, since direct quantitative assay for HSC proliferation is unavailable. The aim of this study is to investigate the effects of preeclampsia in pregnancy on the stemness and differentiation potency of UCB-HSC. METHODS Mononuclear cells (MNC) were isolated from UCB and further enriched for CD34+ cells using immune-magnetic method followed by CFU assay. A panel of HSC markers including differentiated haematopoietic markers were used to confirm the differentiation ability of UCB-HSC by flow cytometry analysis. RESULTS/ DISCUSSION The HSC progenitor's colonies from the preeclampsia group were significantly lower compared to the control. This correlates with the low UCB volume, TNC and CD34+ cells count. In addition, the UCB-enriched CD34+ population were lymphoid progenitors and capable to differentiate into natural killer cells and T-lymphocytes. CONCLUSION These findings should be taken into consideration when selecting UCB from preeclamptic mothers for banking and predicting successful treatment related to UCB transplant.
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Affiliation(s)
- Fazlina Nordin
- Centre for Tissue Engineering and Regenerative Medicine (CTERM), Universiti Kebangsaan Malaysia Medical Centre (UKMMC), 12th Floor, Clinical Block, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia.
| | - Mohd Razif Mohd Idris
- Cell Therapy Centre (CTC), UKMMC, 12th Floor, Clinical Block, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Zaleha Abdullah Mahdy
- Department of Obstetrics and Gynaecology, UKMMC, Clinical Block, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia
| | - S Fadilah Abd Wahid
- Cell Therapy Centre (CTC), UKMMC, 12th Floor, Clinical Block, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia
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5
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Di Tullio I, Azzolina D, Piras GN, Comoretto RI, Minto C, De Angeli S, Gregori D. Factors associated with blood cord unit bankability: an analysis of a 15-year-long case series. Cell Tissue Bank 2020; 21:77-87. [PMID: 31848776 DOI: 10.1007/s10561-019-09799-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 12/01/2019] [Indexed: 11/29/2022]
Abstract
Blood banking is a long and complex process requiring an accurate screening of potential donors and high-quality control systems. Previous studies in literature investigated factors potentially determining a higher cell levels with the aim of optimizing donors' selection and improving banking process. This study aims to identify factors associated with the concentration of stem cells in umbilical cord blood, so increasing the probability of bankability, focusing on the possible implications in terms of obstetric and resources management. This is a retrospective study conducted in the Obstetric Units of two Italian Hospitals in Montebelluna and Castelfranco Veneto. Study has been conducted on cord blood units banked between 1999 and 2015. Data on medical histories and clinical characteristics of mother and baby have been retrieved via a retrospective examination of medical records. A total of 869 cord blood units were studied. At multivariable analysis, in agreement with literature, birthweight and placental weight have been found to be associated with higher concentration of total nucleated cells. As additional factor, amount of fluid infused was associated with cord blood units' count. This study is the first one to clearly identify the role of fluid infusion on cord blood units' counts in addition to placental weight and delivery. Some non-modifiable features can help in predicting bankability from pre-natal aspects to factors more related with obstetric management is suggested.
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Affiliation(s)
- Isabella Di Tullio
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35131, Padua, Italy
| | - Danila Azzolina
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35131, Padua, Italy
| | - Gianluca Niccolò Piras
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35131, Padua, Italy
| | - Rosanna Irene Comoretto
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35131, Padua, Italy
| | - Clara Minto
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35131, Padua, Italy
| | - Sergio De Angeli
- ULSS 9, Treviso, Viale Bartolomeo D'Alviano 34, 31100, Treviso, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35131, Padua, Italy.
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6
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Mousavi SH, Zarrabi M, Abroun S, Ahmadipanah M, Abbaspanah B. Umbilical cord blood quality and quantity: Collection up to transplantation. Asian J Transfus Sci 2019; 13:79-89. [PMID: 31896912 PMCID: PMC6910041 DOI: 10.4103/ajts.ajts_124_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 06/16/2019] [Indexed: 11/04/2022] Open
Abstract
Umbilical cord blood (UCB) is an attractive source of hematopoietic stem cells for transplantation in some blood disorders. One of the major factors that influence on transplantation fate is cord blood (CB) cell count, in addition to human leukocyte antigen similarity and CD34+ cell number. Here, we review the factors that could effect on quality and quantity of CBUs. Relevant English-language literatures were searched and retrieved from PubMed using the terms: CB, quality, collection, and transplantation. The numbers of total nucleated cells (TNCs) and CD34+ cells are good indicators of CB quality because they have been associated with engraftment; thereby, whatever the TNCs in a CB unit (CBU) are higher, more likely they led to successful engraftment. Many factors influence the quantity and quality of UCB units that collect after delivery. Some parameters are not in our hands, such as maternal and infant factors, and hence, we cannot change these. However, some other factors are in our authority, such as mode of collection, type and amount of anticoagulant, and time and temperature during collection to postthaw CBUs and freeze-and-thaw procedures. By optimizing the CB collection, we can improve the quantity and quality of UCB for storage and increase the likelihood of its use for transplantation.
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Affiliation(s)
- Seyed Hadi Mousavi
- Department of Hematology, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Zarrabi
- Cord Blood Bank, Royan Stem Cell Technology Institute, Tehran, Iran
| | - Saeid Abroun
- Department of Hematology, School of Medical Sciences, Tarbiat Modarres University, Tehran, Iran
| | - Mona Ahmadipanah
- Cord Blood Bank, Royan Stem Cell Technology Institute, Tehran, Iran
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7
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Barker JN, Mazis CM, Devlin SM, Davis E, Maloy MA, Naputo K, Nhaissi M, Wells D, Scaradavou A, Politikos I. Evaluation of Cord Blood Total Nucleated and CD34 + Cell Content, Cell Dose, and 8-Allele HLA Match by Patient Ancestry. Biol Blood Marrow Transplant 2019; 26:734-744. [PMID: 31756534 DOI: 10.1016/j.bbmt.2019.11.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/28/2019] [Accepted: 11/10/2019] [Indexed: 12/16/2022]
Abstract
How cord blood (CB) CD34+ cell content and dose and 8-allele HLA match vary by patient ancestry is unknown. We analyzed cell content, dose, and high-resolution HLA-match of units selected for CB transplantation (CBT) by recipient ancestry. Of 544 units (286 infused, 258 next-best backups) chosen for 144 racially diverse adult patients (median weight, 81 kg), the median total nucleated cell (TNC) and CD34+cell +contents were higher for Europeans than for non-Europeans: 216 × 107versus 197 × 107 (P = .002) and 160 × 105 versus 132 × 105 (P = .007), respectively. There were marked cell content disparities among ancestry groups, with units selected for Africans having the lowest TNC (189 × 107) and CD34+ cell (122 × 105) contents. Units for non-Europeans were also more HLA-mismatched (P = .017). When only the 286 transplanted units were analyzed, the adverse effect of reduced cell content was exacerbated by the higher weights in some groups. For example, northwestern Europeans (high patient weight, high unit cell content) had the best-dosed units, and Africans (high weight, low unit cell content) had the lowest. In Asians, low cell content was partially compensated for by lower weight. Marked differences in 8-allele HLA-match distribution were also observed by ancestry group; for example, 23% of units for northwestern Europeans were 3/8 to 4/8 HLA-matched, compared with 40% for southern Europeans, 46% for white Hispanics, and 51% for Africans. During the study period, 20 additional patients (17 non-Europeans; median weight, 98 kg) did not undergo CBT owing to the lack of a suitable graft. CB extends transplantation access to most patients, but racial disparities exist in cell content, dose, and HLA match.
