George Thomas J, Sugrue Michele W, George Sarah N, Wingard John R
University of Florida, College of Medicine, Gainesville, Florida, USA.
Transfusion. 2006 Oct;46(10):1803-12. doi: 10.1111/j.1537-2995.2006.00971.x.
Umbilical cord blood (UCB) is an acceptable source of hematopoietic cells for transplantation with success being associated with the nucleated cell count (NCC), CD34+ cells, and colony-forming unit-granulocyte-macrophage (CFU-GM) content infused. A total of 1033 UCB samples with neonatal and paternal characteristics that might influence hematopoietic content were examined.
UCB samples were screened, processed, and reevaluated for the above cell counts. These parameters of engraftment potential were analyzed for associations with neonatal and parental characteristics.
Postprocessed NCCs (median, 6.53 x 10(8)+/- 2.80 x 10(8) SD; mean 7.30 x 10(8)), CD34+ counts (median, 2.02 x 10(6) +/- 2.20 x 10(6) SD; mean, 2.65 x 10(6); r = 0.66; p < 0.001), and CFU-GM content (median, 2.65 x 10(5) +/- 3.16 x 10(5) SD; mean, 3.54 x 10(5); r = 0.61; p < 0.001) all were strongly interrelated. Both initial volume (median, 77.5 +/- 26.2 mL SD; mean, 81.9 mL) and initial NCC (median, 9.75 x 10(8) +/- 4.88 x 10(8) SD; mean, 10.9 x 10(8)) correlated well with postprocessed NCC (r = 0.60; r = 0.90; p < 0.01), CD34+ count (r = 0.40; r = 0.63; p < 0.01), and CFU-GM content (r = 0.38; r = 0.59; p < 0.01), with a stronger relationship seen with initial NCC. Infant birth weight (specifically, >3000 g), but not sex, gestational age, or cytomegalovirus status correlated strongly with collection volume and UCB cell counts. Units from minority volunteers contained relatively smaller volumes and hematopoietic content.
UCB banks should emphasize selecting the heaviest infants and processing large-volume units with high NCCs to optimize hematopoietic potential. Minority recruitment should be encouraged with consideration given to inherent racial differences in cell counts. There does not appear to be a significant relationship between other neonatal and parental characteristics and that of engraftment potential.
脐带血(UCB)是可接受的造血细胞移植来源,移植成功与输注的有核细胞计数(NCC)、CD34+细胞以及集落形成单位-粒细胞-巨噬细胞(CFU-GM)含量相关。共检测了1033份具有可能影响造血含量的新生儿和父亲特征的脐带血样本。
对脐带血样本进行筛选、处理,并针对上述细胞计数进行重新评估。分析这些植入潜力参数与新生儿和父母特征之间的关联。
处理后的NCC(中位数,6.53×10⁸±2.80×10⁸标准差;均值7.30×10⁸)、CD34+细胞计数(中位数,2.02×10⁶±2.20×10⁶标准差;均值,2.65×10⁶;r = 0.66;p < 0.001)和CFU-GM含量(中位数,2.65×10⁵±3.16×10⁵标准差;均值,3.54×10⁵;r = 0.61;p < 0.001)均密切相关。初始体积(中位数,77.5±26.2 mL标准差;均值,81.9 mL)和初始NCC(中位数,9.75×10⁸±4.88×10⁸标准差;均值,10.9×10⁸)与处理后的NCC(r = 0.60;r = 0.90;p < 0.01)、CD34+细胞计数(r = 0.40;r = 0.63;p < 0.01)和CFU-GM含量(r = 0.38;r = 0.59;p < 0.01)均具有良好的相关性,与初始NCC的关系更强。婴儿出生体重(特别是>3000 g)与采集量和脐带血细胞计数密切相关,而性别、胎龄或巨细胞病毒状态则无此关联。来自少数族裔志愿者的样本体积和造血含量相对较小。
脐带血库应着重选择体重最重的婴儿,并处理有核细胞计数高的大容量样本,以优化造血潜力。应鼓励招募少数族裔,同时考虑细胞计数方面固有的种族差异。其他新生儿和父母特征与植入潜力之间似乎没有显著关系。