Concise Review: Umbilical Cord Blood Transplantation: Past, Present, and Future

Overview

Journal Stem Cells Transl Med

Publisher Oxford University Press

Specialties Cell Biology
Pharmacology

Date 2014 Nov 8

PMID 25378655

Citations 38

Authors

Javier Munoz

Nina Shah

Katayoun Rezvani

Chitra Hosing

Catherine M Bollard

Betul Oran

Amanda Olson

Uday Popat

Jeffrey Molldrem

Ian K McNiece

Elizabeth J Shpall

Affiliations

Soon will be listed here.

Abstract

Allogeneic hematopoietic stem cell transplantation is an important treatment option for fit patients with poor-risk hematological malignancies; nevertheless, the lack of available fully matched donors limits the extent of its use. Umbilical cord blood has emerged as an effective alternate source of hematopoietic stem cell support. Transplantation with cord blood allows for faster availability of frozen sample and avoids invasive procedures for donors. In addition, this procedure has demonstrated reduced relapse rates and similar overall survival when compared with unrelated allogeneic hematopoietic stem cell transplantation. The limited dose of CD34-positive stem cells available with single-unit cord transplantation has been addressed by the development of double-unit cord transplantation. In combination with improved conditioning regimens, double-unit cord transplantation has allowed for the treatment of larger children, as well as adult patients with hematological malignancies. Current excitement in the field revolves around the development of safer techniques to improve homing, engraftment, and immune reconstitution after cord blood transplantation. Here the authors review the past, present, and future of cord transplantation.

Citing Articles

Word-of-mouth referrals between patients are a critical component of medical tourism for pediatric hematopoietic cell transplantation.

Wen Y, Wang Y, Pai L, Yang S, Chang T, Chen S Medicine (Baltimore). 2025; 104(2):e41244.

PMID: 39792744 PMC: 11730650. DOI: 10.1097/MD.0000000000041244.

A phase 2 pilot study of umbilical cord blood infusion as an adjuvant consolidation therapy in elderly patients with acute myeloid leukemia.

Wang J, Li X, Liu P, Dai Y, Zhu H, Zhang Y Signal Transduct Target Ther. 2024; 9(1):358.

PMID: 39702351 PMC: 11659310. DOI: 10.1038/s41392-024-02065-y.

More balance toward activating receptors and cytotoxic activity of NK cells ex vivo differentiated from human umbilical cord blood-derived CD34 stem cells in comparison with peripheral blood NK cells.

Ghaedrahmati F, Esmaeil N, Akbari V, Ashrafi F Heliyon. 2024; 10(15):e35509.

PMID: 39170467 PMC: 11336728. DOI: 10.1016/j.heliyon.2024.e35509.

Nephrons and non-relapse mortality: simplified comorbidity index and acute kidney injury are associated with NRM in adults undergoing allogeneic hematopoietic cell transplant.

Robinson C, Habib A, Klomjit N, Cao Q, Holtan S Front Transplant. 2024; 3:1352413.

PMID: 38993762 PMC: 11235361. DOI: 10.3389/frtra.2024.1352413.

Manufacturing CAR-NK against tumors: Who is the ideal supplier?.

Guo F, Zhang Y, Cui J Chin J Cancer Res. 2024; 36(1):1-16.

PMID: 38455373 PMC: 10915637. DOI: 10.21147/j.issn.1000-9604.2024.01.01.

References

Ballen K, Spitzer T, Yeap B, McAfee S, Dey B, Attar E . Double unrelated reduced-intensity umbilical cord blood transplantation in adults. Biol Blood Marrow Transplant. 2007; 13(1):82-9. PMC: 2947324. DOI: 10.1016/j.bbmt.2006.08.041. View

Brunstein C, Miller J, Cao Q, McKenna D, Hippen K, Curtsinger J . Infusion of ex vivo expanded T regulatory cells in adults transplanted with umbilical cord blood: safety profile and detection kinetics. Blood. 2010; 117(3):1061-70. PMC: 3035067. DOI: 10.1182/blood-2010-07-293795. View

Peled T, Mandel J, Goudsmid R, Landor C, Hasson N, Harati D . Pre-clinical development of cord blood-derived progenitor cell graft expanded ex vivo with cytokines and the polyamine copper chelator tetraethylenepentamine. Cytotherapy. 2005; 6(4):344-55. DOI: 10.1080/14653240410004916. View

Cutler C, Multani P, Robbins D, Kim H, Le T, Hoggatt J . Prostaglandin-modulated umbilical cord blood hematopoietic stem cell transplantation. Blood. 2013; 122(17):3074-81. PMC: 3811179. DOI: 10.1182/blood-2013-05-503177. View

Sanz G, Saavedra S, Planelles D, Senent L, Cervera J, Barragan E . Standardized, unrelated donor cord blood transplantation in adults with hematologic malignancies. Blood. 2001; 98(8):2332-8. DOI: 10.1182/blood.v98.8.2332. View

