![]() It has been shown in early studies by Broxmeyer et al 7 and others that both term and preterm umbilical cord blood contains a significantly higher number of early and committed progenitor cells when compared with adult peripheral blood. 6 UMBILICAL CORD BLOOD STEM/PROGENITOR CELLS The average length of time from donor search to transplant is approximately 135 days, and the cost for donor search and marrow procurement ranges from $25,000 to $50,000 dollars. Despite the recent success in using unrelated donor matched BM, there continue to be limitations and obstacles in using this form of therapy. ![]() To date, more than 5,700 unrelated donor BMTs have been facilitated by the NMDP (personal communication, May 1997). These potential allogeneic donors have been typed for HLA A and B antigens and approximately one third have additionally been typed for HLA DR. As of May 1997, more than 2.7 million donors in the United States have been registered by the NMDP. ![]() To increase the pool of potential donors for allogeneic BMT, the National Marrow Donor Program (NMDP) was established in 1987 to develop a registry of available BM donors, promote cooperation with other international BM donor pools, and develop clinical and basic research relative to unrelated donor BMT. Since 1988, there have been an estimated 500 related and unrelated donor umbilical cord blood transplants. Gluckman et al 5 first reported the successful use of HLA-matched sibling umbilical cord blood stem cells to reconstitute a child with severe Fanconi anemia. 1 The recent use of either related or unrelated donor umbilical cord blood stem cells for allogeneic stem cell transplantation has been secondary to a number of factors, most important of which have been (1) the attempt to reduce transplant-related complications and (2) augmentation of the donor pool. However, the major limitation of using HLA-matched related sibling donors in BM transplantation (BMT) has been that only 30% to 40% of potential recipients in need of such therapy have an HLA-matched related family donor. 2-4 Initial studies have suggested that the risk of graft rejection and the risk of developing severe acute graft-versus-host disease (GVHD) are similar when using matched related allogeneic peripheral blood stem cells as compared with matched related allogeneic bone marrow (BM) stem cells. ![]() 1 Recently, the use of matched related allogeneic peripheral blood stem cells as a source of transplantable stem cells has been reported by a variety of groups. HLA-MATCHED RELATED allogeneic stem cell transplantation has been successfully used as the treatment of choice in selected high-risk or recurrent hematologic malignancies, marrow failure syndromes, severe congenital immunodeficiency states, and selected metabolic disorders. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |