Cord blood transplantation

Less stringent HLA compatibility with recipient is required.

Acceptable donor can be acquired in a median of 13.5 days.

Contains about one-tenth the hematopoietic progenitor cells as a bone marrow harvest.

An acceptable source of hematopoietic stem cell graft for adults in the absence of an HLA-matched adult donor.

Cord stem cells are less developed than adult stem cells, and do not have to be matched as stringently to a patient’s HLA type.

Is the pref2242ed graft source for pediatric patients with acute leukemia and double cord transplants are making it possible for adults to be transplanted.

Hematopoietic graft reconstitution in children and adults occurs more slowly than do bone marrow grafts and this contributes to relatively high rates of post-transplant infection and early death.

Reduces risk of graft versus host disease: and match-by-match comparison between donor and recipient, graft versus host disease is less common with stem cells from cord blood than from bone marrow or peripheral blood.

Reduction in graft versus host disease increases the donor pool by expanding the degree and definition of acceptable matches.

Cord blood is the only source of stem cells that is banked, and procurement is fast.

Associated with more graft failures due to the limited amount of cells available.

Has the potential for delayed time to engraftment, with longer hospitalizations, longer requirement for transfusion therapy, and increased risk of infections.

Associated with delayed immune recovery, especially in adults.

The use of mesenchymoma stromal cell expansion technique with cord blood transplant expands CD 34 positive cells by a median factor of approximately 30 times.

With the use of mesenchymoma stromal cell expansion technique engraftment decreases to a median of approximately 15 days.

Cord blood transplant is associated with prolonged thrombocytopenia, especially in adults.

Associated often with prolonged neutrophil and platelet recovery.