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Muthu B, Manivannan P, Subbaiah M, Vanju S, Basavarajegowda A. Effect of fetal distress on viability and yield of umbilical cord blood stem cells-a prospective comparative study. Hematol Transfus Cell Ther 2024:S2531-1379(24)00221-9. [PMID: 38763843 DOI: 10.1016/j.htct.2024.03.004] [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: 04/12/2023] [Revised: 02/06/2024] [Accepted: 03/04/2024] [Indexed: 05/21/2024] Open
Abstract
INTRODUCTION Different factors affect the quality and viability of cord blood stem cells, and therefore the efficacy of umbilical cord stem cell transplantation. Fetal distress is one factor affecting the quantity of CD34+ cells in cord blood. This study was designed to compare the viability and yield of the umbilical cord blood stem cells of women who have undergone emergency lower segment caesarean section for fetal distress or for other causes. MATERIALS AND METHODS This cross-sectional analytical study was performed at a tertiary care hospital facility with a total sample size of 68: 34 participants had undergone emergency C-section for fetal distress, and 34 had undergone emergency C-section for other causes. Umbilical cord blood was collected ex-utero in a 350 mL bag with citrate-phosphate-dextrose solution with adenine. Three milliliter of blood were transferred to an ethylenediaminetetraacetic acid (EDTA) tube for cell counts and flow cytometry testing for CD34+. The chi-square test was used to compare the total mononuclear cell, CD34+, and viability between the groups. RESULTS The CD34+ count [mean 4.9 versus 1.1 (× 106 cells/unit)] and total nucleated cell count [mean 14.2 versus 7.5 (× 108/unit)] were significantly higher in cord blood units collected from women who delivered by C-section for fetal distress (p-value <0.05). However, the volume of umbilical cord stem cells and viability of stem cells did not vary significantly based on the presence or absence of fetal distress (p-value >0.05). CONCLUSION The current study shows that umbilical cord blood collected during fetal distress has a significantly higher content of stem cells and total nucleated cells than the non-fetal distress group.
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Affiliation(s)
- Bharathi Muthu
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Prabhu Manivannan
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Murali Subbaiah
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Shreya Vanju
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Korkor MS, Khashaba M, Mohamed SA, Darwish A. Effect of different timings of umbilical cord clamping on the level of CD34 + cells in full-term neonates. Sci Rep 2023; 13:22917. [PMID: 38129640 PMCID: PMC10739938 DOI: 10.1038/s41598-023-50100-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023] Open
Abstract
Despite the fact that delayed cord clamping (DCC) is recommended by many international organizations, early cord clamping is still widely practiced worldwide. The overarching goal of the DCC practice is to maximize neonatal benefits as achieving higher hemoglobin levels and decreasing the incidence of anemia as well as avoiding the adverse consequences. The current study was conducted to identify the effect of of DCC on the number of CD34+ stem cells in cord blood of full term neonates after two different timings (30 and 60 s after birth). One hundred and three full-term (FT) newborn babies (gestational age 37-40 weeks) delivered by elective cesarean section were randomly assigned into 2 groups: Group 1: babies were subjected to DCC 30 s after birth (50 newborns). Group 2: babies were subjected to DCC 60 s after birth (53 newborns). Neonates in group 2 had significantly higher levels of hemoglobin, hematocrit, total nucleated cells and CD34+ cells compared to those in group 1. The practice of DCC 60 s after birth achieved better CD34+ stem cells transfer in FT neonates than clamping the cord after 30 s.
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Affiliation(s)
- Mai S Korkor
- Pediatric Department, Mansoura University Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | - Mohamed Khashaba
- Neonatology Unit, Pediatric Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Sara A Mohamed
- Obstetric and Gynecology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
- Mansoura Research Center for Cord Stem Cells (MARC-CSC), Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmad Darwish
- Mansoura Research Center for Cord Stem Cells (MARC-CSC), Faculty of Medicine, Mansoura University, Mansoura, Egypt
- Hematology/Oncology/Bone Marrow Transplantation Unit, Pediatric Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Farina-Eckhardt P, Granado C, Mueller-Borer D, Schötzau A, Tsakiris DA, Hösli I, Manegold-Brauer G. [Harvest of Stem Cells from Umbilical Cord Blood: Relevance of Perinatal Factors for the Quality of Umbilical Cord Transplant Units]. Z Geburtshilfe Neonatol 2021; 226:129-135. [PMID: 34571542 PMCID: PMC9270104 DOI: 10.1055/a-1642-1234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Einleitung
Nabelschnurblut (NSB) enthält hämatopoetische
Stammzellen mit therapeutischem Potenzial und einzigartigen zellulären
Eigenschaften. Aufgrund der begrenzten Anzahl an Stammzellen im NSB
(Surrogatmarker total nucleated cells, TNC) eignet sich nur jede fünfte
Spende für eine Transplantation. Ziel dieser Studie war es, zu
untersuchen, ob prädiktive Faktoren für eine TNC-Zahl
über der 99. Perzentile existieren.
