Statistical Center, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Semin Hematol. 2010 Jan;47(1):46-50. doi: 10.1053/j.seminhematol.2009.10.007.
Umbilical cord blood (UCB) has gradually emerged over the last decade as an alternative source of hematopoietic cells for transplantation in children and adults with high-risk or advanced hematologic malignancies who do not have a suitably matched related or unrelated adult donor. This increase in use of UCB is due to favorable results in children, growing availability of UCB units with large cell doses, less stringent donor-recipient HLA matching, and rapid identification and acquisition of the unit. In children with acute leukemia, the data support similar leukemia-free survival after transplantation of human leukocyte antigen (HLA)-matched and one or two HLA-mismatched UCB and HLA-matched unrelated donor bone marrow. In adults with acute leukemia, some reports suggest a survival advantage after transplantation of matched unrelated bone marrow compared to UCB, while others report similar leukemia-free survival. Work is in progress to improve hematopoietic recovery and lower early transplant-related deaths, the two major limitations to a successful outcome after UCB transplant. The importance of HLA-matching and cell dose on outcomes after UCB transplantation support the need for an even greater investment in public cord blood banks. Simultaneously searching of accredited cord blood banks and bone marrow donor registries for patients without an HLA-matched sibling thought to benefit from hematopoietic stem cell transplantation (HSCT) is encouraged.
脐带血（UCB）在过去十年中逐渐成为高危或晚期血液系统恶性肿瘤的儿童和成人造血细胞移植的替代来源，这些患者没有合适的匹配相关或无关的成年供体。UCB 的使用增加是由于在儿童中取得了良好的结果，具有大细胞剂量的 UCB 单位的可用性增加，对供体-受者 HLA 匹配的要求降低，以及能够快速识别和获取单位。在急性白血病患儿中，数据支持 HLA 匹配和一个或两个 HLA 错配 UCB 与 HLA 匹配的无关供体骨髓移植后无白血病生存相似。在急性白血病成人中，一些报告表明，与 UCB 相比，匹配的无关骨髓移植后有生存优势，而其他报告则显示无白血病生存相似。目前正在努力改善造血恢复并降低早期与移植相关的死亡，这是 UCB 移植后成功的两个主要限制。HLA 匹配和细胞剂量对 UCB 移植后结果的重要性支持需要在公共脐带血库中进行更大的投资。鼓励同时在经过认证的脐带血库和骨髓供体登记处为没有 HLA 匹配兄弟姐妹但被认为受益于造血干细胞移植（HSCT）的患者进行搜索。
