Future of cord blood for oncology uses

Abstract

The utilization of umbilical cord blood (UCB) as a source of stem cells for transplantation has grown substantially in the last decade. Already an established practice for the treatment of children with hematological malignancies, its application for the treatment of adults is also expanding. The development of the double UCB and reduced-intensity transplantation platforms have contributed to this expansion. Recent registry-based analysis and ongoing single institution and multicenter clinical trials are investigating ways to make UCB transplantation more widely available. We review here the background data on the utilization of UCB for the treatment of hematological malignancies, and discuss the current challenges and future directions in the field of UCB transplantation.

Stem cell transplantation for treatment of sickle cell disease: Bone marrow versus cord blood transplants

“…This source of stem cells may be most appropriate for pediatric patients due to their smaller size. 33 The Eurocord study published by Locatelli and colleagues 34 analyzed 44 patients age 1-20 years with either thalassemia (n = 33) or SCD (n = 11) who received a cord blood transplant from a sibling between 1994 and 2001. All but 1 of the patients with SCD had a history of cerebral vasculopathy, acute chest syndrome with either severe pain or splenic sequestration, or multiple vaso-occlusive episodes associated with osteomyelitis.…”

Umbilical cord blood banking: from personal donation to international public registries to global bioeconomy

“…Since then, the efficacy of transplants of UCB stem cells for both malignant3,4 and nonmalignant5–8 diseases has been amply demonstrated: transplants of UCB stem cells can be used to treat acute9,10 and chronic11 leukemias, lymphomas,12 myelodysplastic syndromes,13 thalassaemia,14 Fanconi anemia,15 and other bone marrow failure syndromes, immune deficiencies,16 and metabolic/storage diseases 17…”

Hematopoietic Stem Cell Transplantation for MDS

“…With increasing degrees of mismatching, there is a higher probability of non-engraftment (particularly with HLA-C disparities) and a higher probability of GVHD. For patients without an HLA-matched related or unrelated donor, cord blood cells or cells from a haploidentical related donor may offer alternatives 34–36. Cord blood has the advantage of “immaturity”, allowing to transplant HLA-mismatched cells without a significant increase in GvHD incidence.…”

“…A third option is, as discussed, the use of UCB transplantation34;37;39;95;96 The introduction of two-unit transplants39 has helped to overcome restrictions associated with the low cell dose of UCB units,95 and in vitro expansion of UCB is emerging as a further option (reviewed in38). Few studies are available on the use of UCB in MDS (reviewed in97).…”