Material und Methodik
Retrospektive Datenanalyse der 100
größten NSB-Spenden (Top100-Kohorte) aus 2299 registrierten
Einheiten. Unterschiede zwischen maternalen, fetalen und geburtshilflichen
Faktoren wurden analysiert und mit einer standardisierten Kohorte von 731
NSB-Spenden verglichen.
Ergebnisse
Das mütterliche Alter und der BMI in der Top100-Kohorte
waren höher als in der Vergleichskohorte (32 vs. 31 Jahre,
p=0,007; 30 kg/m2 vs. 29 kg/m2,
p=0,024). Es gab mehr Erstgebärende (76,0 vs. 62,8%,
p=0,013) und Gestationsdiabetikerinnen (5,00 vs. 1,65%,
p=0,044). Die Schwangerschaftswoche, das Geburtsgewicht, der Anteil
vaginal-operativer Geburten und sekundärer Sectiones war in der
Top100-Kohorte höher (40+4 vs. 40+1 SSW,
p=0,002), (3700 vs. 3450 g, p<0,001), (53,0 vs.
22,7%, p<0,001) (10 vs. 6,2%, p=0,014).
Fazit
Für eine erfolgreiche Transplantation ist die Höhe
der TNC-Zahl entscheidend. Vaginal-operative Entbindungen, sekundäre
Sectiones und ein Geburtsgewicht über 3700 g sind
günstige Faktoren. Gerade bei Geburten mit einem pathologischen Verlauf
sollte nach sicherer Versorgung von Mutter und Kind nicht auf eine Entnahme
verzichtet werden.
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Affiliation(s)
- Patricia Farina-Eckhardt
- Klinik für Geburtshilfe und Schwangerschaftsmedizin, Frauenklinik, Universitätsspital Basel, Basel, Schweiz
| | - Cristina Granado
- Klinik für Geburtshilfe und Schwangerschaftsmedizin, Frauenklinik, Universitätsspital Basel, Basel, Schweiz
| | - Doris Mueller-Borer
- Klinik für Geburtshilfe und Schwangerschaftsmedizin, Frauenklinik, Universitätsspital Basel, Basel, Schweiz
| | | | | | - Irene Hösli
- Klinik für Geburtshilfe und Schwangerschaftsmedizin, Frauenklinik, Universitätsspital Basel, Basel, Schweiz
| | - Gwendolin Manegold-Brauer
- Klinik für Geburtshilfe und Schwangerschaftsmedizin, Frauenklinik, Universitätsspital Basel, Basel, Schweiz
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Antenatal predictors of stem cell content for successful umbilical cord blood donation. Arch Gynecol Obstet 2021; 304:377-384. [PMID: 33590333 PMCID: PMC8277615 DOI: 10.1007/s00404-021-05970-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 01/12/2021] [Indexed: 12/03/2022]
Abstract
Purpose The most important HLA-independent factor for the selection of cord blood units (CBU) for hematopoietic stem cell transplantation is the total nucleated cell (TNC) count over 150 × 107 as a surrogate marker for stem cell content. The purpose of this prospective study was to define prenatal clinical predictors for TNC count that would help to identify successful CBU donors before the onset of active labor. Methods This was a prospective analysis of 594 CBUs, collected from all eligible term singleton pregnancies at Basel University Hospital between 4/2015 and 9/2016 analyzing several maternal and fetal factors. The impact of these factors on TNC count (< 150 × 107 cells vs. ≥ 150 × 107 cells) of the CBUs was modeled in a multivariate analysis. Results A total of 114 (19.2%) CBUs had a TNC count of ≥ 150 × 107. In a ROC analysis there was no significant difference between the AUC of all prenatal factors (AUC 0.62) and estimated fetal birth weight by ultrasound alone (AUC 0.62). For women planning a trial of labor a recruitment cut-off at an estimated birth weight of 3300 g would allow 72.6% of all donors with sufficient TNC count to be recruited and 22.8% of all collected CBUs would have a sufficient TNC count for banking. For women planning for elective CS a cut-off of 3400 g would allow 71.4% of all donors with sufficient TNC count to be recruited and 22.7% of all collected CBUs would have sufficient TNC count for banking. Conclusion The estimated fetal birth weight within 2 weeks of delivery by ultrasound as single parameter can be considered at the time of recruitment to estimate the chances of a successful CBU donation.
