About 14,000 unrelated cord blood transplantation (UCBT) procedures have been performed worldwide in the past decade, based on estimates from the major registries in North America, Europe, Asia and elsewhere. The joint NMDP/AABB program “Clinical Advances in Hematopoietic Cell Transplantation” (9134-TC-CT) included three speakers providing the most recent information on clinical progress and future directions.

Vanderson Rocha MD, PhD, from Eurocord gave an update from the European perspective, reviewing hematopoietic stem cell transplant (HSCT) volumes by product type and patient outcomes. The focus continued on cord blood, which provides the convenience of a readily available donor source and rapid availability. Lower cell dose--leading to graft failure and delayed immune recovery--continued to be the major challenge. As expected, engraftment is better in pediatric patients, with Eurocord reporting 78% two-year overall survival in children receiving UCBT with an HLA-identical or one-antigen mismatch graft. UCBT remains an alternative source of cells in the absence of an HLA-matched sibling donor for children with malignant and nonmalignant disorders.
In reviewing adult UCBT data, Rocha described the major factors affecting outcomes. A detailed breakdown by product type, disease state, conditioning regimens and outcomes followed. Outcomes of single UCBT using a myeloablative regimen are comparable with results of 7/8 matched unrelated marrow grafts. The Eurocord presentation concluded with current recommendations including: Cell doses ≥ 2.5 x 10⁷ nucleated cells/kg and/or ≥ 1.5 x 10⁵ CD34+cells/kg. The second factor for consideration is minimal mismatches (0-1 preferred) and Class I HLA mismatches preferred over Class II.
From：www.aabb.org