Umbilical Cord Blood Transplantation: Connecting Its Origin to Its Future

Authors

Gabriela Sanchez-Petitto
Katayoun Rezvani
May Daher
Hind Rafei
Partow Kebriaei
Elizabeth J Shpall
Amanda Olson

Publication Date

3-3-2023

Journal

Stem Cells Translational Medicine

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.

Keywords

adult hematopoietic stem cells, stem/progenitor cell, stem cell transplantation, cord blood, umbilical cord blood

Comments

PMID: 36779789