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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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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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de Jamblinne Y, Baudoux E, Delo C, Coppieters Y. [Influence of obstetric factors on characteristics of umbilical cord blood transplants]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2018; 46:639-644. [PMID: 30122365 DOI: 10.1016/j.gofs.2018.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVES There is a correlation between the success of the cord blood transplant and the numbers of HSC found in the unit of cord blood donation. The purpose of this analysis is to identify obstetric factors that may influence the quality of a cord blood unit taken during delivery. METHODS A retrospective study was carried out at the Liège cord blood bank on a sample of 7.463 cord blood units collected between 2000 and 2016. Eight obstetric factors were analyzed in relation to two dependent variables; the total nucleated cells (TNC) and the volume of one unit of cord blood. The Welch test, the percentiles 25 and 75 and the non-parametric Mann-Whitney Wilcoxon test were used. RESULTS Several obstetric parameters were found to influence (P<0.05) the quality of the cord blood unit are: cord clamping (>15 seconds), the use of oxytocin during labor, a more advanced gestational age (38-41 weeks), a higher birth weight (>3300 gr), and a higher weight of the placenta (>500 gr). A female newborn and the use of epidural, influence (P<0.05) the number of TNC but not the volume of the cord blood unit. CONCLUSION We can conclude that the birth weight, the weight of the placenta, the gestational age and cord clamping are parameters that could be used by maternity hospitals to identify births that enable more voluminous grafts which are richer in total nucleated cells.
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Affiliation(s)
- Y de Jamblinne
- Centre de recherche Epidémiologie, biostatistique et recherche clinique, École de Santé Publique, Université libre de Bruxelles (ULB), Bruxelles, Belgique.
| | - E Baudoux
- Laboratoire de Thérapie Cellulaire et Génique (LTCG), CHU de Liège, Université de Liège, Liège, Belgique
| | - C Delo
- Centre de recherche Économie de la santé, gestion des institutions de soins et sciences infirmières, École de Santé Publique, Université libre de Bruxelles (ULB), Bruxelles, Belgique
| | - Y Coppieters
- Centre de recherche Epidémiologie, biostatistique et recherche clinique, École de Santé Publique, Université libre de Bruxelles (ULB), Bruxelles, Belgique
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From cord to caudate: characterizing umbilical cord blood stem cells and their paracrine interactions with the injured brain. Pediatr Res 2018; 83:205-213. [PMID: 28981488 DOI: 10.1038/pr.2017.251] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 10/02/2017] [Indexed: 01/01/2023]
Abstract
Stem cells are proving to be a promising therapy for a wide range of pediatric disorders, from neonatal hypoxic-ischemic encephalopathy to pediatric leukemia. Owing to their low immunogenicity and ease of availability, umbilical cord blood (UCB) progenitor cells are increasingly replacing fetal- and adult-derived cells in therapeutic settings. Multiple environmental and demographic factors affect the number and type of stem cells extracted from UCB, and these differences have been associated with disparities in outcomes after transplantation. To avoid variations in efficacy, as well as the potential adverse effects of stem cell transplantation, evaluation of the stem cell secretome is critical to identify key paracrine signals released by the stem cells that could be used to provide similar neuroprotective effects to stem cell transplantation. This article describes the cell types found in UCB and reviews the available literature surrounding the effects of collection timing and volume, maternal risk factors, delivery characteristics, and neonatal demographics on the cellular composition of UCB. In addition, the current findings regarding the stem cell secretome are discussed to identify factors that could be used to supplement or replace stem cell transplantation in pediatric neuroprotection.
