Alkindi Salam, Dennison David
Department of Haematology, College of Medicine & Health Sciences, Muscat, Oman;
Sultan Qaboos Univ Med J. 2011 Nov;11(4):455-61. Epub 2011 Oct 25.
It is more than 20 years since the first cord blood transplant (CBT) was performed, following the realisation that cord blood (CB), which is normally wasted, is rich in progenitor cells and capable of rescuing haematopoiesis. Since then it has been appreciated that CB is rich in stem cells, and has many other features not the least of which is its ability to rescue the transplanted patient without a rigid need for full human lymphocyte antigen (HLA) compatibility. Also it is easily accessible, relatively free from infections and poses no medical risk to the donor. However, the quantity of the stem cells is rather small, thus predominantly restricting its use to children or adults requiring double units. In Oman, we have taken a keen interest in stem cell research and also CBT. We see such activities as an avenue for our patients, for whom a compatible bone marrow (BM) or a peripheral blood donor cannot be found, to have an alternative in the form of CBT. This has encouraged us to establish a national voluntary cord blood bank (CBB) which is a valuable option open to a selected group of patients, as compared to the controversial private CBB. This national CBB will have a better representation of HLA-types common in the region, an improvement on relying on banks in other countries. Considering the need for stem cell transplant/therapy in this country, it is only appropriate that this sort of bank is established to cater for some of these requirements.
自首次进行脐带血移植(CBT)以来已有20多年,此前人们认识到通常被浪费的脐带血(CB)富含祖细胞且能够挽救造血功能。从那时起,人们认识到CB富含干细胞,并且具有许多其他特征,其中最重要的是它能够在对人类淋巴细胞抗原(HLA)完全匹配没有严格要求的情况下挽救移植患者。此外,它易于获取,相对不易感染,并且对供体没有医疗风险。然而,干细胞的数量相当少,因此主要将其使用限制于需要双份单位的儿童或成人。在阿曼,我们对干细胞研究以及脐带血移植有着浓厚的兴趣。我们将此类活动视为为我们的患者提供的一条途径,对于这些患者来说,如果找不到匹配的骨髓(BM)或外周血供体,脐带血移植可以作为一种替代选择。这鼓励我们建立一个国家自愿脐带血库(CBB),与有争议的私人脐带血库相比,这对特定患者群体来说是一个有价值的选择。这个国家脐带血库将更好地代表该地区常见的HLA类型,这比依赖其他国家的血库有所改进。考虑到该国对干细胞移植/治疗的需求,建立这样的血库来满足其中一些需求是恰当的。