Chandra Tulika, Afreen Sheeba, Kumar Ashutosh, Singh Uma, Gupta Ashish
Department of Transfusion Medicine, Chhatrapati Shahuji Maharaj Medical University, Lucknow, India.
J Pediatr Hematol Oncol. 2012 Apr;34(3):184-7. doi: 10.1097/MPH.0b013e318249adb6.
Umbilical cord blood has recently been considered as an alternative source of hematopoietic progenitor cells for clinical application. Patient survival in allogenic cord blood transplantation is critically dependent on the cord blood-derived total nucleated cell count and the total CD34 cell count/kg of the body weight. A number of factors such as maternal age, gestational age, newborn's sex and weight, umbilical cord length, and placental weight can influence the volume, amount of mononuclear cells, and the CD34 cell concentration. Cord blood was collected from normal vaginal and cesarean deliveries. It was immediately processed and assessed for the total nucleated cell count and CD34 cell concentration. Assessment of maternal and neonatal parameters such as gestational age, baby's birth weight, and sex was carried out with the CD34 cell concentration. The mean CD34 cell concentration was 0.21±0.24% for the group with <2500 g (low birth weight) birth weight of the baby (n=104). The mean CD34 cell concentration was 1.84±1.12% for the group with ≥2500 g (normal birth weight) birth weight of the baby (n=396). A strong positive correlation was found between birth weight of the baby with cord blood-derived CD34 cell concentration (*P<0.0001, r=0.81). A positive correlation was found between gestational age and cord blood-derived CD34 cell concentration (*P<0.0001, r=0.31). No significant correlation was found between the baby's sex with the CD34 cell concentration and the total nucleated cell count. This study concludes that the higher the birth weight of the baby, the better the yield of the CD34 cell concentration, and hence these should be the preferred samples for infusion.
脐带血最近被视为一种用于临床应用的造血祖细胞替代来源。异基因脐带血移植中患者的存活情况严重依赖于脐带血来源的总核细胞计数以及每千克体重的总CD34细胞计数。许多因素,如母亲年龄、孕周、新生儿性别和体重、脐带长度以及胎盘重量,都会影响脐带血的体积、单核细胞数量以及CD34细胞浓度。脐带血取自正常阴道分娩和剖宫产分娩。采集后立即进行处理,并评估总核细胞计数和CD34细胞浓度。结合CD34细胞浓度对母亲和新生儿参数进行评估,如孕周、婴儿出生体重和性别。婴儿出生体重<2500g(低出生体重)组(n=104)的平均CD34细胞浓度为0.21±0.24%。婴儿出生体重≥2500g(正常出生体重)组(n=396)的平均CD34细胞浓度为1.84±1.12%。发现婴儿出生体重与脐带血来源的CD34细胞浓度之间存在强正相关(*P<0.0001,r=0.81)。发现孕周与脐带血来源的CD34细胞浓度之间存在正相关(*P<0.0001,r=0.31)。未发现婴儿性别与CD34细胞浓度和总核细胞计数之间存在显著相关性。本研究得出结论,婴儿出生体重越高,CD34细胞浓度的产量越高,因此这些应是输注的首选样本。