Abstract
Human umbilical cord blood has proven to be a feasible alternative source of hematopoietic
stem cells for pediatric and some adult patients with major hematologic disorders.
This has promoted the establishment of cord blood banks for use in unrelated transplants
worldwide. The banking of umbilical cord blood offers many advantages: absence of
donor risk, absence of donor attrition, immediate availability, and the ability to
expand available donor pools in targeted ethnic and racial minorities currently underrepresented
in all bone marrow registries. Preliminary clinical experience suggests that, due
to the immunological immaturity of cord blood cells, graft versus host disease might
be lower than when using bone marrow from adult donors and HLA restrictions might
be less stringent. Techniques to improve the efficacy of blood banks are currently
under investigation. Closed cord blood collection methods have proven to be superior
to open in reducing the risk of microbial contamination. Efficient banking requires
volume reduction of cord blood units without significant loss of progenitor cells,
in order to decrease storage space and cost, and this may be achieved by using the
separation techniques. Cryopreservation and thawing techniques have been established
and do not seem to affect the viability and progenitor cell recovery or the feasibility
of CD34+ selection and ex vivo expansion. Nevertheless, many scientific, ethical, and social
questions have arisen in connection with cord blood banking that need to be addressed.
Keywords
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Article info
Publication history
Accepted:
August 12,
1999
Received in revised form:
July 14,
1999
Received:
May 15,
1999
Identification
Copyright
© 2000 Elsevier Science Ireland Ltd. Published by Elsevier Inc. All rights reserved.
