Abstract
Various factors make cord blood (CB) a significant source of hematopoietic stem cells (HSCs), including ease of procurement and lack of donor attrition, with the ability to process and store the donor cells long term. Importantly, high proliferative potential of the immature HSCs allows one log less use of cells compared to bone marrow or peripheral blood stem cells. As total nucleated cell (TNC) and CD34+ cell content of CB grafts are correlated to engraftment rate and speed, strategies to expand HSC and homing have been developed. This chapter will focus only on modalities such as intrabone administration, fucosylation, CD26 inhibition, prostaglandin E2 derivative or complement 3 exposure, and SDF-1/CXCR4/CXCL-12 pathway interventions that have been experimented successfully. Furthermore, increasing evidence in line with better recognition of CB progenitors that are involved in engraftment and homing will also be addressed.
Highlights
How to improve Cord Blood engraftment?Case Western Reserve University and University Hospitals Case Medical Center, USA
The first decade of unrelated donor CBT (UCBT) experience was important in defining critical total nucleated cell (TNC) and CD34+ cell dose thresholds required for acceptable clinical outcomes, and in moving from related to UCBT and from pediatric to adult patients
Phase I/II clinical trials to evaluate the impact of infusion of expanded cryopreserved cord blood (CB) progenitor cells with Notch ligand or nicotinamide (NiCord) (Clinical Trial Identifier: NCT 01175785 and NCT01816230, respectively) on augmenting the UCBT outcome are ongoing in Fred Hutchinson and Duke Universities
Summary
Case Western Reserve University and University Hospitals Case Medical Center, USA. Reviewed by: Owen McCarty, Oregon Health & Science University, USA Mary Joan Laughlin, Cleveland Cord Blood Center, USA. Specialty section: This article was submitted to Hematology, a section of the journal
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