PMID- 36066376
OWN - NLM
STAT- MEDLINE
DCOM- 20221011
LR  - 20231102
IS  - 1531-7048 (Electronic)
IS  - 1065-6251 (Print)
IS  - 1065-6251 (Linking)
VI  - 29
IP  - 6
DP  - 2022 Nov 1
TI  - Umbilical cord blood: an undervalued and underutilized resource in allogeneic 
      hematopoietic stem cell transplant and novel cell therapy applications.
PG  - 317-326
LID - 10.1097/MOH.0000000000000732 [doi]
AB  - PURPOSE OF REVIEW: The purpose of this review is to primarily discuss the 
      unwarranted decline in the use of umbilical cord blood (UCB) as a source of donor 
      hematopoietic stem cells (HSC) for hematopoietic cell transplantation (HCT) and 
      the resulting important implications in addressing healthcare inequities, and 
      secondly to highlight the incredible potential of UCB and related birthing 
      tissues for the development of a broad range of therapies to treat human disease 
      including but not limited to oncology, neurologic, cardiac, orthopedic and 
      immunologic conditions. RECENT FINDINGS: When current best practices are 
      followed, unrelated donor umbilical cord blood transplant (CBT) can provide 
      superior quality of life-related survival compared to other allogeneic HSC donor 
      sources (sibling, matched or mismatched unrelated, and haploidentical) through 
      decreased risks of relapse and chronic graft vs. host disease. Current best 
      practices include improved UCB donor selection criteria with consideration of 
      higher resolution human leukocyte antigen (HLA) typing and CD34+ cell dose, 
      availability of newer myeloablative but reduced toxicity conditioning regimens, 
      and rigorous supportive care in the early posttransplant period with monitoring 
      for known complications, especially related to viral and other infections that 
      may require intervention. Emerging best practice may include the use of ex vivo 
      expanded single-unit CBT rather than double-unit CBT (dCBT) or 'haplo-cord' 
      transplant, and the incorporation of posttransplant cyclophosphamide as with 
      haploidentical transplant and/or incorporation of novel posttransplant therapies 
      to reduce the risk of relapse, such as NK cell adoptive transfer. Novel, non-HCT 
      uses of UCB and birthing tissue include the production of UCB-derived immune 
      effector cell therapies such as unmodified NK cells, chimeric antigen 
      receptor-natural killer cells and immune T-cell populations, the isolation of 
      mesenchymal stem cells for immune modulatory treatments and derivation of induced 
      pluripotent stem cells haplobanks for regenerative medicine development and 
      population studies to facilitate exploration of drug development through 
      functional genomics. SUMMARY: The potential of allogeneic UCB for HCT and novel 
      cell-based therapies is undervalued and underutilized. The inventory of 
      high-quality UCB units available from public cord blood banks (CBB) should be 
      expanding rather than contracting in order to address ongoing healthcare 
      inequities and to maintain a valuable source of cellular starting material for 
      cell and gene therapies and regenerative medicine approaches. The expertise in 
      Good Manufacturing Practice-grade manufacturing provided by CBB should be 
      supported to effectively partner with groups developing UCB for novel cell-based 
      therapies.
CI  - Copyright (c) 2022 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Shi, Patricia A
AU  - Shi PA
AD  - Lindsley F. Kimball Research Institute, New York Blood Center, New York, New 
      York.
FAU - Luchsinger, Larry L
AU  - Luchsinger LL
AD  - Lindsley F. Kimball Research Institute, New York Blood Center, New York, New 
      York.
FAU - Greally, John M
AU  - Greally JM
AD  - Department of Genetics, Albert Einstein College of Medicine, Bronx, New York.
FAU - Delaney, Colleen S
AU  - Delaney CS
AD  - Division of Hematology-Oncology, Seattle Children's Hospital; Department of 
      Pediatrics, University of Washington School of Medicine.
AD  - Deverra Therapeutics, Inc., Seattle, Washington, USA.
LA  - eng
GR  - P50 HD105352/HD/NICHD NIH HHS/United States
GR  - R01 HL155574/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Review
DEP - 20220829
PL  - United States
TA  - Curr Opin Hematol
JT  - Current opinion in hematology
JID - 9430802
RN  - 0 (HLA Antigens)
RN  - 0 (Receptors, Chimeric Antigen)
RN  - 8N3DW7272P (Cyclophosphamide)
SB  - IM
MH  - Cell- and Tissue-Based Therapy
MH  - *Cord Blood Stem Cell Transplantation
MH  - Cyclophosphamide
MH  - Fetal Blood
MH  - *Graft vs Host Disease
MH  - HLA Antigens/genetics
MH  - *Hematopoietic Stem Cell Transplantation/adverse effects
MH  - Humans
MH  - Quality of Life
MH  - *Receptors, Chimeric Antigen
MH  - Recurrence
MH  - Unrelated Donors
PMC - PMC9547826
MID - NIHMS1819150
COIS- Conflicts of interest: New York Blood Center has an FDA-licensed cord blood bank. 
      Deverra Therapeutics is currently developing UCB-derived allogeneic cell 
      therapies.
EDAT- 2022/09/07 06:00
MHDA- 2022/10/12 06:00
PMCR- 2023/11/01
CRDT- 2022/09/06 10:04
PHST- 2022/09/07 06:00 [pubmed]
PHST- 2022/10/12 06:00 [medline]
PHST- 2022/09/06 10:04 [entrez]
PHST- 2023/11/01 00:00 [pmc-release]
AID - 00062752-202211000-00008 [pii]
AID - 10.1097/MOH.0000000000000732 [doi]
PST - ppublish
SO  - Curr Opin Hematol. 2022 Nov 1;29(6):317-326. doi: 10.1097/MOH.0000000000000732. 
      Epub 2022 Aug 29.