Umbilical cord blood transplantation: current practice and future innovations.

Overview

As a source of hematopoietic stem cells (HSCs), umbilical cord blood (UCB) has the advantages of speed of availability, tolerance of 1-2 antigen HLA mismatch, and a low incidence of severe GVHD. Thus, UCB represents a highly convenient HSC source that may significantly extend the HSC donor pool. UCB transplantation (UCBT) has become a standard practice in the treatment of pediatric malignancies. Now, UCBT is being investigated in adults using both conventional and non-myeloablative preparative regimens. As graft cell dose is the major factor determining hematopoietic recovery and survival in URD UCBT, methods to increase cell dose such as multiple-unit transplant and ex vivo expansion are being pursued. This review outlines the current status of UCBT with emphasis on current and future innovations.