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Affiliation(s)
- Juliet N Barker
- Adult Bone Marrow Transplantation Service, Department of Medicine Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York.
| | - Christopher M Mazis
- Adult Bone Marrow Transplantation Service, Department of Medicine Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sean M Devlin
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Eric Davis
- Adult Bone Marrow Transplantation Service, Department of Medicine Memorial Sloan Kettering Cancer Center, New York, New York
| | - Molly A Maloy
- Adult Bone Marrow Transplantation Service, Department of Medicine Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kristine Naputo
- Adult Bone Marrow Transplantation Service, Department of Medicine Memorial Sloan Kettering Cancer Center, New York, New York
| | - Melissa Nhaissi
- Adult Bone Marrow Transplantation Service, Department of Medicine Memorial Sloan Kettering Cancer Center, New York, New York
| | - Deborah Wells
- Adult Bone Marrow Transplantation Service, Department of Medicine Memorial Sloan Kettering Cancer Center, New York, New York
| | - Andromachi Scaradavou
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York
| | - Ioannis Politikos
- Adult Bone Marrow Transplantation Service, Department of Medicine Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York
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Faivre L, Couzin C, Boucher H, Domet T, Desproges A, Sibony O, Bechard M, Vanneaux V, Larghero J, Cras A. Associated factors of umbilical cord blood collection quality. Transfusion 2017; 58:520-531. [PMID: 29277910 DOI: 10.1111/trf.14447] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 10/11/2017] [Accepted: 10/12/2017] [Indexed: 12/11/2022]
Abstract
After 30 years of hematopoietic stem cell use for various indications, umbilical cord blood is considered as an established source of cells with marrow and postmobilization peripheral blood. The limited number of cells still remains a problematic element restricting their use, especially in adults who require to be grafted with a higher cell number. Improving the quality of harvested cord blood, at least in terms of volume and amount of cells, is essential to decrease the number of discarded units. In this review, we examine several variables related to parturient, pregnancy, labor, delivery, collection, the newborn, umbilical cord, and placenta. We aim to understand the biologic mechanisms that can impact cord blood quality. This knowledge will ultimately allow targeting donors, which could provide a rich graft and improve the efficiency of the collection.
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Affiliation(s)
- Lionel Faivre
- AP-HP, Hôpital Saint-Louis, Unité de Thérapie Cellulaire
| | - Chloé Couzin
- AP-HP, Hôpital Saint-Louis, Unité de Thérapie Cellulaire
| | - Hélène Boucher
- AP-HP, Hôpital Saint-Louis, Unité de Thérapie Cellulaire.,Université Paris Descartes, Sorbonne Paris Cité
| | - Thomas Domet
- AP-HP, Hôpital Saint-Louis, Unité de Thérapie Cellulaire
| | | | - Olivier Sibony
- AP-HP, Hôpital Saint-Louis, Unité de Thérapie Cellulaire.,Université Paris Diderot, Sorbonne Paris Cité
| | - Marina Bechard
- Institut Hospitalier Franco-Britannique, Levallois-Perret
| | - Valérie Vanneaux
- AP-HP, Hôpital Saint-Louis, Unité de Thérapie Cellulaire.,Inserm, UMR_S1160, Centre d'Investigation Clinique en Biothérapies
| | - Jérôme Larghero
- AP-HP, Hôpital Saint-Louis, Unité de Thérapie Cellulaire.,Université Paris Diderot, Sorbonne Paris Cité.,Inserm, UMR_S1160, Centre d'Investigation Clinique en Biothérapies
| | - Audrey Cras
- AP-HP, Hôpital Saint-Louis, Unité de Thérapie Cellulaire.,Université Paris Descartes, Sorbonne Paris Cité.,Inserm UMR_S1140, Faculté de Pharmacie, Paris, France
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9
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Mousavi SH, Abroun S, Zarrabi M, Ahmadipanah M. The effect of maternal and infant factors on cord blood yield. Pediatr Blood Cancer 2017; 64. [PMID: 27905684 DOI: 10.1002/pbc.26381] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 11/05/2016] [Accepted: 11/07/2016] [Indexed: 11/11/2022]
Abstract
Umbilical cord blood (CB) can be used as an alternative hematopoietic stem cell source for transplantation in hematological malignancy and blood disorders. The success of transplantation is highly related to the levels of total nucleated cell and CD34+ cell counts. The evaluation of optimal conditions can decrease the rate of graft rejection due to low cell count and increases the quality of CB units (CBUs) in the blood bank and the success rate of engraftment. To this end, we review the maternal and infant parameters affecting the quality and quantity of CBUs.
