Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, Washington.
Marcus Center for Cellular Cures, Duke University, Durham, North Carolina; Department of Pediatrics, Duke University, Durham, North Carolina.
Transplant Cell Ther. 2021 Dec;27(12):968-972. doi: 10.1016/j.jtct.2021.09.013. Epub 2021 Sep 24.
Cord blood (CB) is the stem cell source of choice for approximately 30% of pediatric patients undergoing hematopoietic cell transplantation. Cord blood is readily available and is a particularly appealing stem cell source for patients who lack appropriate HLA-matched related or unrelated donors. Pediatric cord blood transplant (CBT) recipients have low rates of disease relapse in the malignant setting and very low rates of chronic graft-versus-host disease (GVHD). In addition, CB has unique properties that make it the stem cell source of choice for some nonmalignant conditions such as metabolic disorders. This review provides evidence-based and experience-based pediatric-specific guidelines for CBT including considerations for infectious disease management, CB unit selection and infusion, conditioning regimen selection, and GVHD management. In addition, it covers unique bedside considerations for pediatric patients and CB banking. In concert with the other topic specific CB guidelines previously published in this series, it provides a comprehensive overview of the clinical management of pediatric CBT.
脐带血 (CB) 是约 30%接受造血细胞移植的儿科患者首选的干细胞来源。脐带血易于获得，对于缺乏合适 HLA 匹配的相关或无关供体的患者来说，是一种特别有吸引力的干细胞来源。儿科脐带血移植 (CBT) 受者在恶性疾病中疾病复发率较低，慢性移植物抗宿主病 (GVHD) 发生率非常低。此外，CB 具有独特的特性，使其成为某些非恶性疾病（如代谢紊乱）的首选干细胞来源。本综述提供了基于循证和经验的儿科 CBT 具体指南，包括传染病管理、CB 单位选择和输注、预处理方案选择以及 GVHD 管理方面的考虑。此外，还涵盖了儿科患者和 CB 库的独特床边注意事项。与该系列之前发表的其他特定 CB 指南一起，它全面概述了儿科 CBT 的临床管理。