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Vanegas D, Triviño L, Galindo C, Franco L, Salguero G, Camacho B, Perdomo-Arciniegas AM. A new strategy for umbilical cord blood collection developed at the first Colombian public cord blood bank increases total nucleated cell content. Transfusion 2017; 57:2225-2233. [PMID: 28653354 DOI: 10.1111/trf.14190] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 05/05/2017] [Accepted: 05/06/2017] [Indexed: 12/16/2023]
Abstract
BACKGROUND The total nucleated cell dosage of umbilical cord blood (UCB) is an important factor in determining successful allogeneic hematopoietic stem cell transplantation after a minimum human leukocyte antigen donor-recipient match. The northern South American population is in need of a new-generation cord blood bank that cryopreserves only units with high total nucleated cell content, thereby increasing the likelihood of use. Colombia set up a public cord blood bank in 2014; and, as a result of its research for improving high total nucleated cell content, a new strategy for UCB collection was developed. STUDY DESIGN AND METHODS Data from 2933 collected and 759 cryopreserved cord blood units between 2014 and 2015 were analyzed. The correlation of donor and collection variables with cellularity was evaluated. Moreover, blood volume, cell content, CD34+ count, clonogenic capacity, and microbial contamination were assessed comparing the new method, which combines in utero and ex utero techniques, with the conventional strategies. RESULTS Multivariate analysis confirmed a correlation between neonatal birth weight and cell content. The new collection method increased total nucleated cell content in approximately 26% and did not alter pre-cryopreservation and post-thaw cell recovery, viability, or clonogenic ability. Furthermore, it showed a remarkably low microbial contamination rate (1.2%). CONCLUSION The strategy for UCB collection developed at the first Colombian public cord blood bank increases total nucleated cell content and does not affect unit quality. The existence of this bank is a remarkable breakthrough for Latin-American patients in need of this kind of transplantation.
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Affiliation(s)
| | | | | | | | - Gustavo Salguero
- Cell Therapy Unit, Instituto Distrital de Ciencia, Biotecnología e Innovación en Salud, Bogotá Distrito Capital, Colombia
| | - Bernardo Camacho
- Cord Blood Bank
- Cell Therapy Unit, Instituto Distrital de Ciencia, Biotecnología e Innovación en Salud, Bogotá Distrito Capital, Colombia
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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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Armson BA, Allan DS, Casper RF. Sang de cordon ombilical : Counseling, prélèvement et mise en banque. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2017; 38:S724-S739. [PMID: 28063576 DOI: 10.1016/j.jogc.2016.09.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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12
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Time related variations in stem cell harvesting of umbilical cord blood. Sci Rep 2016; 6:21404. [PMID: 26906327 PMCID: PMC4764902 DOI: 10.1038/srep21404] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 01/22/2016] [Indexed: 12/15/2022] Open
Abstract
Umbilical cord blood (UCB) contains hematopoietic stem cells and multipotent
mesenchymal cells useful for treatment in malignant/nonmalignant
hematologic-immunologic diseases and regenerative medicine. Transplantation outcome
is correlated with cord blood volume (CBV), number of total nucleated cells (TNC),
CD34+ progenitor cells and colony forming units in UCB donations. Several studies
have addressed the role of maternal/neonatal factors associated with the
hematopoietic reconstruction potential of UCB, including: gestational age, maternal
parity, newborn sex and birth weight, placental weight, labor duration and mode of
delivery. Few data exist regarding as to how time influences UCB collection and
banking patterns. We retrospectively analyzed 17.936 cord blood donations collected
from 1999 to 2011 from Tuscany and Apulia Cord Blood Banks. Results from generalized
multivariable linear mixed models showed that CBV, TNC and CD34+ cell were
associated with known obstetric and neonatal parameters and showed rhythmic patterns
in different time domains and frequency ranges. The present findings confirm that
volume, total nucleated cells and stem cells of the UCB donations are hallmarked by
rhythmic patterns in different time domains and frequency ranges and suggest that
temporal rhythms in addition to known obstetric and neonatal parameters influence
CBV, TNC and CD34+ cell content in UBC units.