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Affiliation(s)
- Seyed Hadi Mousavi
- Department of Hematology, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeid Abroun
- Department of Hematology, School of Medical Sciences, Tarbiat Modarres University, Tehran, Iran
| | - Morteza Zarrabi
- Royan Stem Cell Technology Institute, Cord Blood Bank, Tehran, Iran
| | - Mona Ahmadipanah
- Royan Stem Cell Technology Institute, Cord Blood Bank, Tehran, Iran
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10
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Santos SVF, Barros SMO, Santos MS, Marti LC, Ribeiro AAF, Kondo AT, Kutner JM. Predictors of high-quality cord blood units. Transfusion 2016; 56:2030-6. [PMID: 27232272 DOI: 10.1111/trf.13653] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 04/04/2016] [Accepted: 04/07/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Analysis of umbilical cord blood (UCB) transplants shows a correlation between engraftment and total number of infused cells. Thus, it is worth evaluating what maternal and neonatal characteristics and collection techniques may affect the quality of UCB units. STUDY DESIGN AND METHODS A cross-sectional study was performed with 7897 donors sequentially selected in three health care institutions in Brazil from October 2004 to March 2012, in which both quantitative and qualitative approaches were applied. All donors were considered suitable for cord blood collection. RESULTS The maternal and neonatal characteristics and techniques of collection that influenced the total number of nucleated cells (TNCs; p < 0.001) were type of delivery, newborn weight and sex, and institution of UCB collection. The TNC count was associated with gestational age (p = 0.008), type of delivery (p < 0.001), newborn sex (p < 0.001), newborn weight (p < 0.001), and UCB collection technique (p = 0.003). Center B presented the largest number of nucleated cells in its results (p < 0.001), followed by Center A (p = 0.001). Other characteristics, such as maternal age, were analyzed but were not relevant for the nucleated cell number. CONCLUSION This study provides elements for a model that allows an efficient selection of UCB donors, prioritizing candidates who have a better chance to lead to an optimized use of cord blood cells units.
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Affiliation(s)
- Sandra V F Santos
- Universidade Federal de São Paulo-UNIFESP, Escola Paulista de Enfermagem, São Paulo, Brazil
| | - Sonia M O Barros
- Universidade Federal de São Paulo-UNIFESP, Escola Paulista de Enfermagem, São Paulo, Brazil
| | | | - Luciana C Marti
- Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil
| | - Andreza A F Ribeiro
- Departamento de Hemoterapia, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Andrea T Kondo
- Departamento de Hemoterapia, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Jose M Kutner
- Departamento de Hemoterapia, Hospital Israelita Albert Einstein, São Paulo, Brazil
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11
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Rich IN. Improving Quality and Potency Testing for Umbilical Cord Blood: A New Perspective. Stem Cells Transl Med 2015; 4:967-73. [PMID: 26160959 DOI: 10.5966/sctm.2015-0036] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 06/01/2015] [Indexed: 12/18/2022] Open
Abstract
UNLABELLED This article critically reviews current methods to test and characterize umbilical cord blood (UCB) for hematopoietic stem cell transplantation. These tests include total nucleated cell (TNC) count, viability, viable CD34-positive content, and the colony-forming unit assay. It is assumed that the data obtained are sufficient to perform a UCB stem cell transplant without actually determining the quality and potency of the stem cells responsible for engraftment. This assumption has led not only to a high graft failure rate attributed to low or lack of potency, but also to noncompliance with present statutes that require UCB stem cells to be of high quality and, indeed, potency for a transplant to be successful. New evidence now calls into question the quality of the data, based on the UCB processed TNC fraction because using this impure fraction masks and significantly underestimates the functionality of the stem cells in both the segment and the unit. It is proposed that UCB units should be processed to the mononuclear cell fraction and that new cost-effective technology that measures the quality and potency of UCB stem cells be implemented to achieve better practices in UCB testing. These changes would provide the transplant physician with the assurance that the stem cells will perform as intended and would reduce risk and increase safety and efficacy for the patient. SIGNIFICANCE Current stem cell transplantation of umbilical cord blood cells requires testing that includes four basic parameters that do not determine whether the stem cells are of high quality, as required by the Stem Cell Therapeutic and Research Act of 2005. No cord blood units collected or transplanted so far have been tested for stem cell quality or potency. New scientific evidence calls into question cord blood processing and testing practices required by regulatory agencies and standards organizations. A new perspective is described that includes stem cell quality and potency testing that could reduce graft failure rates.
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Affiliation(s)
- Ivan N Rich
- HemoGenix, Inc., Colorado Springs, Colorado, USA
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12
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Pannopnut P, Kitporntheranunt M, Paritakul P, Kongsomboon K. Correlation of ultrasound estimated placental volume and umbilical cord blood volume in term pregnancy. J Turk Ger Gynecol Assoc 2015; 16:64-7. [PMID: 26097385 DOI: 10.5152/jtgga.2015.15235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 03/08/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate the correlation between ultrasound measured placental volume and collected umbilical cord blood (UCB) volume in term pregnancy. MATERIAL AND METHODS An observational cross-sectional study of term singleton pregnant women in the labor ward at Maha Chakri Sirindhorn Medical Center was conducted. Placental thickness, height, and width were measured using two-dimensional (2D) ultrasound and calculated for placental volume using the volumetric mathematic model. After the delivery of the baby, UCB was collected and measured for its volume immediately. Then, birth weight, placental weight, and the actual placental volume were analyzed. The Pearson's correlation was used to determine the correlation between each two variables. RESULTS A total of 35 pregnant women were eligible for the study. The mean and standard deviation of estimated placental volume and actual placental volume were 534±180 mL and 575±118 mL, respectively. The median UCB volume was 140 mL (range 98-220 mL). The UCB volume did not have a statistically significant correlation with the estimated placental volume (correlation coefficient 0.15; p=0.37). However, the UCB volume was significantly correlated with the actual placental volume (correlation coefficient 0.62; p<0.001) and birth weight (correlation coefficient 0.38; p=0.02). CONCLUSION The estimated placental volume by 2D ultrasound was not significantly correlated with the UCB volume. Further studies to establish the correlation between the UCB volume and the estimated placental volume using other types of placental imaging may be needed.
