A new strategy for umbilical cord blood collection developed at the first Colombian public cord blood bank increases total nucleated cell content

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 2933collected 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, CD341 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 precryopreservation 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. U mbilical cord blood (UCB) transplantation is an alternative to marrow (BM) and mobilized peripheral blood (PB) transplantation in candidate patients who lack a suitable compatible donor.1,2 The clinical advantages of UCB transplantation compared with BM and PB include faster availability, a lower incidence and severity of graft-versus-host disease (GVHD), higher human leukemic antigen (HLA) mismatch permissiveness, and a higher proportion of primitive hematopoietic stem/progenitor cells, resulting in longer In this work, we analyze data from the public Colombian UCB bank (Col CBB), including variables affecting blood volume and TNC counts. We also report a new collection procedure combining in utero and ex utero techniques, which results in significant increases in blood volume and TNC counts and a lower contamination rate. We also demonstrate that this collection method has a minimal impact on cellularity after volume reduction, post-thawing recovery, and the clonogenic capacity (ClonE) before and after cryopreservation. MATERIALS AND METHODS Cord blood donor eligibility and collectionThis study was conducted at the Col CBB (from Instituto Distrital de Ciencia, Biotecnolog ıa e Innovaci on en Salud [IDCBIS]) using data from UCB units collected between 2014 and 2015 at five public hospitals in the Bogota Capital District (Hospital Occ...

Fatores interferentes da qualidade do sangue de cordão umbilical/placentário para transplante autólogo: revisão integrativa

“…2. Fatores Neonatais a) Peso Há relatos de que o peso do recém-nascido está diretamente relacionado ao volume de SCUPA coletado e também à celularidade, e fortes correlações positivas entre a circunferência abdominal e o volume de SCUP, bem como o número de UFC, tendo sido encontrado melhores resultados em recém-nascidos com peso entre 3390g e 3500g (27,23,25,22,20,24) .…”

“…e) Tipo de coleta A técnica intra-útero (coleta realizada antes da dequitação/parto da placenta) produz volumes um pouco maiores de SCUP e maiores rendimentos de células nucleadas totais em comparação com a técnica extra útero (após a dequitação/parto da placenta) (22,11) e estudos apontam que mesclar a coleta intra-útero com a coleta extra-útero há um aumento significativo do volume sanguíneo coletado, comparado às coletas intra-útero e extra-útero separadas.A técnica intra útero possui sucesso de 75% enquanto a extra útero possui 67%. A coleta extra útero pode estar associada a menores volumes e celularidade devido ao fato de haver, após a dequitação, focos hemorrágicos e coágulos nas veias do cordão umbilical (27,25) . f) Tipo de parto Após o parto cesáreo foi encontrado maior volume de SCUP para coleta, comparado ao parto vaginal (95,4 mL versus 85,0 mL, respectivamente), mas foi na coleta após o parto vaginal que se obteve maior celularidade no SCUP (9,70x10 8 células versus 8,74x10 8 células).…”

“…Já as normas brasileiras vigentes preconizam que "o material permaneça à temperatura de 4 °C (mais ou menos 2 °C)" (10) . Discussão É consenso entre os autores o entendimento de que o volume de SCUP coletado no momento do parto tem forte relação com a celularidade inicial da amostra (20)(21)(22)(23)(24)(25)(26)(27) . Essa informação leva a crer que para que uma coleta seja bem-sucedida, o profissional responsável pela coleta deve, além de observar as normas que envolvem a coleta de SCUP e assegurar a qualidade do procedimento, co-ao intervalo ótimo varia, mas todos sugerem que quanto menor for o intervalo, menor é a perda celular que ocorre durante o processamento (13,20,29) , sendo o limite máximo estabelecido pelas normas brasileiras de 48 horas (10) ; 5.…”

“…O primeiro foi descrito como sendo fonte de um maior volume coletado (22) . Mas um dos autores mencionou que a mescla das duas técnicas poderia ser causa de uma coleta ainda mais volumosa, se comparado às técnicas separadas (27) . Apenas um dos autores correlacionou a técnica intra-útero ao aumento de celularidade do SCUP coletado (11) .…”

Human Leukocyte Antigen and Red Blood Cells Impact Umbilical Cord Blood CD34+ Cell Viability after Thawing

“…All UCB units were collected from healthy donors at public hospitals in Bogotá, Colombia after signing an informed consent form reviewed by the Ethical Committee of the District Secretary of Health. As previously described [41], UCB units were obtained from single-birth, full-term deliveries. The exclusion criteria were maternal infections or viral diseases, absence of prenatal care and low neonatal weight.…”