Experience in autologous and allogeneic cord blood banking.

Abstract

Transplantation and gene therapy offer the hope of treating thousands of individuals with various malignancies and genetic disorders. However, if this approach is to become a reality, there must be readily available sources of suitable HLA-A typed stem cells. Cord blood has been demonstrated to be a suitable source of hematopoietic stem cells that can be used in place of bone marrow stem cells for transplant. However, to implement the widespread clinical use of cord blood, it is necessary to establish both autologous and allogeneic cord blood banks from which stem cell specimens can be obtained. These cord blood banks must be large in size, reflect the ethnic diversity of the patient populations in need, and be financially and logistically feasible. At the Cord Blood Stem Cell Bank at the University of Arizona, we have addressed many of these issues and have taken the necessary steps to create both autologous and allogeneic cord blood banks. We have developed simple, efficient, and reproducible methods for cord blood collection that can be used by any physician without need for previous training. Further, we have developed methodologies to process the cord blood specimen so that samples can be stored in cryovials. This approach to cord blood banking allows for the storage of more than 10,000 independent cord blood specimens in a single liquid nitrogen freezer, reducing the costs and physical space requirements for such a facility. We also have developed the use of electronic integration of laboratory worksheets and controlled rate freezers that permit high laboratory throughput with reduced problems of reproducibility, data entry, and management errors. In terms of allogeneic cord blood banking, we have based our bank on several important assumptions regarding HLA haplotype frequency, ethnic diversity, and the need for less than perfect HLA matching between donor and recipient. These assumptions have allowed us to begin to create an allogeneic cord blood bank that can rapidly attain the size needed for clinical utility without exorbitant costs or time involved. Results of our efforts in autologous and allogeneic cord blood banking are presented (including factors that positively and negatively affect cord blood collection and banking).