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Affiliation(s)
- Papinwit Pannopnut
- Department of Obstetrics and Gynecology, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Maethaphan Kitporntheranunt
- Department of Obstetrics and Gynecology, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Panwara Paritakul
- Department of Obstetrics and Gynecology, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Kittipong Kongsomboon
- Department of Preventive and Social Medicine, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
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Eldjerou LK, Cogle CR, Rosenau EH, Lu X, Bennett CA, Sugrue MW, Hoyne J, Lambert A, Ashley L, Sazama K, Fields G, Wingard JR, Zubair AC. Vitamin D effect on umbilical cord blood characteristics: a comparison between African Americans and Caucasians. Transfusion 2015; 55:1766-71. [DOI: 10.1111/trf.13124] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 12/23/2014] [Accepted: 12/30/2014] [Indexed: 12/29/2022]
Affiliation(s)
- Lamis K. Eldjerou
- Departments of Pediatric Blood & Marrow Transplantation; Medicine and Biostatistics, University of Florida; Gainesville Florida
| | - Christopher R. Cogle
- Departments of Pediatric Blood & Marrow Transplantation; Medicine and Biostatistics, University of Florida; Gainesville Florida
| | - Emma H. Rosenau
- Departments of Pediatric Blood & Marrow Transplantation; Medicine and Biostatistics, University of Florida; Gainesville Florida
| | - Xiaomin Lu
- Departments of Pediatric Blood & Marrow Transplantation; Medicine and Biostatistics, University of Florida; Gainesville Florida
| | | | - Michele W. Sugrue
- Departments of Pediatric Blood & Marrow Transplantation; Medicine and Biostatistics, University of Florida; Gainesville Florida
| | - Jonathan Hoyne
- Department of Laboratory Medicine and Pathology; Mayo Clinic; Jacksonville Florida
| | - Amy Lambert
- Michigan Blood Cord Blood Bank; Grand Rapids Michigan
| | | | - Kathleen Sazama
- San Diego Blood Bank Cord Blood Program; San Diego California
| | - Gary Fields
- Department of Laboratory Medicine and Pathology; Mayo Clinic; Jacksonville Florida
| | - John R. Wingard
- Departments of Pediatric Blood & Marrow Transplantation; Medicine and Biostatistics, University of Florida; Gainesville Florida
| | - Abba C. Zubair
- Department of Laboratory Medicine and Pathology; Mayo Clinic; Jacksonville Florida
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Patterson J, Moore CH, Palser E, Hearn JC, Dumitru D, Harper HA, Rich IN. Detecting primitive hematopoietic stem cells in total nucleated and mononuclear cell fractions from umbilical cord blood segments and units. J Transl Med 2015; 13:94. [PMID: 25784613 PMCID: PMC4374586 DOI: 10.1186/s12967-015-0434-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 02/11/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rare hematopoietic stem cell populations are responsible for the transplantation engraftment process. Umbilical cord blood (UCB) is usually processed to the total nucleated cell (TNC), but not to the mononuclear cell (MNC) fraction. TNC counts are used to determine UCB unit storage, release for transplantation and correlation with time to engraftment. However, the TNC fraction contains varying concentrations of red blood cells, granulocytes, platelets and other cells that dilute and mask the stem cells from being detected. This does not allow the quality and potency of the stem cells to be reliably measured. METHODS 63 UCB segments and 10 UCB units plus segments were analyzed for the response of both primitive lympho-hematopoietic and primitive hematopoietic stem cells in both the TNC and MNC fractions. The samples were analyzed using a highly sensitive, standardized and validated adenosine triphosphate (ATP) bioluminescence stem cell proliferation assay verified against the colony-forming unit (CFU) assay. Dye exclusion and metabolic viability were also determined. RESULTS Regardless of whether the cells were derived from a segment or unit, the TNC fraction always produced a significantly lower and more variable stem cell response than that derived from the MNC fraction. Routine dye exclusion cell viability did not correspond with metabolic viability and stem cell response. Paired UCB segments produced highly variable results, and the UCB segment did not produce similar results to the unit. DISCUSSION The TNC fraction underestimates the ability and capacity of the stem cells in both the UCB segment and unit and therefore provides an erroneous interpretation of the of the results. Dye exclusion viability can result in false positive values, when in fact the stem cells may be dead or incapable of proliferation. The difference in response between the segment and unit calls into question the ability to use the segment as a representative sample of the UCB unit. It is apparent that present UCB processing and testing methods are inadequate to properly determine the quality and potency of the unit for release and use in a patient.
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Affiliation(s)
- John Patterson
- />Beth-Ell College of Nursing and Health Science, University of Colorado at Colorado Springs, Colorado Springs, Colorado USA
| | - Cally H Moore
- />Department of Biological Engineering, University of Colorado, Boulder, Colorado USA
| | - Emily Palser
- />Department of Biology, University of Colorado at Colorado Springs, Colorado Springs, Colorado USA
| | - Jason C Hearn
- />HemoGenix, Inc, 1485 Garden of the Gods Road, Suite 152, Colorado Springs, CO 80906 USA
| | - Daniela Dumitru
- />HemoGenix, Inc, 1485 Garden of the Gods Road, Suite 152, Colorado Springs, CO 80906 USA
| | - Holli A Harper
- />HemoGenix, Inc, 1485 Garden of the Gods Road, Suite 152, Colorado Springs, CO 80906 USA
| | - Ivan N Rich
- />HemoGenix, Inc, 1485 Garden of the Gods Road, Suite 152, Colorado Springs, CO 80906 USA
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15
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Cord blood collection and banking from a population with highly diverse geographic origins increase HLA diversity in the registry and do not lower the proportion of validated cord blood units: experience of the Marseille Cord Blood Bank. Bone Marrow Transplant 2015; 50:531-5. [PMID: 25621799 DOI: 10.1038/bmt.2014.314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 10/09/2014] [Accepted: 11/29/2014] [Indexed: 12/11/2022]
Abstract
Several Cord Blood (CB) Bank studies suggested that ethnicity impaired CB unit (CBU) qualification. The Bone Marrow Donors Worldwide registries present an over-representation of unrelated donors (UD) from Northwestern European descent. This raises the question of equality of access to hematopoietic stem cells transplant, especially in the Mediterranean zone, which has taken in many waves of immigration. The aim of our study is to address whether, in the Marseille CB Bank, CBU qualification rate is impaired by geographic origin. The study compared biological characteristics of 106 CBU disqualified for total nucleated cell (TNC) count (dCBU) and 136 qualified CBU in relation to registry enrichment and haplotype origin. A high proportion (>80%) of both dCBU and CBU had at least one non-European haplotype and enrich CB and UD registries to a higher extent than those with two European haplotypes (P<0.001). No difference was observed between TNC count and volume according to geographic origin. Our study shows that diverse Mediterranean origins do not have an impact on the CBU qualification rate. Partnership with Mediterranean birth clinics with highly trained staff is a reasonable option to increase the HLA diversity of CB Bank inventories and to improve the representation of minorities.
