Cord blood stem cell transplantation. Why it is necessary to establish a Bulgarian cord blood bank?

Abstract

The allogenic transplantation of hemopoietic stem cell from bone marrow and peripheral blood is limited due to the necessity to identify HLA matched donor within the family or in bone marrow donor registries. Although, more than 10 million donors are available worldwide, completely HLA matched donors could be found only for 75% of the patients. It is well known that transplantations of hematopoietic stem cell from cord blood are characterized with a lower risk of GvHD and therefore do not require so strict criteria for HLA matching, and less time for search of matched donor is needed. The necessity to establish a National cord blood bank in Bulgaria is emphasized further by the heterogeneity of HLA allele and haplotype distribution in the Bulgarian population. That could be explained by the ethnic diversity of the population. As a result some alleles are more frequent in Bulgarians compared to other populations. The organization, accreditation, and development of a strategy for a National cord blood bank will be discussed.

Development of a New Third-Party Unit for Adult Stem Cell Transplantation using Clinical-Grade Rejected Cord Blood Units

“…The creation of this third-party unit required thawing, pooling, and CD34 + selection of a median of 39 (30-45) small clinical-grade rejected CBUs. Median times to neutrophil and platelet engraftment were 19.5 days (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) and 53 days (29-175) respectively, similar to those reported with dCBUs and thirdparty haplo-related transplantation. One patient had a longer platelet engraftment time (day +175), which was attributed to early reactivation of CMV and treatment with ganciclovir.…”

“…The principal HSC sources for the adult population are bone marrow and peripheral blood. However, only 25 to 30% of recipients have a compatible related donor, and approximately 65% will find an unrelated adult donor through the international registry [17,18]. In the absence of a suitably matched adult donor, alternative graft sources arecord blood stem cells or a related haplo-identical donor.…”

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“…Сог лас но дан ным за 2008 г. [55], в ми ре уже сущес тво ва ли око ло 100 бан ков ПК: 40 -в Евро пе, 30 -в США и Ка на де, 20 -в ази ат ском ре ги о не и 10в Австралии. При ме ча тель но, что от дель ные бан ки в Англии и США по льзу ют ся фе де раль ны ми фонда ми для це ле нап рав лен ной за го тов ки и хра не ния образ цов ПК, гис то сов мес ти мых с кон крет ны ми пациен та ми, стра да ю щи ми ге мог ло би но па ти я ми и други ми ге не ти чес ки ми за бо ле ва ни я ми, тре бу ю щи ми дли тель но го ле че ния сре дствам ци то те ра пии [56,57].…”

“…Бол гар ские спе ци а лис ты вы ска за ли убеж дение, что для стра ны на и бо лее при ем ле мо со зда ние цен тра ли зо ван но го на ци о наль но го бан ка с боль шим ко ли чес твом ЕПК [56], по сколь ку за куп ки по следних об хо дят ся для по тре би те лей при мер но на 30 % де шев ле, ес ли об раз цы СК скон цен три ро ва ны в одном круп ном бан ке, а не раз бро са ны по не сколь ким с не боль ши ми об ъ е ма ми де по зи тов. В стра нах Восточ ной Евро пы воп рос со хра не ния ПК огра ни чился еди нич ны ми час тны ми бан ка ми, в Укра и не призы вы к со зда нию на ци о наль но го бан ка ПК [55,58] по ка оста ют ся без от ве та.…”