Impact of obstetric factors on cord blood donation for transplantation

Abstract

Summary. Recent reports have shown that low nucleated cell dose signi®cantly decreases survival after cord blood transplantation. Prior to starting clinical cord blood banking we investigated the impact of obstetric factors on cell dose and volume of cord blood donations. Cord blood was obtained from 114 normal full-term deliveries. Mean volume collected was 93´5 ml, mean total nucleated cell count (TNC) was 13´1´10 8 . Statistical analysis was by backwards stepwise regression. Signi®cant factors affecting nucleated cell yield were volume of blood collected (P < 0´001), length of gestation (P < 0´0001), time from delivery of the infant to cord clamping (P 0´018) and total length of labour (P 0´002). In clinical cord blood banking we have successfully used these ®ndings for pre-collection assessment of placentae. Out of 476 cord blood donations subsequently collected for banking, only 29 (6´1%) have been discarded due to low volume. The mean TNC of the 409 banked units following volume reduction was 10´1´10 8 . Despite careful optimization of collection, processing and storage techniques, cell dose still limits cord blood transplantation to smaller recipients.

Maternal and Neonatal Factors Associated with the High Yield of Mononuclear Low-Density/CD34+ Cells from Placental/Umbilical Cord Blood

“…However, the multiple linear regression analyses in the present study show the significantly positive correlations between the total LD/CD34 + cells and maternal/neonatal factors (Table 3). These results are consistent with most of the previous reports (Donaldson et al 1999;Yamada et al 2000;Li et al 2001;George et al 2006;Mancinelli et al 2006), including that meconium in the amniotic fluid correlates with better cell counts (Askari et al 2005). Therefore the total LD cells per CB unit analyzed in the present study can be assumed as a substitute variable instead of the total nucleated cells in some previous studies (Lasky et al 2002;Mohyeddin Bonab et al 2004;Solves et al 2005), and can be also confirmed by other previous studies (Pafumi et al 2001;Bornstein et al 2005).…”

“…These results are consistent with several previous studies showing that maternal age does not affect either nucleated cells or CD34 + cells (Donaldson et al 1999;Nakagawa et al 2004;George et al 2006;Mancinelli et al 2006). However, focusing on the 1-gravidae alone, the maternal age of 1-gravidae have a slightly positive correlation with the total LD cells (Fig.…”

“…In the multiple regressions, significant positive correlations are observed between the total LD/CD34 + cells and RDT (Table 3), which can support the result that CB units from 1-gravidae have higher cell yields than 2-gavidae and 3-gavidae (Table 4). The previous studies also reported that greater cell counts are obtained from the woman with longer first stage of labor (Ballen et al 2001) and the total length of labor is one of the significant factors affecting nucleated cell yield (Donaldson et al 1999).…”

“…The number of samples is relatively smallscale compared to other data from CB banks. However, although there are some limitations due to the relatively small sample size, some previous studies were also analyzed by using small samples around 100 CB units (Donaldson et al 1999;Yamada et al 2000;Pafumi et al 2001). We therefore believe that our present study is appropriate to some extent.…”

“…Some previous studies described the context of CB banking regarding the cost of CB cell processing and freezing in storage (Sirchia et al 1998(Sirchia et al , 1999Ballen et al 2001;Nakagawa et al 2004). Other previous studies also demonstrated the correlations between the number of nucleated/CD34 + cells and maternal/neonatal factors (Donaldson et al 1999;Yamada et al 2000;Li et al 2001;Askari et al 2005;George et al 2006;Mancinelli et al 2006). Most of the findings were more likely to be the aspects from multiple hospitals affiliated with CB banks located in the metropolitan areas.…”