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16
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Navarrete C. Cord Blood Banking. CORD BLOOD STEM CELLS AND REGENERATIVE MEDICINE 2015. [PMCID: PMC7150031 DOI: 10.1016/b978-0-12-407785-0.00015-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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17
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Bijou F, Ivanovic Z, Fizet D, Dazey B, Boiron JM, Lafarge X. Neonatal sex and weight influence CD34(+) cell concentration in umbilical cord blood but not stromal cell-derived factor 1-3'A polymorphism. Cytotherapy 2015; 17:68-72. [PMID: 25446160 DOI: 10.1016/j.jcyt.2014.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 06/30/2014] [Accepted: 09/23/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Umbilical cord blood (UCB) has been used as an alternative source of donor hematopoietic stem cells for hematologic transplant setting over the past decade. This study attempted to evaluate potential predictors of cord blood quality. METHODS A total of 750 UCB samples were studied (male, n = 365; female, n = 385). The impact of neonatal sex, weight and stromal cell-derived factor-1α polymorphism on the quality of these UCB samples was investigated. RESULTS Male neonatal UCB was significantly richer in CD34(+) cells than was female UCB (P < 0.001), whereas female UCB was richer in total nucleated cells (P = 0.01). There was a slight correlation between CD34(+) cells concentration and UCB sample weight (P < 0.01) that could be attributed to the higher weight of male neonates. The use of tetra-polymerase chain reaction to detect stromal cell-derived factor-1α polymorphisms in 180 neonates revealed no differences between A/A, G/G and A/G allelic combinations. CONCLUSIONS These data emphasize the lack of predictive factors for CD34(+) cells and total nucleated cell concentrations in UCB samples before processing.
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Affiliation(s)
- Fontanet Bijou
- Etablissement Français du Sang Aquitaine-Limousin, Bordeaux, France.
| | - Zoran Ivanovic
- Etablissement Français du Sang Aquitaine-Limousin, Bordeaux, France
| | - Dominique Fizet
- Etablissement Français du Sang Aquitaine-Limousin, Bordeaux, France
| | - Bernard Dazey
- Etablissement Français du Sang Aquitaine-Limousin, Bordeaux, France
| | | | - Xavier Lafarge
- Etablissement Français du Sang Aquitaine-Limousin, Bordeaux, France
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18
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Akyurekli C, Chan JY, Elmoazzen H, Tay J, Allan DS. Impact of ethnicity on human umbilical cord blood banking: a systematic review. Transfusion 2014; 54:2122-7. [DOI: 10.1111/trf.12630] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 01/09/2014] [Accepted: 01/13/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Celine Akyurekli
- Blood and Marrow Transplant Program; Department of Medicine; University of Ottawa; Ottawa Ontario Canada
- Regenerative Medicine; Ottawa Hospital Research Institute; Ottawa Ontario Canada
| | - Joshua Y.S. Chan
- Blood and Marrow Transplant Program; Department of Medicine; University of Ottawa; Ottawa Ontario Canada
| | - Heidi Elmoazzen
- National Public Cord Blood Bank; Canadian Blood Services; Ottawa Ontario Canada
| | - Jason Tay
- Blood and Marrow Transplant Program; Department of Medicine; University of Ottawa; Ottawa Ontario Canada
- Clinical Epidemiology Programs; Ottawa Hospital Research Institute; Ottawa Ontario Canada
| | - David S. Allan
- Blood and Marrow Transplant Program; Department of Medicine; University of Ottawa; Ottawa Ontario Canada
- Regenerative Medicine; Ottawa Hospital Research Institute; Ottawa Ontario Canada
- National Public Cord Blood Bank; Canadian Blood Services; Ottawa Ontario Canada
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19
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Jamali M, Atarodi K, Nakhlestani M, Abolghasemi H, Sadegh H, Faranoosh M, Golzade K, Fadai R, Niknam F, Zarif MN. Cord blood banking activity in Iran National Cord Blood Bank: a two years experience. Transfus Apher Sci 2014; 50:129-35. [PMID: 24262492 DOI: 10.1016/j.transci.2013.09.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Revised: 09/09/2013] [Accepted: 09/30/2013] [Indexed: 10/26/2022]
Abstract
Today umbilical cord blood (UCB) has known as a commonly used source of hematopoietic stem cells for allogeneic transplantation and many cord blood banks have been established around the world for collection and cryopreservation of cord blood units. Herein, we describe our experience at Iran National Cord Blood Bank (INCBB) during 2 years of activity. From November 2010 to 2012, UCBs were collected from 5 hospitals in Tehran. All the collection, processing, testing, cryopreservation and storage procedures were done according to standard operation procedures. Total nucleated cells (TNC) count, viability test, CD34+ cell count, colony forming unit (CFU) assay, screening tests and HLA typing were done on all banked units. Within 3770 collected units, only 32.9% fulfilled banking criteria. The mean volume of units was 105.2 ml and after volume reduction the mean of TNC, viability, CD34+ cells and CFUs was 10.76×10(8), 95.2%, 2.99×10(6) and 7.1×10(5), respectively. One unit was transplanted at Dec 2012 to a 5-year old patient with five of six HLA compatibilities. In our country banking of UCB is new and high rate of hematopoietic stem cell transplants needs expanding CB banks capacity to find more matching units, optimization of methods and sharing experiences to improve biological characterization of units.
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Affiliation(s)
- Mostafa Jamali
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran; Iran National Cord Blood Bank, Iran Blood Transfusion Organization, Tehran, Iran
| | - Kamran Atarodi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran; Iran National Cord Blood Bank, Iran Blood Transfusion Organization, Tehran, Iran
| | - Mozhdeh Nakhlestani
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran; Iran National Cord Blood Bank, Iran Blood Transfusion Organization, Tehran, Iran
| | - Hasan Abolghasemi
- Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hosein Sadegh
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Mohammad Faranoosh
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Khadije Golzade
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran; Iran National Cord Blood Bank, Iran Blood Transfusion Organization, Tehran, Iran
| | - Razieh Fadai
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Fereshte Niknam
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran; Iran National Cord Blood Bank, Iran Blood Transfusion Organization, Tehran, Iran
| | - Mahin Nikougoftar Zarif
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran; Iran National Cord Blood Bank, Iran Blood Transfusion Organization, Tehran, Iran.
