Umbilical Cord Blood Transplantation: Connecting Its Origin to Its Future

Overview

Journal Stem Cells Transl Med

Publisher Oxford University Press

Specialties Cell Biology
Pharmacology

Date 2023 Feb 13

PMID 36779789

Authors

Gabriela Sanchez-Petitto

Katayoun Rezvani

May Daher

Hind Rafei

Partow Kebriaei

Elizabeth J Shpall

Amanda Olson

Affiliations

Soon will be listed here.

Abstract

Transplantation of umbilical cord blood (UCB) is an attractive alternative source of hematopoietic stem cells (HSCs). The unique properties of cord blood and its distinct immune tolerance and engraftment kinetics compared to bone marrow (BM) and peripheral blood progenitor cells, permit a wider disparity in human leukocyte antigen levels between a cord blood donor and recipient after an unrelated umbilical cord blood transplant (UCBT). In addition, it is readily available and has a lowered risk of graft-versus-host disease (GvHD), with similar long-term clinical outcomes, compared to BM transplants. However, the relatively low number of cells administered by UCB units, as well as the associated delayed engraftment and immune reconstitution, pose limitations to the wide application of UCBT. Research into several aspects of UCBT has been evaluated, including the ex vivo expansion of cord blood HSCs and the process of fucosylation to enhance engraftment. Additionally, UCB has also been used in the treatment of several neurodegenerative and cardiovascular disorders with varying degrees of success. In this article, we will discuss the biology, clinical indications, and benefits of UCBT in pediatric and adult populations. We will also discuss future directions for the use of cord blood.

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References

Rubinstein P, Carrier C, Scaradavou A, Kurtzberg J, Adamson J, Migliaccio A . Outcomes among 562 recipients of placental-blood transplants from unrelated donors. N Engl J Med. 1998; 339(22):1565-77. DOI: 10.1056/NEJM199811263392201. View

Li X, Hu Y, Guo Y, Chen Y, Guo D, Zhou H . Safety and efficacy of intracoronary human umbilical cord-derived mesenchymal stem cell treatment for very old patients with coronary chronic total occlusion. Curr Pharm Des. 2014; 21(11):1426-32. DOI: 10.2174/1381612821666141126100636. View

Gluckman E, Broxmeyer H, Auerbach A, Friedman H, Douglas G, Devergie A . Hematopoietic reconstitution in a patient with Fanconi's anemia by means of umbilical-cord blood from an HLA-identical sibling. N Engl J Med. 1989; 321(17):1174-8. DOI: 10.1056/NEJM198910263211707. View

Ruggeri A, Paviglianiti A, Gluckman E, Rocha V . Impact of HLA in cord blood transplantation outcomes. HLA. 2016; 87(6):413-21. DOI: 10.1111/tan.12792. View

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

Withers B, Blyth E, Clancy L, Yong A, Fraser C, Burgess J . Long-term control of recurrent or refractory viral infections after allogeneic HSCT with third-party virus-specific T cells. Blood Adv. 2018; 1(24):2193-2205. PMC: 5737128. DOI: 10.1182/bloodadvances.2017010223. View

Shah N, Li L, McCarty J, Kaur I, Yvon E, Shaim H . Phase I study of cord blood-derived natural killer cells combined with autologous stem cell transplantation in multiple myeloma. Br J Haematol. 2017; 177(3):457-466. PMC: 5856008. DOI: 10.1111/bjh.14570. View

Gao L, Chen Y, Zhang N, Yang X, Liu H, Wang Z . Intracoronary infusion of Wharton's jelly-derived mesenchymal stem cells in acute myocardial infarction: double-blind, randomized controlled trial. BMC Med. 2015; 13:162. PMC: 4499169. DOI: 10.1186/s12916-015-0399-z. View

Hill J, Mayer B, Xie H, Leisenring W, Huang M, Stevens-Ayers T . The cumulative burden of double-stranded DNA virus detection after allogeneic HCT is associated with increased mortality. Blood. 2017; 129(16):2316-2325. PMC: 5399484. DOI: 10.1182/blood-2016-10-748426. View

10.

Ulus A, Mungan C, Kurtoglu M, Celikkan F, Akyol M, Sucu M . Intramyocardial Transplantation of Umbilical Cord Mesenchymal Stromal Cells in Chronic Ischemic Cardiomyopathy: A Controlled, Randomized Clinical Trial (HUC-HEART Trial). Int J Stem Cells. 2020; 13(3):364-376. PMC: 7691850. DOI: 10.15283/ijsc20075. View

11.

Pidala J, Kim J, Schell M, Lee S, Hillgruber R, Nye V . Race/ethnicity affects the probability of finding an HLA-A, -B, -C and -DRB1 allele-matched unrelated donor and likelihood of subsequent transplant utilization. Bone Marrow Transplant. 2012; 48(3):346-50. PMC: 4500122. DOI: 10.1038/bmt.2012.150. View

12.

Albu S, Kumru H, Coll R, Vives J, Valles M, Benito-Penalva J . Clinical effects of intrathecal administration of expanded Wharton jelly mesenchymal stromal cells in patients with chronic complete spinal cord injury: a randomized controlled study. Cytotherapy. 2020; 23(2):146-156. DOI: 10.1016/j.jcyt.2020.08.008. View

13.

Aljitawi O, Paul S, Ganguly A, Lin T, Ganguly S, Vielhauer G . Erythropoietin modulation is associated with improved homing and engraftment after umbilical cord blood transplantation. Blood. 2016; 128(25):3000-3010. PMC: 5179334. DOI: 10.1182/blood-2016-05-715292. View

14.

Kim D, Lee D, Chang E, Kim J, Hwang J, Kim J . GDF-15 secreted from human umbilical cord blood mesenchymal stem cells delivered through the cerebrospinal fluid promotes hippocampal neurogenesis and synaptic activity in an Alzheimer's disease model. Stem Cells Dev. 2015; 24(20):2378-90. PMC: 4598918. DOI: 10.1089/scd.2014.0487. View

15.

Lee S, Klein J, Haagenson M, Baxter-Lowe L, Confer D, Eapen M . High-resolution donor-recipient HLA matching contributes to the success of unrelated donor marrow transplantation. Blood. 2007; 110(13):4576-83. DOI: 10.1182/blood-2007-06-097386. View

16.

Meng F, Xu R, Wang S, Xu Z, Zhang C, Li Y . Human umbilical cord-derived mesenchymal stem cell therapy in patients with COVID-19: a phase 1 clinical trial. Signal Transduct Target Ther. 2020; 5(1):172. PMC: 7450163. DOI: 10.1038/s41392-020-00286-5. View

17.

Henslee-Downey P . Allogeneic transplantation across major HLA barriers. Best Pract Res Clin Haematol. 2002; 14(4):741-54. DOI: 10.1053/beha.2001.0170. View

18.

Cohen S, Roy J, Lachance S, Delisle J, Marinier A, Busque L . Hematopoietic stem cell transplantation using single UM171-expanded cord blood: a single-arm, phase 1-2 safety and feasibility study. Lancet Haematol. 2019; 7(2):e134-e145. DOI: 10.1016/S2352-3026(19)30202-9. View

19.

Yao L, He C, Zhao Y, Wang J, Tang M, Li J . Human umbilical cord blood stem cell transplantation for the treatment of chronic spinal cord injury: Electrophysiological changes and long-term efficacy. Neural Regen Res. 2014; 8(5):397-403. PMC: 4146127. DOI: 10.3969/j.issn.1673-5374.2013.05.002. View

20.

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