Optimizing donor selection for public cord blood banking: influence of maternal, infant, and collection characteristics on cord blood unit quality

Abstract

Background Banked unrelated donor umbilical cord blood (CB) has improved access to hematopoietic stem cell transplantation for patients without a suitably matched donor. In a resource-limited environment, ensuring that the public inventory is enriched with high-quality cord blood units (CBUs) addressing the needs of a diverse group of patients is a priority. Identification of donor characteristics correlating with higher CBU quality could guide operational strategies to increase the yield of banked high-quality CBUs. Methods Characteristics of 5267 CBUs donated to the Carolinas Cord Blood Bank, a public bank participating in the National Cord Blood Inventory, were retrospectively analyzed. Eligible CBUs, collected by trained personnel, were processed using standard procedures. Routine quality and potency metrics [post-processing total nucleated cell count (post-TNCC), CD34+, colony-forming units (CFUs)] were correlated with maternal, infant, and collection characteristics. Results High-quality CBUs were defined as those with higher post-TNCC (>1.25×109), and CD34+ + CFU in the upper quartile. Factors associated with higher CD34+ or CFU content included a shorter interval from collection to processing (<10 hours), younger gestational age (34–37 weeks; CD34++CFU) Caucasian race, higher birth weight (>3500grams) and larger collection volumes (>80ml). Conclusions We describe characteristics identifying high-quality CBUs, which can be used to inform strategies for CBU collection for public banks. Efforts should be made to prioritize collections from larger babies born before 38 weeks of gestation. CBUs should be rapidly transported to the processing laboratory. The lower quality of CBUs from non-Caucasian donors highlights the challenges of building a racially diverse public CB inventory.

Circadian and circannual variations in cord blood hematopoietic cell composition

“…Large studies have reported several maternal, fetal and obstetrical factors impacting CB cell yield. [4][5][6] Recently, it has been documented in adult individuals that hematopoietic stem and progenitor cells circulate from the bone marrow to the peripheral blood according to a circadian rhythm, 7 leading to circadian variations in their concentrations in blood (reviewed by ).…”

Cord blood collection and banking from a population with highly diverse geographic origins increase HLA diversity in the registry and do not lower the proportion of validated cord blood units: experience of the Marseille cord blood bank

“…Birth weight, 6,7,23 length 8 and gender 4,10,17,24 have been correlated with CBU volume and TNCC; as well as different obstetric parameters, such as placenta weight, 17 time of cord clamping and time of UCB collection after birth. 17,23,25 A Canadian study showed that birth weights from different ethnic groups are significantly different, and encouraged modification of birth weight curves according to ethnicity; it is interesting to note that Middle Eastern and North African populations present the closest mean birth weight to European and Western populations.…”

“…Indeed, the Bone Marrow Donors Worldwide collaboration of registries presents a lack of genetic diversity with an over-representation of donors from Northwestern European descent. 4,6,7,[10][11][12][13][14] Thus, patients with non-European ancestry have lower odds of obtaining a graft with high HLA compatibility and/or high TNCC. [13][14][15][16] These studies highlight the importance of developing CB banking in partnership with birth clinics that care for pregnant women originating from populations that are underrepresented in existing CBBs and registries.…”

“…4,10,11,15,[17][18][19] According to some studies, CBU from Caucasian donors display significantly higher volumes, and TNCC, CD34+ cell or CFU-GM counts. 4,6,7,10,11,17 This queries the existence of a difference in CBU volume and TNCC according to donor geographical origin in other regions than North America. The Mediterranean zone was originally populated by specific Paleolithic, Neolithic and Iron migration routes.…”

“…1,2 Advantages of CBU recruitment compared with peripheral blood and BM are immediate availability, improved access to transplant, especially for ethnic minorities 3,4 and their biological properties detailed in a graft context in many reviews. 2,5 The main drawbacks of CBU are their low TNC and progenitor content.…”