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20
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Magalon J, Gamerre M, Picard C, Chabannon C. Increase the quality of banked cord blood units without limiting HLA diversity: how cord blood banks could face this dilemma. Transfusion 2014; 54:495-6. [PMID: 24517133 DOI: 10.1111/trf.12439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jeremy Magalon
- Cell Therapy Facility, Institut Paoli-Calmettes, Cord Blood Bank, Inserm CBT-510, Centre d'Investigations Cliniques en Biothérapie, Marseille, France.
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21
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Page KM, Mendizabal A, Betz-Stablein B, Wease S, Shoulars K, Gentry T, Prasad VK, Sun J, Carter S, Balber AE, Kurtzberg J. Optimizing donor selection for public cord blood banking: influence of maternal, infant, and collection characteristics on cord blood unit quality. Transfusion 2014; 54:340-52. [PMID: 23711284 PMCID: PMC3766489 DOI: 10.1111/trf.12257] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 04/07/2013] [Accepted: 04/09/2013] [Indexed: 01/18/2023]
Abstract
BACKGROUND Banked unrelated donor umbilical cord blood (CB) has improved access to hematopoietic stem cell transplantation for patients without a suitably matched donor. In a resource-limited environment, ensuring that the public inventory is enriched with high-quality cord blood units (CBUs) addressing the needs of a diverse group of patients is a priority. Identification of donor characteristics correlating with higher CBU quality could guide operational strategies to increase the yield of banked high-quality CBUs. STUDY DESIGN AND METHODS Characteristics of 5267 CBUs donated to the Carolinas Cord Blood Bank, a public bank participating in the National Cord Blood Inventory, were retrospectively analyzed. Eligible CBUs, collected by trained personnel, were processed using standard procedures. Routine quality and potency metrics (postprocessing total nucleated cell count [post-TNCC], CD34+, colony-forming units [CFUs]) were correlated with maternal, infant, and collection characteristics. RESULTS High-quality CBUs were defined as those with higher post-TNCC (>1.25 × 10(9)) with CD34+ and CFUs in the upper quartile. Factors associated with higher CD34+ or CFU content included a shorter interval from collection to processing (<10 hr), younger gestational age (34-37 weeks; CD34+ and CFUs), Caucasian race, higher birthweight (>3500 g), and larger collection volumes (>80 mL). CONCLUSIONS We describe characteristics identifying high-quality CBUs, which can be used to inform strategies for CBU collection for public banks. Efforts should be made to prioritize collections from larger babies born before 38 weeks of gestation. CBUs should be rapidly transported to the processing laboratory. The lower quality of CBUs from non-Caucasian donors highlights the challenges of building a racially diverse public CB inventory.
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Affiliation(s)
- Kristin M. Page
- Robertson Cell and Translational Therapy Program, Carolinas Cord Blood Bank, Duke University Medical Center, Durham, NC 27705
| | | | | | | | - Kevin Shoulars
- Robertson Cell and Translational Therapy Program, Carolinas Cord Blood Bank, Duke University Medical Center, Durham, NC 27705
| | - Tracy Gentry
- Robertson Cell and Translational Therapy Program, Carolinas Cord Blood Bank, Duke University Medical Center, Durham, NC 27705
| | - Vinod K. Prasad
- Robertson Cell and Translational Therapy Program, Carolinas Cord Blood Bank, Duke University Medical Center, Durham, NC 27705
| | - Jessica Sun
- Robertson Cell and Translational Therapy Program, Carolinas Cord Blood Bank, Duke University Medical Center, Durham, NC 27705
| | | | - Andrew E. Balber
- Robertson Cell and Translational Therapy Program, Carolinas Cord Blood Bank, Duke University Medical Center, Durham, NC 27705
| | - Joanne Kurtzberg
- Robertson Cell and Translational Therapy Program, Carolinas Cord Blood Bank, Duke University Medical Center, Durham, NC 27705
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22
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Magalon J, Billard-Daufresne LM, Gilbertas C, Hermanche E, Simon S, Lemarie C, Calmels B, Sabatier F, Gamerre M, Picard C, Chabannon C. Assessing the HLA diversity of cord blood units collected from a birth clinic caring for pregnant women in an ethnically diverse metropolitan area. Transfusion 2013; 54:1046-54. [PMID: 23944705 DOI: 10.1111/trf.12379] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 06/26/2013] [Accepted: 06/28/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND New strategies are emerging in cord blood banking where focusing on birth clinics caring for a high number of mothers belonging to ethnic minorities could offer new possibilities for allotransplantation both for patients of European origin and for patients from ethnic minorities or mixed ancestries. STUDY DESIGN AND METHODS Marseilles Cord Blood Bank works with one university birth clinic caring for a culturally and sociologically diverse population. Stringent French legal restrictions apply to recording the geographic origin of parents. To circumvent this limitation and evaluate the contribution of newly banked cord blood units (CBUs) to increasing HLA diversity, we applied an algorithm that allows for the determination of parents' putative haplotypes and thus grossly deduce information on their ancestry. Generic resolution HLA-A, HLA-B, and allelic resolution HLA-DRB1 genotyping for 328 CBUs and 2691 unrelated donors (UDs) between January 2009 and May 2012 were performed. Enrichment from international CBU registry with nonreferenced generic HLA-A, HLA-B, and allelic HLA-DRB1 phenotypes was compared between CBUs identified with one or two non-European haplotypes and CBUs identified with two European haplotypes. RESULTS Marseilles CBUs display an increased proportion of HLA antigens frequently expressed in African populations compared to UDs. Whereas 93% of 199 CBUs identified with one or two non-European haplotypes enrich international CBU registry, this result is reduced to 42% for the 129 CBUs identified with two European haplotypes. CONCLUSION This study supports a new method to assess HLA diversity. However, such an increased of HLA diversity raises questions about frequencies of CBUs released and clinical relevance from their uses.
