The role and potential of umbilical cord blood in an era of new therapies: a review

Abstract

In light of pioneering findings in the 1980s and an estimation of more than 130 million global annual births, umbilical cord blood (UCB) is considered to be the most plentiful reservoir of cells and to have regenerative potential for many clinical applications. Although UCB is used mainly against blood disorders, the spectrum of diseases for which it provides effective therapy has been expanded to include non-hematopoietic conditions; UCB has also been used as source for regenerative cell therapy and immune modulation. Thus, collection and banking of UCB-derived cells have become a popular option. However, there are questions regarding the cost versus the benefits of UCB banking, and it also raises complex ethical and legal issues. This review discusses many issues surrounding the conservation of UCB-derived cells and the great potential and current clinical applications of UCB in an era of new therapies. In particular, we describe the practical issues inherent in UCB collection, processing, and long-term storage as well as the different types of ‘stem’ or progenitor cells circulating in UCB and their uses in multiple clinical settings. Given these considerations, the trend toward UCB will continue to provide growing assistance to health care worldwide.

Stem Cells in Regenerative Medicine: Prospects and Pitfalls

“…However, UCB is routinely used for hematopoietic stem cell transplantation in order to treat haematological conditions for a wide range of diseases but it can be used for regenerative cellular based treatment and immunomodulation [25,34,35]. There are some clinical studies that have already been done and some of them have been halted for some issues [25].…”

“…MSCs consist of multipotent progenitors which can be differentiated towards chondrogenic, osteogenic and adipogenic lineage and it is estimated that approximately 100 ml of UCB contains 1000-5000 MSCs [31,25]. Other population with different pluripotency potential can be derived from UCB includes unrestricted somatic stem cells (USSC) having the potential to differentiate into all three fates as observed [32].…”

“…UCB contains hematopoietic progenitor cells (HPCs) as well as non-hematopoietic cells including mesenchymal stromal/stem cells (MSCs) and endothelial progenitor cells [25]. MSCs consist of multipotent progenitors which can be differentiated towards chondrogenic, osteogenic and adipogenic lineage and it is estimated that approximately 100 ml of UCB contains 1000-5000 MSCs [31,25].…”

“…Contrary to any unrelated donor cell, UCB is collected without any risk and non-invasively which can be cryopreserved for longer time without the loss of basic features like cell viability, functionality and have lower risk to transfer viral infections and mutations which causes complications to the patient after transplantation [25,26]. Disadvantage of UCB includes cell dosage and delayed engraftment which are the main hurdles and the conventional UCBrelated treatment have restrictions whenever receivers are more and patients with known resistant to engraftment due to lower hematopoietic per UCB unit [25,[27][28][29][30].…”

“…An estimated yearly birth rate of more than 140 million births worldwide offers the umbilical cord blood (UCB) as a source for cells to be used in a wide variety of clinical conditions [24,25]. Contrary to any unrelated donor cell, UCB is collected without any risk and non-invasively which can be cryopreserved for longer time without the loss of basic features like cell viability, functionality and have lower risk to transfer viral infections and mutations which causes complications to the patient after transplantation [25,26].…”