Rubinstein Pablo
National Cord Blood Program, Milstein Cord Blood Center, New York Blood Center, NY, USA.
Hum Immunol. 2006 Jun;67(6):398-404. doi: 10.1016/j.humimm.2006.03.015. Epub 2006 Mar 30.
Cord blood, donated by mothers after the birth of their children, has become an accepted source of related and unrelated hematopoietic stem cells for marrow reconstitution. We estimate that some 7-8000 unrelated-donor cord blood transplants have been performed worldwide since 1993. The development of cord blood as a source of hematopoietic stem cells for transplantation started with the early recognition of the presence in cord blood of colony-forming cells by Knudtzon in 1974. The first cord blood transplant from a human leukocyte antigen (HLA)-identical sib to a young patient with Fanconi anemia was performed by Gluckman in 1988 and opened the way for the subsequent development of a bank for donations for unrelated patients by our group at the New York Blood Center. It is now widely recognized that two transplant-dependent variables exert strong influence on the chance for long-term recipient survival: the hematopoietic stem and progenitor cell dose and the HLA match grade. Hence, despite the generally milder graft-vs-host disease after mismatched cord blood transplantation, large and ethnically diverse inventories of cord blood are needed to permit better HLA matches and long-term survivals. In this review, a number of issues that are relevant to the history and development of an effective system for cord blood banking are discussed.
脐带血是母亲在孩子出生后捐献的，已成为用于骨髓重建的相关和无关造血干细胞的公认来源。据我们估计，自1993年以来，全球已进行了约7000至8000例无关供者脐带血移植。脐带血作为移植造血干细胞来源的发展始于1974年克努茨松早期认识到脐带血中存在集落形成细胞。1988年，格鲁克曼进行了首例从人类白细胞抗原（HLA）匹配的同胞向一名患有范可尼贫血的年轻患者进行的脐带血移植，为我们纽约血液中心的团队随后为无关患者建立捐赠库的发展开辟了道路。现在人们普遍认识到，两个与移植相关的变量对受者长期存活的机会有很大影响：造血干细胞和祖细胞剂量以及HLA匹配程度。因此，尽管不匹配的脐带血移植后移植物抗宿主病通常较轻，但仍需要大量且种族多样的脐带血库存，以实现更好的HLA匹配和长期存活。在这篇综述中，讨论了一些与有效脐带血库系统的历史和发展相关的问题。