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Affiliation(s)
- Jeremy Magalon
- Cell Therapy Facility, Institut Paoli-Calmettes, Marseille; Cord Blood Bank, Marseille; Inserm CBT-510, Centre d'Investigations Cliniques en Biothérapie, Marseille
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23
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Al-Sweedan SA, Musalam L, Obeidat B. Factors predicting the hematopoietic stem cells content of the umbilical cord blood. Transfus Apher Sci 2013; 48:247-52. [DOI: 10.1016/j.transci.2013.01.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2012] [Revised: 10/23/2012] [Accepted: 01/10/2013] [Indexed: 10/27/2022]
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24
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Abdul Wahid FS, Nasaruddin MZ, Mohd Idris MR, Tusimin M, Tumian NR, Abdullah Mahdy Z. Effects of preeclampsia on the yield of hematopoietic stem cells obtained from umbilical cord blood at delivery. J Obstet Gynaecol Res 2012; 38:490-7. [DOI: 10.1111/j.1447-0756.2011.01740.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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25
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Rosenau EH, Sugrue MW, Haller M, Fisk D, Kelly SS, Chang M, Hou W, Eldjerou L, Slayton W, Cogle CR, Wingard JR. Characteristics of thawed autologous umbilical cord blood. Transfusion 2012; 52:2234-42. [DOI: 10.1111/j.1537-2995.2011.03556.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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Omori A, Hirai M, Chiba T, Takahashi K, Yamaguchi S, Takahashi TA, Kashiwakura I. Quality-assessments of characteristics of placental/umbilical cord blood associated with maternal age- and parity-related factor. Transfus Apher Sci 2011; 46:7-13. [PMID: 22192902 DOI: 10.1016/j.transci.2011.10.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Revised: 10/26/2011] [Accepted: 10/26/2011] [Indexed: 11/20/2022]
Abstract
Umbilical cord blood (CB) has been widely used for unrelated allogeneic stem cell transplantation. It is important to determine the quality of CB units to avoid frequent problem of limited cell yields. However, no practical and/or optimum obstetric factors to predict them are yet available. This study analyzed the relationship between maternal/neonatal obstetric factors and the laboratory parameters of CB units to identify the optimum factors associated with a high yield of total nucleated cells (TNC). Primiparae in their early 30s may be one of the first selection criteria for CB donors to obtain higher yield of TNC.
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Affiliation(s)
- Atsuko Omori
- Department of Radiological Life Sciences, Division of Medical Life Sciences, Hirosaki University Graduate School of Health Sciences, 66-1 Hon-cho, Hirosaki 036-8564, Japan
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27
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Valéria Santos S, Marti L, Ribeiro AAF, Conti F, Barros SM. A cross-sectional study of umbilical cord blood donor profiles and their influence on umbilical cord blood collection in a Brazilian hospital. Cytotherapy 2011; 13:1120-7. [DOI: 10.3109/14653249.2011.598145] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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28
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Carilli AR, Sugrue MW, Rosenau EH, Chang M, Fisk D, Medei-Hill M, Williams K, Wiggins L, Wingard JR. African American adult apheresis donors respond to granulocyte-colony-stimulating factor with neutrophil and progenitor cell yields comparable to those of Caucasian and Hispanic donors. Transfusion 2011; 52:166-72. [DOI: 10.1111/j.1537-2995.2011.03253.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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29
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Lee HR, Park JS, Shin S, Roh EY, Yoon JH, Han KS, Kim BJ, Storms RW, Chao NJ. Increased numbers of total nucleated and CD34+ cells in blood group O cord blood: an analysis of neonatal innate factors in the Korean population. Transfusion 2011; 52:76-81. [PMID: 21790633 DOI: 10.1111/j.1537-2995.2011.03262.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND We analyzed neonatal factors that could affect hematopoietic variables of cord blood (CB) donated from Korean neonates. STUDY DESIGN AND METHODS The numbers of total nucleated cells (TNCs), CD34+ cells, and CD34+ cells/TNCs of CB in neonates were compared according to sex, gestational age, birth weight, birth weight centile for gestational age, and ABO blood group. RESULTS With 11,098 CB units analyzed, blood group O CB showed an increased number of TNCs, CD34+ cells, and CD34+ cells/TNCs compared with other blood groups. Although TNC counts were lower in males, no difference in the number of CD34+ cells was demonstrated because the number of CD34+ cells/TNCs was higher in males. An increase in the gestational age resulted in an increase in the number of TNCs and decreases in the number of CD34+ cells and CD34+ cells/TNCs. The numbers of TNCs, CD34+ cells, and CD34+ cells/TNCs increased according to increased birth weight centile as well as birth weight. CONCLUSION CB with blood group O has unique hematologic variables in this large-scale analysis of Korean neonates, although the impact on the storage policies of CB banks or the clinical outcome of transplantation remains to be determined.
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Affiliation(s)
- Hye Ryun Lee
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
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Delaney C, Ratajczak MZ, Laughlin MJ. Strategies to enhance umbilical cord blood stem cell engraftment in adult patients. Expert Rev Hematol 2011; 3:273-83. [PMID: 20835351 DOI: 10.1586/ehm.10.24] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Umbilical cord blood (UCB) has been used successfully as a source of hematopoietic stem cells (HSCs) for allogeneic transplantation in children and adults in the treatment of hematologic diseases. However, compared with marrow or mobilized peripheral blood stem cell grafts from adult donors, significant delays in the rates and kinetics of neutrophil and platelet engraftment are noted after UCB transplant. These differences relate in part to the reduced numbers of HSCs in UCB grafts. To improve the rates and kinetics of engraftment of UCB HSC, several strategies have been proposed, including ex vivo expansion of UCB HSCs, addition of third-party mesenchymal cells, intrabone delivery of HSCs, modulation of CD26 expression, and infusion of two UCB grafts. This article will focus on ex vivo expansion of UCB HSCs and strategies to enhance UCB homing as potential solutions to overcome the problem of low stem cell numbers in a UCB graft.
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Affiliation(s)
- Colleen Delaney
- Fred Hutchinson Cancer Research Center, Mailstop D2-100, 1100 Fairview Ave N, PO Box, 9024, Seattle, WA 98109, USA
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Urbaniak Hunter K, Yarbrough C, Ciacci J. Stem cells in the treatment of stroke. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2010; 671:105-16. [PMID: 20455499 DOI: 10.1007/978-1-4419-5819-8_9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Stroke is an often devastating insult resulting in neurological deficit lasting greater than 24 hours. In the United States, stroke is the third leading cause of death. In those who do not succumb, any outcome from total recovery over a period of weeks to months to persistent profound neurological deficits is possible. Present treatment centers on the decision to administer tissue plasminogen activator, subsequent medical stabilization and early intervention with rehabilitation and risk factor management. The advent of stem cell therapy presents an exciting new frontier for research in stroke treatment, with the potential to cause a paradigm shift from symptomatic control and secondary prevention to reconstitution of neural networks and prevention of neuronal cell death after neurologic injury.
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Affiliation(s)
- Klaudia Urbaniak Hunter
- University of Michigan, Department of Radiation Oncology, UH B2C490, 1500 E. Medical Center Dr., Ann Arbor, Michigan, USA.
