State Key Laboratory of Elemento-organic chemistry, College of Chemistry, Nankai University, Tianjin, People's Republic of China.
Newish Technology (Beijing) Co., Ltd., Beijing, People's Republic of China.
Stem Cells Transl Med. 2022 Sep 21;11(9):912-926. doi: 10.1093/stcltm/szac056.
The application of umbilical cord blood (UCB) as an important source of hematopoietic stem and progenitor cells (HSPCs) for hematopoietic reconstitution in the clinical context has steadily grown worldwide in the past 30 years. UCB has advantages that include rapid availability of donors, less strict HLA-matching demands, and low rates of graft-versus-host disease (GVHD) versus bone marrow (BM) and mobilized peripheral blood (PB). However, the limited number of HSPCs within a single UCB unit often leads to delayed hematopoietic engraftment, increased risk of transplant-related infection and mortality, and proneness to graft failure, thus hindering wide clinical application. Many strategies have been developed to improve UCB engraftment, most of which are based on 2 approaches: increasing the HSPC number ex vivo before transplantation and enhancing HSPC homing to the recipient BM niche after transplantation. Recently, several methods have shown promising progress in UCB engraftment improvement. Here, we review the current situations of UCB manipulation in preclinical and clinical settings and discuss challenges and future directions.
在过去的 30 年中，脐带血（UCB）作为造血干细胞和祖细胞（HSPC）在临床造血重建中的重要来源，在全球范围内的应用稳步增长。UCB 具有以下优势：供者快速可得、对 HLA 配型要求较低、移植物抗宿主病（GVHD）发生率低于骨髓（BM）和动员外周血（PB）。然而，单个 UCB 单位中 HSPC 的数量有限，这往往导致造血植入延迟、增加移植相关感染和死亡率的风险以及易于发生移植物衰竭，从而阻碍了广泛的临床应用。已经开发了许多策略来改善 UCB 植入，其中大多数基于以下 2 种方法：在移植前体外增加 HSPC 数量和增强 HSPC 归巢到受者 BM 龛后。最近，几种方法在改善 UCB 植入方面显示出了有希望的进展。在这里，我们综述了 UCB 在临床前和临床环境中的操作现状，并讨论了挑战和未来方向。
