PMID- 15183901
OWN - NLM
STAT- MEDLINE
DCOM- 20041223
LR  - 20220321
IS  - 0268-960X (Print)
IS  - 0268-960X (Linking)
VI  - 18
IP  - 3
DP  - 2004 Sep
TI  - Umbilical cord blood transplantation--how, when and for whom?
PG  - 167-79
AB  - In recent years, umbilical cord blood (UCB) has emerged as a feasible alternative 
      source of hematopoietic progenitors (CD34+) for allogeneic stem cell 
      transplantation, mainly in patients who lack HLA-matched marrow donors. Since the 
      first case reported in 1998, more than 3500 patients have received UCB 
      transplants for a variety of malignant and non-malignant diseases. The vast 
      majority of recipients were children with an average weight of 20 kg; however, 
      more than 500 UCB transplantations (UCBTs) have already been performed in adults. 
      The "naive" nature of UCB lymphocytes also permits the use of HLA-mismatched 
      grafts at 1-2 loci without higher risk for severe graft versus host disease 
      (GvHD) relative to bone marrow transplantation (BMT) from a full matched 
      unrelated donor. Furthermore, UCB is rich in primitive CD16(-)CD56++ NK cells, 
      which possess impressive proliferative and cytotoxic capacities and can be 
      induced to expand using IL-12 or IL-15, so as to mount a substantial graft versus 
      leukemia (GvL) effect. The main disadvantage of UCB is the low stem cell yields, 
      resulting in higher rates of graft failure as well as delayed time to engraftment 
      compared to BMT. One rational approach to overcome this limitation involves ex 
      vivo expansion of UCB derived hematopoietic precursors. In this review we tried 
      to answer the question: UCBT how, when and for whom. This procedure is mostly 
      applicable for children and especially those with indication for full allogeneic 
      transplantation but who lack a matched sibling donor. Experimental approaches 
      including ex vivo expansion of CB with cocktail of hematopoietic growth factors, 
      with or without differentiation blocking agents, co-transplantation of 
      haploidentical and CB cells or co-transfusion of CB and mesenchymal cells may 
      enable successful UCBT in adults and probably will result in expanding the 
      indication to solid tumors or autoimmune disorders.
FAU - Cohen, Yossi
AU  - Cohen Y
AD  - Institute of Hematology, Bone Marrow Transplantation and Cord Blood Bank, Chaim 
      Sheba Medical Center, Tel Hashomer, Ramat-Gan 52621, Israel.
FAU - Nagler, Arnon
AU  - Nagler A
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Blood Rev
JT  - Blood reviews
JID - 8708558
RN  - 0 (Antigens, CD)
RN  - 0 (Histocompatibility Antigens Class I)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Antigens, CD
MH  - Bone Marrow Transplantation/immunology/mortality
MH  - Child
MH  - Child, Preschool
MH  - *Cord Blood Stem Cell Transplantation/mortality
MH  - Female
MH  - Graft vs Host Disease/*prevention & control
MH  - *Graft vs Leukemia Effect
MH  - Hematologic Neoplasms/therapy
MH  - Histocompatibility Antigens Class I/immunology
MH  - Histocompatibility Testing
MH  - Humans
MH  - Infant
MH  - Killer Cells, Natural/immunology
MH  - Male
MH  - Middle Aged
MH  - Transplantation Conditioning
MH  - Transplantation Immunology
MH  - Treatment Outcome
RF  - 63
EDAT- 2004/06/09 05:00
MHDA- 2004/12/24 09:00
CRDT- 2004/06/09 05:00
PHST- 2004/06/09 05:00 [pubmed]
PHST- 2004/12/24 09:00 [medline]
PHST- 2004/06/09 05:00 [entrez]
AID - S0268960X0300064X [pii]
AID - 10.1016/S0268-960X(03)00064-X [doi]
PST - ppublish
SO  - Blood Rev. 2004 Sep;18(3):167-79. doi: 10.1016/S0268-960X(03)00064-X.