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Juutistenaho S, Eskola M, Sainio S, Aranko K, Kekomäki R. TRANSPLANTATION AND CELLULAR ENGINEERING: Association of stress-related perinatal factors and cord blood unit hematopoietic progenitors is dependent on delivery mode. Transfusion 2009; 50:663-71. [DOI: 10.1111/j.1537-2995.2009.02467.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Takebe N, Gage F, Cheng X, Lauw MIS. Preliminary findings on the use of pulsatile machine reperfusion of a placenta to improve the cord blood collection yield including primitive hematopoietic stem cell fractions. Transfusion 2009; 49:1911-6. [PMID: 19497058 DOI: 10.1111/j.1537-2995.2009.02227.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Umbilical cord blood (CB) use is limited in most adults since the mean amount of hematopoietic stem cells (HSCs) collected is generally insufficient to engraft successfully. This study demonstrates for the first time the feasibility of pulsatile machine placenta reperfusion (PMPR), which significantly improves CB collection quantity and quality compared to standard collection methods. STUDY DESIGN AND METHODS PMPR was performed on eight delivered placentas up to 39 hours after venipuncture-based collection. PMPR was performed on average for 26 (20-30) minutes, 17 hours after delivery (6.25-39), using perfusate approved for donated organ reperfusion. Both PMPR and conventional collection-derived CB cells were analyzed using immunophenotyping and colony assays. RESULTS The combination of PMPR and the conventional venipuncture method yielded a mean of 1.5-, 4.9-, 11-, 7.5-, 7.5-, and 7.7-fold increased number of total mononuclear, CD34+, CD34+/CD38-, CD133+, CD133+/CD34+, and CD133+/CD34- cells, respectively, compared to conventional venipuncture alone. CB cells obtained by PMPR alone generally demonstrated a significant increase in percentages of primitive HSC phenotype with equivalent cell viability between PMPR and venipuncture. CONCLUSION This article demonstrates for the first time that CB can be collected up to 39 hours after delivery with PMPR while maximizing CB collection including HSCs with primitive phenotypes.
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Affiliation(s)
- Naoko Takebe
- Greenebaum Cancer Center and Pharmacology and Experimental Therapeutics, University of Maryland School of Medicine, Baltimore, Maryland, USA.
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Omori A, Takahashi K, Hazawa M, Misaki N, Ohba H, Manabe M, Sato H, Kudo K, Takahashi TA, Kashiwakura I. Maternal and neonatal factors associated with the high yield of mononuclear low-density/CD34+ cells from placental/umbilical cord blood. TOHOKU J EXP MED 2008; 215:23-32. [PMID: 18509232 DOI: 10.1620/tjem.215.23] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Placental/umbilical cord blood (CB) contains nucleated cells and hematopoietic stem/progenitor cells (CD34(+) cells). However it is difficult to predict the number of nucleated/CD34(+) cells in each CB before cell processing. Despite many previous studies from institutes affiliated with CB banks in metropolitan areas, little information is available regarding the characteristics of CB units from other medical facilities. The purpose of the present study was to analyze the maternal/neonatal factors on the yield of cells in CB units. A total of 176 CB units were obtained from single-birth and normal vaginal deliveries. Mononuclear low-density (LD) cells were separated using Ficoll-Paque within 24 hrs after CB collection and then processed for the purification of CD34(+) cells. A multiple linear regression analysis was performed to assess the correlations between the yield of cells and maternal/neonatal factors including maternal age, gravid status, duration of labor, gestational age, neonatal height and weight, cord length, and meconium in the amniotic fluid. The total LD cells per CB unit had a weak positive correlation with the maternal age of primigravidae. The total LD cells per CB unit from the primigravidae aged > or = 25 were significantly higher than those from the primigravidae aged < or = 24. The total CD34(+) cells per CB unit from the 1-gravidae were significantly higher than those from the 2-gravidae and 3-gravidae, respectively among all donors. These results indicate that the CB units from the primigravidae aged > or = 25 are more likely to contain higher yield of LD/CD34(+) cells.
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Affiliation(s)
- Atsuko Omori
- Department of Radiological Life Sciences, Division of Medical Life Sciences, Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
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López MC, Lawrence DA. Proficiency testing experience for viable CD34+ stem cell analysis. Transfusion 2008; 48:1115-21. [DOI: 10.1111/j.1537-2995.2008.01652.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Manegold G, Meyer-Monard S, Tichelli A, Pauli D, Holzgreve W, Troeger C. Cesarean section due to fetal distress increases the number of stem cells in umbilical cord blood. Transfusion 2008; 48:871-6. [DOI: 10.1111/j.1537-2995.2007.01617.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
PURPOSE OF REVIEW Umbilical cord haematopoietic stem cell transplantation for primary immunodeficiencies is examined with other developments in treatment. Cord blood biology is reviewed, and advantages and disadvantages of umbilical cord blood stem cell transplantation for primary immunodeficiencies discussed. Clinical outcome data and future developments are reviewed. RECENT FINDINGS Cord blood T lymphocytes become tolerant to host human leukocyte antigen antigens, but retain alloreactivity to other antigens, in part due to immaturity of cord blood T lymphocytes and dendritic cells. Although naïve T lymphocytes can generate herpes virus specificity after transplantation, the risk of viral death is increased within the first 100 days. The clinical success of umbilical cord blood stem cell transplantation for primary immunodeficiencies is reviewed and new methods for expanding the stem cell number or encouraging engraftment with the use of third-party haematopoietic or mesenchymal stem cells examined. SUMMARY Many advantages make umbilical cord blood an attractive source of stem cells; over 100 umbilical cord blood stem cell transplantations have been performed for primary immunodeficiencies, with low rates of significant graft vs. host disease, despite significant human leukocyte antigen mismatch. Immune reconstitution is as good as for other stem cell sources: use of nascent stem cells in young recipients may have long-term advantages. Stem cell engineering to improve engraftment will expand potential beneficiaries of umbilical cord blood stem cell transplantation to older patients.
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Chaudhuri A, Hollands P, Bhattacharya N. Placental umbilical cord blood transfusion in acute ischaemic stroke. Med Hypotheses 2007; 69:1267-71. [DOI: 10.1016/j.mehy.2007.01.091] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2006] [Accepted: 01/02/2007] [Indexed: 11/26/2022]
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