Oncology Research Unit, National Medical Center, Mexican Institute of Social Security, Mexico City, Mexico.
Arch Med Res. 2024 Sep;55(6):103042. doi: 10.1016/j.arcmed.2024.103042. Epub 2024 Jul 14.
Umbilical cord blood (UCB) is a rich source of hematopoietic stem and progenitor cells that are biologically superior to their adult counterparts. UCB cells can be stored for several years without compromising their numbers or function. Today, public and private UCB banks have been established in several countries around the world. After 35 years since the first UCB transplant (UCBT), more than 50,000 UCBTs have been performed worldwide. In pediatric patients, UCBT is comparable to or superior to bone marrow transplantation. In adult patients, UCB can be an alternative source of hematopoietic cells when an HLA-matched unrelated adult donor is not available and when a transplant is urgently needed. Delayed engraftment (due to reduced absolute numbers of hematopoietic cells) and higher costs have led many medical institutions not to consider UCB as a first-line cell source for hematopoietic transplants. As a result, the use of UCB as a source of hematopoietic stem and progenitor cells for transplantation has declined over the past decade. Several approaches are being investigated to make UCBTs more efficient, including improving the homing capabilities of primitive UCB cells and increasing the number of hematopoietic cells to be infused. Several of these approaches have already been applied in the clinic with promising results. UCB also contains immune effector cells, including monocytes and various lymphocyte subsets, which, together with stem and progenitor cells, are excellent candidates for the development of cellular therapies for hematological and non-hematological diseases.
脐带血（UCB）是造血干细胞和祖细胞的丰富来源，其生物学特性优于成人对应物。UCB 细胞可以储存数年而不影响其数量或功能。如今，世界上许多国家都建立了公共和私人的 UCB 库。自首例 UCB 移植（UCBT）以来已经过去了 35 年，全世界已经进行了超过 50,000 例 UCBT。在儿科患者中，UCBT 与骨髓移植相当或优于骨髓移植。在成年患者中，当没有 HLA 匹配的无关成年供体且需要紧急移植时，UCB 可以作为造血细胞的替代来源。延迟植入（由于造血细胞绝对数量减少）和更高的成本导致许多医疗机构不考虑将 UCB 作为造血移植的一线细胞来源。因此，在过去十年中，UCB 作为造血干细胞和祖细胞移植来源的使用有所减少。正在研究几种方法来提高 UCBT 的效率，包括改善原始 UCB 细胞的归巢能力和增加输注的造血细胞数量。其中一些方法已经在临床上应用，并取得了有希望的结果。UCB 还含有免疫效应细胞，包括单核细胞和各种淋巴细胞亚群，它们与干细胞和祖细胞一起，是开发用于治疗血液系统和非血液系统疾病的细胞疗法的优秀候选者。
