Gluckman E
Eurocord, Hospital Saint Louis , Paris, France.
Leuk Suppl. 2012 Aug;1(Suppl 2):S10-1. doi: 10.1038/leusup.2012.8. Epub 2012 Aug 9.
Cord blood is an unlimited source of hematopoietic stem cells (HSCs) for allogeneic HSC transplant. Since the first human cord blood transplant performed 20 years ago, cord blood banks have been established worldwide for collection and cryopreservation of cord blood for allogeneic HSC transplant. More than 500 000 cord blood units are now available for international exchange of cord blood units. A global network of cord blood banks and transplant centers has been established for a common inventory and study of clinical outcomes. Results of unrelated allogeneic cord blood transplants in malignant and nonmalignant diseases, in adults and children, show that, compared with HLA-matched unrelated bone marrow transplant, cord blood has several advantages including prompt availability of the transplant, decrease of graft versus host disease and better long-term immune recovery resulting in a similar long-term survival. Several studies have shown that the number of cells is the most important factor for engraftment while some degree of HLA mismatches is acceptable. Progresses in this field are expected to facilitate engraftment including ex vivo expansion of stem cells, intra-bone injection of cord blood cells and double cord blood transplants.
脐带血是用于异基因造血干细胞移植的无限造血干细胞来源。自20年前首次进行人类脐带血移植以来，世界各地已建立脐带血库，用于采集和冷冻保存用于异基因造血干细胞移植的脐带血。现在有超过50万个脐带血单位可用于国际间脐带血单位的交换。已经建立了一个由脐带血库和移植中心组成的全球网络，用于共同管理库存和研究临床结果。成人和儿童恶性及非恶性疾病的非亲缘异基因脐带血移植结果表明，与HLA匹配的非亲缘骨髓移植相比，脐带血有几个优点，包括移植可迅速获得、移植物抗宿主病减少以及长期免疫恢复更好，从而导致相似的长期生存率。多项研究表明，细胞数量是植入的最重要因素，而一定程度的HLA不匹配是可以接受的。预计该领域的进展将促进植入，包括干细胞的体外扩增、脐带血细胞的骨内注射和双份脐带血移植。
