The Mannheim Cord Blood Bank: Experiences and Perspectives for the Future

Abstract

Summary Background and Methods: As a source of hematopoietic stem cells, cord blood (CB) is an alternative to bone marrow or peripheral blood stem cells (PBSC). The Mannheim CordBlood Bank has currently stored about 1,750 allogeneic CB units. Here we report our experiences and discuss future perspectives of CB banking. We analyzed CB units for nucleated cell (NC), mononucleated cell (MNC) and CD34+ cell count, volume, colony-forming units (CFU-GM) as well as ethnic background of the donor. Transplanted CB units were analyzed for patient and transplant characteristics and compared to stored CB units. Results: Only 25% of all collected CB units met storage criteria. Main reasons for exclusion were: i) insufficient volume (57.7%), ii) delayed arrival at the processing site (19.2%) and iii) little cell count (7.2%). Up to now 36 CB units have been released for transplantation mainly to children (62%). Transplant indications were hematological diseases, immune deficiencies and metabolic diseases. Transplanted CB units showed significantly higher cell counts compared to stored units (NC: 12.5 vs. 7.2 × 10 8 , MNC: 4.7 vs. 2.9 × 10 8 , CD34+ cells: 3.3 vs. 1.8 × 10 6 , mean; p < 0.001 each) and were found more often in ethnic minority groups (36 vs. 20%; p = 0.04). Conclusions: Even though cell count and volume are key parameters for the eligibility of CB units, our data indicate that the ethnic background of the donor also plays a major role. Collection and processing of CB should be optimized in order to gain maximum volume and cell counts.Schlüsselwörter Nabelschnurblut · Nabelschnurblut-Aufarbeitung · Stammzelltransplantation · Hämatopoetische Stammzellen Zusammenfassung Hintergrund und Methoden: Nabelschnurblut (CB) ist eine Alternative zur Gewinnung von hämatopoetischen Stammzellen aus Knochenmark oder peripheren Stammzellen. Die Mannheimer Nabelschnurblutbank hat bisher 1750 allogene Nabelschnurblutpräparate eingelagert. Wir berichten über unsere Erfahrungen und diskutieren Zukunftsperspektiven der Nabelschnurbluteinlagerung. Folgende CB-Parameter wurden untersucht: Volumen, nukleäre (NC), mononukleäre (MNC) und CD34+ Zellen, Kolonie bildende Einheiten (CFU-GM) sowie ethnische Herkunft des Spenders. Bei den transplantierten Präparaten wurden die Patienten-und Transplantatdaten ausgewertet und die Präparateeigenschaften mit eingelagerten CB verglichen. Ergebnisse: Nur 25% aller gesammelten Nabelschnurblutpräparate erfüllten die Einlagerungskriterien. Die Hauptursachen hierfür waren 1) zu niedriges Vollblutvolumen (57,7%), 2) zu spätes Eintreffen der Prä-parate im Verarbeitungszentrum (19,2%) sowie 3) zu niedrige Zellzahl (7,2%). Bisher wurden 36 Mannheimer Nabelschnurblutpräparate, vorwiegend an Kinder (62%) abgegeben. Die Transplantationsindikationen waren primär hämatologische Erkrankungen, Erkrankungen des Immunsystems und metabolische Erkrankungen. Die Zellzahlen der transplantierten Präparate waren signifikant höher, als die der eingelagerten (NC: 12,5 vs. 7,2 × 10 8 , MNC: 4,7 vs. 2,9 × 10 8 , CD34+ Zellen:...

Umbilical cord blood banking: an update

“…These probability estimates would equate to the incidence of cystic fibrosis (1/3,000), spina bifida (1/800) and Down syndrome (1/700) in the general population in which testing is routinely discussed with the parents during the pregnancy. Therefore, researchers continue to evaluate the usefulness of cord blood cells for other purposes than hematological disorders such as repairing damage caused by heart disease and infarcts, diabetes mellitus, strokes, traumatic brain or spinal cord injuries in addition to malignancy [8,17,22,25].…”

“…Healthcare providers should, therefore, inform the interest-ed birthing parents about the advantages and possible disadvantages of cord blood banking and related future cord blood usage. They should be prepared to discuss scientific, legal and ethical issues when the parents and families are provided cord blood banking information during pregnancy [8,17,22].…”

“…Cord blood is considered a treatment option in pediatric and adult patients with hematologic malignancies and disorders (leukemia, thalassemia, sickle cell disease, etc. ), bone marrow failures, inherited metabolic disorders, immunological defects and other genetic diseases [1][2][3][4][5][6][7][8][9][10][11][12]. Double umbilical cord blood grafts, that use cord blood units from two donors, mitigate cell dose limitations for larger children and adults with malignant disorders [12][13][14].…”

“…More than 25,000 allogeneic cord blood transplantations have been performed worldwide since the first cord blood transplantation in 1988 in a patient from Paris, France with Fanconi anemia using an identical HLA matched sibling [8,18]. The results, to date, are encouraging and appear at least comparable to bone marrow or peripheral blood progenitor cells as the donor source for transplants [12,13].…”

“…Over 400,000 cord blood units are now stored for use in more than 100 quality controlled public international cord blood banks [8,22,23]. Stored cord blood samples have been used for transplants in both children and adults having malignant or non-malignant diseases [1-8, 10-14, 22].…”