Human umbilical cord blood is a rich source of progenitor stem cells for transplantation and certain patients might have advantages with cord blood stem cell transplants instead of the same with bone marrow or peripheral blood stem cells. Stem cell transplants can be in the form of autologous transplants or allogenic transplants. Human umbilical cord blood for transplantation is collected from after a baby is delivered and donated cord blood (that meets requirements) is frozen for storage at cord blood banks for future use. The Stem Cell Therapeutic and Research Act of 2005 invested in several programs including the National Cord Blood Inventory (NCBI) for patients in need of transplantation. As for stem cell transplantation, transplanting blood-forming stem cells is acceptable when it comes to treatment for restoring the body’s ability to generate blood and immune cells. Hematopoietic stem cells in umbilical cord blood can develop into blood cells and related cell lineages. Certain patients with leukemia, lymphoma, and myeloma may benefit with chemotherapy or radiation therapy followed by stem cell transplantation.
The cells used in transplants can come from three sources: bone marrow, peripheral blood and the blood in the human umbilical cord. Currently, peripheral blood is the most common source of stem cells for transplant. Human umbilical cord blood stem cells are collected from the umbilical cord and placenta and contain a large number of blood-forming stem cells. The first successful human umbilical cord blood stem cell transplant was performed in 1988 for anemia. Human umbilical cord blood stem cell transplants have now been successful in patients with diseases including acute lymphocytic leukemia, acute myelogenous leukemia (AML), myelodysplastic syndromes (MDS), chronic myelogenous leukemia (CML), juvenile chronic myelogenous leukemia (JCML), chronic lymphocytic leukemia (CLL), Hodgkin and non-Hodgkin lymphoma, neuroblastoma, thalassemia, severe combined immune deficiency (SCID), Wiskott Aldrich syndrome, and metabolic diseases such as adrenoleukodystrophy and Hurler syndrome.
The complications of human umbilical cord blood transplants can be similar to allogeneic stem cell transplants and therefore the procedure should be done with utmost medical expertise! On the brighter side of things, the potential advantages for patients with stem cell transplants from human umbilical cord can be:
• Availability: Cord blood is stored in cord blood bank and is always prescreened, tested and frozen for use in future. Searching for a bone marrow or peripheral blood donor is more difficult than this option when it comes to availing stem cells for transplant.
• Human Leukocyte Antigen (HLA) Matching: The outcomes of donor stem cell transplants are strongly affected by HLA matching between the transplant recipient and the donor human umbilical cord blood. HLA matching is important to ensure successful engraftment, severity of graft-versus-host disease, and transplantation outcome. Clinical studies suggest that the match may not have to be as close as the required degree of match in case of bone marrow or peripheral blood transplants.
• Graft-Versus-Host Disease: Clinical studies report that with human umbilical cord blood stem cell transplant, fewer patients got graft vs host disease and patients with graft vs host disease have less complications than in case of bone marrow or peripheral blood stem cell transplants.
• Infectious Disease Transmission: Human umbilical cord blood stem cell transplants carry less risk of blood-borne infectious disease transmission compared with stem cells from the peripheral blood or bone marrow.
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