Resumen de Hematopoietic stem-cell transplantation using umbilical-cord blood cells
V. Rocha, F. Garnier, I. Ionescu, Ellen L. Glickman
Umbilical-cord blood transplantation (UCBT) has extended the availability of allogeneic hematopoietic stem-cell transplantation (HSCT) to patients who would otherwise not be eligible for this curative approach. Since the first successful UCBT from an HLA-identical sibling in a child with severe Fanconi's anemia reported by Gluckman et al. In 1989, the number of UCB transplants from siblings and unrelated donors has increased dramatically, and between 3, 000 to 6, 000 patients have undergone UCBT from unrelated donors thus far. In Japan, nowadays, approximately 50% of HSCT from unrelated donors are being performed with cord blood cells (T. Takahashi, personal communication). In comparison with other sources of allogeneic HSCT, UCB offers substantial logistic and clinical advantages such as: 1. Significantly faster availability of banked cryopreserved UCB units, with patients receiving UCB transplantation in a median of 25-36 days earlier than those receiving BM. 2. Extension of the donor pool due to tolerance of 1-2 HLA mismatch. 3. Lower incidence and severity of acute graft-versus-host disease (GVHD). 4. Lower risk of transmitting infections by latent viruses, such as cytomegalovirus (CMV) and Epstein-Barr virus (EBV). 5. Lack of donor attrition. 6. Lack of risk to the donor and higher frequency of rare haplotypes compared to bone marrow registries.
