Cord blood banking: current status.

OBJECTIVES

Cord blood is increasingly used as a hematopoietic progenitor cell source for bone marrow transplantation.

METHODS

Development of cord blood banks for altruistic use was essential to open the possibility of opting for cord blood therapy for patients lacking a conventional donor.

RESULTS

Cord blood has major advantages as a resource for donor provision. First, it universalizes the access to the therapy since it allows transplantation of partially matched HLA grafts, benefiting ethnicities less represented in the adult volunteer list. Second, it is an off-the-shelf, ready-to-use source that avoids donor risk and attrition. Third, potentially it has better long term sustainability if a defined optimal size of the inventory is achieved; currently, more than 80% of patients, regardless ethnicity, can find a reliable cord blood donor with the current worldwide inventory.

CONCLUSION

In order that this approach may definitely solve the problem of an equitable access to the therapy, two aspects need to be improved: the quality of CB inventories (driven by a higher stringency of regulatory requirements), and clinical outcomes, particularly understanding the appropriate donor selection and focusing research on accelerating the speed of engraftment and immune reconstitution.