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Umbilical cord blood banking and transplantation Volume 3, issue 4, Juillet - Août 1997

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Umbilical cord blood hematopoietic stem cells have distinct proliferative advantages which increase there potential use for allogeneic hematopoietic stem cell transplantation. In addition, the immune immaturity of the new-born should decrease the risk of graft versus host disease in both matched and mismatched cord blood transplants. Since 1988, date of the first cord blood transplant, more than 300 cases have been reported. Cord blood banks have been established with more than 10 000 units currently available for search for unrelated donors. Related cord blood collection and cryopreservation has been performed in families when a sibling must be treated by allogeneic hematopoietic stem cell transplant. Eurocord is a group whose aim is to standardize methods of cord blood banking, study the properties of cord blood stem cells and establish a registry of cord blood hematopoietic stem cells transplants. Results of the analysis show that cord blood hematopoietic stem cells are a good alternative to bone marrow hematopoietic stem cells in children and in adults with hematologic malignant and non malignant diseases. Factors associated with outcome were the number of nucleated cells infused, the number of HLA disparities, recipient CMV serology and, in leukemia, the status of the disease. Graft versus host disease is decreased both in frequency and severity confirming the advantage of cord blood. More studies are needed to study long term effect and particularly the incidence of leukemic relapses.