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Armson BA, Allan DS, Casper RF. Umbilical Cord Blood: Counselling, Collection, and Banking. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2016; 37:832-844. [PMID: 26605456 DOI: 10.1016/s1701-2163(15)30157-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To review current evidence regarding umbilical cord blood counselling, collection, and banking and to provide guidelines for Canadian health care professionals regarding patient education, informed consent, procedural aspects, and options for cord blood banking in Canada. OPTIONS Selective or routine collection and banking of umbilical cord blood for future stem cell transplantation for autologous (self) or allogeneic (related or unrelated) treatment of malignant and non-malignant disorders in children and adults. Cord blood can be collected using in utero or ex utero techniques. OUTCOMES Umbilical cord blood counselling, collection, and banking, education of health care professionals, indications for cord blood collection, short- and long-term risk and benefits, maternal and perinatal morbidity, parental satisfaction, and health care costs. EVIDENCE Published literature was retrieved through searches of Medline and PubMed beginning in September 2013 using appropriate controlled MeSH vocabulary (fetal blood, pregnancy, transplantation, ethics) and key words (umbilical cord blood, banking, collection, pregnancy, transplantation, ethics, public, private). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date limits, but results were limited to English or French language materials. Searches were updated on a regular basis and incorporated in the guideline to September 2014. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, and national and international medical specialty societies. VALUES The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). BENEFITS, HARMS, AND COSTS Umbilical cord blood is a readily available source of hematopoetic stem cells used with increasing frequency as an alternative to bone marrow or peripheral stem cell transplantation to treat malignant and non-malignant conditions in children and adults. There is minimal harm to the mother or newborn provided that priority is given to maternal/newborn safety during childbirth management. Recipients of umbilical cord stem cells may experience graft-versus-host disease, transfer of infection or genetic abnormalities, or therapeutic failure. The financial burden on the health system for public cord blood banking and on families for private cord blood banking is considerable. Recommendations 1. Health care professionals should be well-informed about cord blood collection and storage and about factors that influence the volume, quality, and ability to collect a cord blood unit. (III-A) 2. Health care professionals caring for women and families who choose private umbilical cord blood banking must disclose any financial interests or potential conflicts of interest. (III-A) 3. Pregnant women should be provided with unbiased information about umbilical cord blood banking options, including the benefits and limitations of public and private banks. (III-A) 4. Health care professionals should obtain consent from mothers for the collection of umbilical cord blood prior to the onset of active labour, ideally during the third trimester, with ample time to address any questions. (III-A) 5. Health care professionals must be trained in standardized procedures (ex utero and in utero techniques) for cord blood collection to ensure the sterility and quality of the collected unit. (II-2A) 6. Umbilical cord blood should be collected with the goal of maximizing the content of hematopoietic progenitors through the volume collected. The decision to bank the unit will depend upon specific measures of graft potency. (II-2A) 7. Umbilical cord blood collection must not adversely affect the health of the mother or newborn. Cord blood collection should not interfere with delayed cord clamping. (III-E) 8. Health care professionals should inform pregnant women and their partners of the benefits of delayed cord clamping and of its impact on cord blood collection and banking. (II-2A) 9. Cord blood units collected for public or private banking can be used for biomedical research, provided consent is obtained, when units cannot be banked or when consent for banking is withdrawn. (II-3B) 10. Mothers may be approached to donate cells for biomedical research. Informed consent for research using cord blood should ideally be obtained prior to the onset of active labour or elective Caesarean section following established research ethics guidelines. (II-2A).
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Wu S, Xie G, Wu J, Chen J, Lu Y, Li Y, Tang X, Liao C. Influence of maternal, infant, and collection characteristics on high-quality cord blood units in Guangzhou Cord Blood Bank. Transfusion 2015; 55:2158-67. [DOI: 10.1111/trf.13126] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 03/06/2015] [Accepted: 03/10/2015] [Indexed: 12/29/2022]
Affiliation(s)
- Shaoqing Wu
- Guangzhou Cord Blood Bank; Guangzhou Women and Children's Medical Center; Guangzhou Medical University; Guangzhou Guangdong China
| | - Guie Xie
- Guangzhou Cord Blood Bank; Guangzhou Women and Children's Medical Center; Guangzhou Medical University; Guangzhou Guangdong China
| | - Jieying Wu
- Guangzhou Cord Blood Bank; Guangzhou Women and Children's Medical Center; Guangzhou Medical University; Guangzhou Guangdong China
| | - Jingsong Chen
- Guangzhou Cord Blood Bank; Guangzhou Women and Children's Medical Center; Guangzhou Medical University; Guangzhou Guangdong China
| | - Yan Lu
- Guangzhou Cord Blood Bank; Guangzhou Women and Children's Medical Center; Guangzhou Medical University; Guangzhou Guangdong China
