Barriga F, Wietstruck M A
Department of Pediatrics, Catholic University of Chile, Santiago, Chile.
Transplant Proc. 2007 Apr;39(3):629-30. doi: 10.1016/j.transproceed.2006.12.025.
Umbilical cord blood (UCB) banks have increased their stock worldwide in the past years. There are more than 230,000 available units today. The ideal UCB graft is a unit that is matched in five or six of six HLA. A, B (low-resolution) and DRB1 (high-resolution) alleles and which has over 2.5 x 107 nucleated cells/kg body weight (BW). Four of six matched units are also used specially if the cell dose gives more than 3 x 10(7) nucleated cells/kg BW. Our unrelated donor UCB transplant program was started in 1996 searching international cord blood banks (Netcord, New York) for patients with a definitive or potential indication for stem cell transplantation who lacked a matched family donor.
From 1995 to 1996, a search was initiated for 87 patients with malignant (n = 56, 37 acute leukemia) and nonmalignant conditions (16 congenital diseases, 14 aplastic anemia). Patient data along with low-resolution A, B, and DR typing were sent to the New York Blood Center, along with a blood sample for high-resolution DRB1 typing. Parallel searches were done in the Netcord database among UCB units with reported high-resolution DRB1 typing. Forty-eight searches were done between 1995 and 2000 (31 with high resolution) and 39 were done between 2000 and 2005 (33 with high resolution). UCB units were considered adequate if they had more than 2.7 x 10(7) cells/kg BW.
During the first period, four patients (13%) matched five of six high-resolution unit and 21 (67%) a four of six match. During the second period, 15 patients (46%) found a five of six match and 16 (48%) a four of six match (P = .012).
Nearly half of our patients find an optimal matched UCB unit for transplantation in international banks. The creation of a local UCB bank in our country is supported by these data.
在过去几年中，脐带血（UCB）库在全球范围内增加了其库存。如今有超过23万个可用单位。理想的UCB移植物是在六个HLA中的五个或六个上匹配的单位。A、B（低分辨率）和DRB1（高分辨率）等位基因，并且每千克体重（BW）有超过2.5×10⁷个有核细胞。如果细胞剂量每千克体重BW超过3×10⁷个有核细胞，六个匹配单位中的四个也会被特别使用。我们的无关供体UCB移植项目始于1996年，在国际脐带血库（纽约Netcord）中为缺乏匹配家族供体且有明确或潜在干细胞移植指征的患者进行搜索。
1995年至1996年，对87例患有恶性疾病（n = 56，37例急性白血病）和非恶性疾病（16例先天性疾病，14例再生障碍性贫血）的患者进行了搜索。患者数据以及低分辨率A、B和DR分型结果被发送到纽约血液中心，同时还送去一份血液样本用于高分辨率DRB1分型。在Netcord数据库中对报告了高分辨率DRB1分型的UCB单位进行了并行搜索。1995年至2000年进行了48次搜索（31次为高分辨率），2000年至2005年进行了39次搜索（33次为高分辨率）。如果UCB单位每千克体重BW有超过2.7×10⁷个细胞，则认为其足够。
在第一阶段，4例患者（13%）与六个高分辨率单位中的五个匹配，21例（67%）与六个中的四个匹配。在第二阶段，15例患者（46%）找到了六个中的五个匹配，16例（48%）找到了六个中的四个匹配（P = 0.012）。
我们近一半的患者在国际库中找到了用于移植的最佳匹配UCB单位。这些数据支持在我国建立本地UCB库。