Robinson S, Simmons P, Thomas M, Brouard N, Javni J, Trilok S . Ex vivo fucosylation improves human cord blood engraftment in NOD-SCID IL-2Rγ(null) mice. Exp Hematol. 2012; 40(6):445-56. PMC: 3352960. DOI: 10.1016/j.exphem.2012.01.015. View

De Bruyn C, Delforge A, Bron D, Bernier M, Massy M, De Hemptinne D . Ex vivo expansion of CD34 + CD38- cord blood cells. J Hematother. 1997; 6(2):93-102. DOI: 10.1089/scd.1.1997.6.93. View

Kogler G, Callejas J, Sorg R, Wernet P . An eight-fold ex vivo expansion of long-term culture-initiating cells from umbilical cord blood in stirred suspension cultures. Bone Marrow Transplant. 1998; 21 Suppl 3:S48-53. View

Rodrigues C, Sanz G, Brunstein C, Sanz J, Wagner J, Renaud M . Analysis of risk factors for outcomes after unrelated cord blood transplantation in adults with lymphoid malignancies: a study by the Eurocord-Netcord and lymphoma working party of the European group for blood and marrow transplantation. J Clin Oncol. 2008; 27(2):256-63. DOI: 10.1200/JCO.2007.15.8865. View

10.

Fernandes J, Rocha V, Labopin M, Neven B, Moshous D, Gennery A . Transplantation in patients with SCID: mismatched related stem cells or unrelated cord blood?. Blood. 2012; 119(12):2949-55. DOI: 10.1182/blood-2011-06-363572. View

11.

Thomas E, Storb R, Clift R, Fefer A, Johnson F, Neiman P . Bone-marrow transplantation (first of two parts). N Engl J Med. 1975; 292(16):832-43. DOI: 10.1056/NEJM197504172921605. View

12.

Jain N, Liu H, Artz A, Anastasi J, Odenike O, Godley L . Immune reconstitution after combined haploidentical and umbilical cord blood transplant. Leuk Lymphoma. 2012; 54(6):1242-9. DOI: 10.3109/10428194.2012.739688. View

13.

Broxmeyer H, Srour E, Hangoc G, Cooper S, Anderson S, Bodine D . High-efficiency recovery of functional hematopoietic progenitor and stem cells from human cord blood cryopreserved for 15 years. Proc Natl Acad Sci U S A. 2003; 100(2):645-50. PMC: 141050. DOI: 10.1073/pnas.0237086100. View

14.

Robinson S, Ng J, Niu T, Yang H, McMannis J, Karandish S . Superior ex vivo cord blood expansion following co-culture with bone marrow-derived mesenchymal stem cells. Bone Marrow Transplant. 2006; 37(4):359-66. PMC: 1885539. DOI: 10.1038/sj.bmt.1705258. View

15.

DiGiusto D, Lee R, Moon J, Moss K, OToole T, VOYTOVICH A . Hematopoietic potential of cryopreserved and ex vivo manipulated umbilical cord blood progenitor cells evaluated in vitro and in vivo. Blood. 1996; 87(4):1261-71. View

16.

Lewis I, Almeida-Porada G, Du J, Lemischka I, Moore K, Zanjani E . Umbilical cord blood cells capable of engrafting in primary, secondary, and tertiary xenogeneic hosts are preserved after ex vivo culture in a noncontact system. Blood. 2001; 97(11):3441-9. DOI: 10.1182/blood.v97.11.3441. View

17.

Brunstein C, Barker J, Weisdorf D, DeFor T, Miller J, Blazar B . Umbilical cord blood transplantation after nonmyeloablative conditioning: impact on transplantation outcomes in 110 adults with hematologic disease. Blood. 2007; 110(8):3064-70. PMC: 2018678. DOI: 10.1182/blood-2007-04-067215. View

18.

Bleyer W, Blaese R, Bujak J, Herzig G, Graw Jr R . Long-term remission from acute myelogenous leukemia after bone marrow transplantation and recovery from acute graft-versus-host reaction and prolonged immunoincompetence. Blood. 1975; 45(2):171-81. View

19.

Fernandez M, Regidor C, Cabrera R, Garcia-Marco J, Fores R, Sanjuan I . Unrelated umbilical cord blood transplants in adults: Early recovery of neutrophils by supportive co-transplantation of a low number of highly purified peripheral blood CD34+ cells from an HLA-haploidentical donor. Exp Hematol. 2003; 31(6):535-44. DOI: 10.1016/s0301-472x(03)00067-5. View

20.

Barker J, Krepski T, DeFor T, Davies S, Wagner J, Weisdorf D . Searching for unrelated donor hematopoietic stem cells: availability and speed of umbilical cord blood versus bone marrow. Biol Blood Marrow Transplant. 2002; 8(5):257-60. DOI: 10.1053/bbmt.2002.v8.pm12064362. View