| | - Yan Li
- Guangzhou Cord Blood Bank; Guangzhou Women and Children's Medical Center; Guangzhou Medical University; Guangzhou Guangdong China
| | - Xuewei Tang
- Guangzhou Cord Blood Bank; Guangzhou Women and Children's Medical Center; Guangzhou Medical University; Guangzhou Guangdong China
| | - Can Liao
- Guangzhou Cord Blood Bank; Guangzhou Women and Children's Medical Center; Guangzhou Medical University; Guangzhou Guangdong China
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Radtke S, Görgens A, Kordelas L, Schmidt M, Kimmig KR, Köninger A, Horn PA, Giebel B. CD133 allows elaborated discrimination and quantification of haematopoietic progenitor subsets in human haematopoietic stem cell transplants. Br J Haematol 2015; 169:868-78. [PMID: 25819405 DOI: 10.1111/bjh.13362] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/26/2015] [Indexed: 12/12/2022]
Abstract
The success of haematopoietic stem cell (HSC) transplantation largely depends on numbers of transplanted HSCs, which reside in the CD34(+) populations of bone marrow (BM), peripheral blood stem cells (PBSC) and umbilical cord blood (UCB). More specifically HSCs reside in the CD38(low/-) subpopulation, which cannot be objectively discriminated from mature CD34(+) CD38(+) progenitors. Thus, better marker combinations for the quantification of more primitive haematopoietic stem and progenitor cells in transplants are required. Recently, by combining CD34 and CD133 we could clearly distinguish CD133(+) CD34(+) multipotent and lympho-myeloid from CD133(low) CD34(+) erythro-myeloid progenitors in UCB samples. To qualify the assessment of CD133 for routine quality control of adult HSC sources, we analysed the developmental potentials of CD133(+) and CD133(low) subpopulations in BM and PBSC. Similar to UCB, CD133 expression objectively discriminated functionally distinct subpopulations in adult HSC sources. By implementing anti-CD45RA staining, which separates multipotent (CD133(+) CD34(+) CD45RA(-) ) from lympho-myeloid (CD133(+) CD34(+) CD45RA(+) ) progenitor fractions, UCB was found to contain 2-3 times higher multipotent progenitor frequencies than BM and PBSC. To test for the consistency of CD133 expression, we compared CD133(+) CD34(+) contents of 128 UCB samples with maternal and obstetrical factors and obtained similar correlations to related studies focusing on CD34(+) cell contents. In conclusion, implementation of anti-CD133 staining into existing routine panels will improve the quality control analyses for HSC transplants.
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Affiliation(s)
- Stefan Radtke
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - André Görgens
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Lambros Kordelas
- Department of Bone Marrow Transplantation, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Markus Schmidt
- Department of Gynaecology and Obstetrics, Hospital Duisburg, Duisburg, Germany
| | - Klaus R Kimmig
- Department of Gynecology and Obstetrics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Angela Köninger
- Department of Gynecology and Obstetrics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Peter A Horn
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Bernd Giebel
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
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Wisgrill L, Schüller S, Bammer M, Berger A, Pollak A, Radke TF, Kögler G, Spittler A, Helmer H, Husslein P, Gortner L. Hematopoietic stem cells in neonates: any differences between very preterm and term neonates? PLoS One 2014; 9:e106717. [PMID: 25181353 PMCID: PMC4152327 DOI: 10.1371/journal.pone.0106717] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 08/07/2014] [Indexed: 01/14/2023] Open
Abstract
Background In the last decades, human full-term cord blood was extensively investigated as a potential source of hematopoietic stem and progenitor cells (HSPCs). Despite the growing interest of regenerative therapies in preterm neonates, only little is known about the biological function of HSPCs from early preterm neonates under different perinatal conditions. Therefore, we investigated the concentration, the clonogenic capacity and the influence of obstetric/perinatal complications and maternal history on HSPC subsets in preterm and term cord blood. Methods CD34+ HSPC subsets in UCB of 30 preterm and 30 term infants were evaluated by flow cytometry. Clonogenic assays suitable for detection of the proliferative potential of HSPCs were conducted. Furthermore, we analyzed the clonogenic potential of isolated HSPCs according to the stem cell marker CD133 and aldehyde dehydrogenase (ALDH) activity. Results Preterm cord blood contained a significantly higher concentration of circulating CD34+ HSPCs, especially primitive progenitors, than term cord blood. The clonogenic capacity of HSPCs was enhanced in preterm cord blood. Using univariate analysis, the number and clonogenic potential of circulating UCB HSPCs was influenced by gestational age, birth weight and maternal age. Multivariate analysis showed that main factors that significantly influenced the HSPC count were maternal age, gestational age and white blood cell count. Further, only gestational age significantly influenced the clonogenic potential of UCB HSPCs. Finally, isolated CD34+/CD133+, CD34+/CD133– and ALDHhigh HSPC obtained from preterm cord blood showed a significantly higher clonogenic potential compared to term cord blood. Conclusion We demonstrate that preterm cord blood exhibits a higher HSPC concentration and increased clonogenic capacity compared to term neonates. These data may imply an emerging use of HSPCs in autologous stem cell therapy in preterm neonates.
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Affiliation(s)
- Lukas Wisgrill
- Dept. of Pediatrics and Adolescent Medicine, Division of Neonatology, Paediatric Intensive Care & Neuropaediatrics, Medical University of Vienna, Vienna, Austria
| | - Simone Schüller
- Dept. of Pediatrics and Adolescent Medicine, Division of Neonatology, Paediatric Intensive Care & Neuropaediatrics, Medical University of Vienna, Vienna, Austria
| | - Markus Bammer
- Dept. of Pediatrics and Adolescent Medicine, Division of Neonatology, Paediatric Intensive Care & Neuropaediatrics, Medical University of Vienna, Vienna, Austria
| | - Angelika Berger
- Dept. of Pediatrics and Adolescent Medicine, Division of Neonatology, Paediatric Intensive Care & Neuropaediatrics, Medical University of Vienna, Vienna, Austria
| | - Arnold Pollak
- Dept. of Pediatrics and Adolescent Medicine, Division of Neonatology, Paediatric Intensive Care & Neuropaediatrics, Medical University of Vienna, Vienna, Austria
| | - Teja Falk Radke
- Institute for Transplantation Diagnostics and Cell Therapeutics, Heinrich Heine University Medical Center, Duesseldorf, Germany
| | - Gesine Kögler
- Institute for Transplantation Diagnostics and Cell Therapeutics, Heinrich Heine University Medical Center, Duesseldorf, Germany
| | - Andreas Spittler
- Department of Surgery, Research Labs & Core Facility Flow Cytometry, Medical University of Vienna, Vienna, Austria
| | - Hanns Helmer
- Dept. of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Peter Husslein
- Dept. of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Ludwig Gortner
- Dept. of Pediatrics and Neonatology, Saarland University, Homburg, Saar, Germany
- * E-mail:
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Manegold-Brauer G, Borner B, Bucher C, Hoesli I, Passweg J, Girsberger S, Schoetzau A, Gisin S, Visca E. A prenatal prediction model for total nucleated cell count increases the efficacy of umbilical cord blood banking. Transfusion 2014; 54:2946-52. [DOI: 10.1111/trf.12676] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 02/20/2014] [Accepted: 03/03/2014] [Indexed: 12/18/2022]
Affiliation(s)
| | - Barbara Borner
- Department of Obstetrics and Gynecology; University Hospital Basel; Basel Switzerland
| | - Christoph Bucher
- Department of Hematology; University Hospital Basel; Basel Switzerland
| | - Irène Hoesli
- Department of Obstetrics and Gynecology; University Hospital Basel; Basel Switzerland
| | - Jakob Passweg
- Department of Hematology; University Hospital Basel; Basel Switzerland
| | - Sabine Girsberger
- Department of Hematology; University Hospital Basel; Basel Switzerland
| | - Andreas Schoetzau
- Department of Obstetrics and Gynecology; University Hospital Basel; Basel Switzerland
| | - Simona Gisin
- Department of Obstetrics and Gynecology; University Hospital Basel; Basel Switzerland
| | - Eva Visca
- Women's Hospital; Kantonsspital Baselland; Switzerland
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Cord blood serum-based eye drops: the impact of donor haematological and obstetric factors on the variability of epidermal growth factor levels. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2013; 12 Suppl 1:s44-50. [PMID: 24120597 DOI: 10.2450/2013.0115-13] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 06/12/2013] [Indexed: 01/17/2023]
Abstract
BACKGROUND Cord blood serum (CBS)-based eye drops are successfully used in corneal epithelial wound healing and are prepared to supply a known amount of epidermal growth factor (EGF). Product standardisation includes expensive EGF dosage in all cord blood (CB) units. The influence of donor obstetric and haematological characteristics on EGF content was evaluated, to exclude unsuitable CBS and pre-select those CB units able to provide the correct EGF supply for healing corneal wounds. MATERIALS AND METHODS Data were retrospectively collected from 135 donors included in the Emilia Romagna Cord Blood Bank records. Obstetric characteristics, parity and gestational age of the mother, sex, birth weight and Apgar score of the neonate, placental weight, duration of labour and mode of delivery were considered. Haematological characteristics, CD34+ cell number, and total nucleated cell, white blood cell and platelet counts were recorded. EGF content in CB units was estimated by enzyme-linked immunosorbent assay. Statistical evaluation was performed by Mann-Whitney unpaired and Student's t tests. Correlations between variables were evaluated by using Pearson's (r) or Spearman's (ρ) correlation coefficients. RESULTS EGF content was significantly higher in CBS from donors aged <30 years and after vaginal deliveries as compared with scheduled Caesarean sections (1,386±580 vs 1,106±391 pg/mL; P=0.002). EGF content was significantly correlated with duration of labour (r=0.45; P=0.0001), number of CD34+ cells/mL (r=0.3; P=0.002) particularly in vaginal deliveries (r=0.36; P=0.003), mother's age (-0.25; P=0.005), neonate's birth weight (r=0.27; P=0.005), and total nucleated cell (r=0.25; P=0.006), white cell (r=0.29; P=0.001) and platelet (r=0.24; P=0.009) counts. No significant correlations were found between EGF content and parity, gestational age, placental weight, neonate's sex or Apgar scores. DISCUSSION EGF levels are higher in CB units from younger mothers (<30 years), with longer labour duration (>6 hours), and higher CD34+ cell content (>0.05×10(6)/mL). In order to optimise the preparation and costs of CBS-based eye drops, pre-selection of CB units is recommended.
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Tschiedel S, Bach E, Jilo A, Wang SY, Lange T, Al-Ali HK, Vucinic V, Niederwieser D, Cross M. Bcr–Abl dependent post-transcriptional activation of NME2 expression is a specific and common feature of chronic myeloid leukemia. Leuk Lymphoma 2012; 53:1569-76. [DOI: 10.3109/10428194.2012.656631] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Meyer-Monard S, Tichelli A, Troeger C, Arber C, de Faveri GN, Gratwohl A, Roosnek E, Surbek D, Chalandon Y, Irion O, Castelli D, Passweg J, Kindler V. Initial cord blood unit volume affects mononuclear cell and CD34+ cell-processing efficiency in a non-linear fashion. Cytotherapy 2012; 14:215-22. [DOI: 10.3109/14653249.2011.634404] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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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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Zhong XY, Zhang B, Asadollahi R, Low SH, Holzgreve W. Umbilical cord blood stem cells: what to expect. Ann N Y Acad Sci 2010; 1205:17-22. [DOI: 10.1111/j.1749-6632.2010.05659.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [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, Granado C, Hösli I, Troeger C. Controversies in hybrid banking: attitudes of Swiss public umbilical cord blood donors toward private and public banking. Arch Gynecol Obstet 2010; 284:99-104. [PMID: 20658141 DOI: 10.1007/s00404-010-1607-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2010] [Accepted: 07/12/2010] [Indexed: 11/28/2022]
Abstract
PURPOSE Umbilical cord blood (UCB) stored in public inventories has become an alternative stem cell source for allogeneic stem cell transplantation. The potential use of autologous UCB from private banks is a matter of debate. In the face of the limited resources of public inventories, a discussion on "hybrid" public and private UCB banking has evolved. We aimed to explore the attitudes of the donating parents toward public and private UCB banking. STUDY DESIGN AND METHODS A standardized, anonymous questionnaire was sent to the most recent 621 public UCB donors including items regarding satisfaction with recruitment process, the need for a second consent before release of the UCB unit for stem cell transplantation, and the donors' views on public and private UCB banking. Furthermore, we asked about their views on UCB research. RESULTS Of the questionnaires, 48% were returned, and 16% were lost due to mail contact. Of our donors, 95% would donate to the public bank again. As much as 35% of them were convinced that public banking was useful. Whereas 27% had never heard about private UCB banking, 34% discussed both options. Nearly 70% of donors opted for public banking due to altruism and the high costs of private banking. Of our public UCB donors, 81% stated that they did not need a re-consent before UCB release for stem cell transplantation. In case of sample rejection, 53.5% wanted to know details about the particular research project. A total of 9% would not consent. CONCLUSIONS Almost all donors would choose public banking again due to altruism and the high costs of private banking. Shortly after donation, mail contact with former UCB donors was difficult. This might be a relevant issue in any sequential hybrid banking.
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Affiliation(s)
- Gwendolin Manegold
- Department of Obstetrics and Gynecology, University Hospital Basel, Basel, Switzerland.
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Hassanein SMA, Amer HA, Shehab AA, Hellal MMKH. Umbilical cord blood CD45+/CD34+cells coexpression in preterm and full-term neonates: a pilot study. J Matern Fetal Neonatal Med 2010; 24:229-33. [DOI: 10.3109/14767058.2010.482606] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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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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Solves P, Perales A, Fillol M, Bonilla F, Mirabet V, Roig R. Presence of meconium-stained amniotic fluid in cesarean deliveries increases the total nucleated cell content of umbilical cord blood units. Transfusion 2009; 49:388-9; author reply 389-90. [PMID: 19389217 DOI: 10.1111/j.1537-2995.2008.01995.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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