title: Differences in quality between privately and publicly banked umbilical cord blood units: a pilot study of autologous cord blood infusion in children with acquired neurologic disorders.
abstract: BACKGROUND
  A pilot study was conducted to determine the safety and feasibility of intravenous administration of autologous umbilical cord blood (CB) in young children with acquired neurologic disorders. Most CB units (CBUs) were electively stored in private CB banks. Unlike public banks, which utilize specific criteria and thresholds for banking, private banks generally store all collected CBUs.
  
  
  METHODS
  CBUs of eligible patients containing more than 1 × 10⁷ cells/kg were shipped to Duke from the banks of origin after confirming identity by HLA typing. On the day of infusion, CBUs were thawed and washed in dextran-albumin and infused intravenously. Patients were medicated with acetaminophen, diphenhydramine, and methylprednisolone before transfusion. Data regarding patients, infusions, and CBUs were collected retrospectively. Characteristics of CBUs were compared to existing data from CBUs publicly banked at the Carolinas Cord Blood Bank.
  
  
  RESULTS
  From March 2004 to December 2009, 184 children received 198 CB infusions. Three patients had infusion reactions, all responsive to medical therapy and stopping the infusion. Median precryopreservation volume (60 mL vs. 89 mL, p < 0.0001), total nucleated cell count (4.7 × 10⁸ vs. 10.8 × 10⁸, p < 0.0001), and CD34 count (1.8 × 10⁶ vs. 3.0 × 10⁶, p < 0.0001) were significantly lower than publicly stored CBUs. Postthaw sterility cultures were positive in 7.6% of infused CBUs.
  
  
  CONCLUSIONS
  IV infusion of autologous CB is safe and feasible in young children with neurologic injuries. Quality parameters of privately banked CBUs are inferior to those stored in public banks. If efficacy of autologous CB is established clinically, the quality of autologous units should be held to the same standards as those stored in public banks.
authors.affiliation: Pediatric Blood and Marrow Transplant Program and the Carolinas Cord Blood Bank, Duke University, Durham, North Carolina, USA. jessica.sun@duke.edu
authors.forename: Jessica
authors.initials: J
authors.lastname: Sun
authors.forename: June
authors.initials: J
authors.lastname: Allison
authors.forename: Colleen
authors.initials: C
authors.lastname: McLaughlin
authors.forename: Linda
authors.initials: L
authors.lastname: Sledge
authors.forename: Barbara
authors.initials: B
authors.lastname: Waters-Pick
authors.forename: Stephen
authors.initials: S
authors.lastname: Wease
authors.forename: Joanne
authors.initials: J
authors.lastname: Kurtzberg
mesh_terms: D001771:Blood Banks / Q000706:statistics & numerical data*; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009422:Nervous System Diseases / Q000628:therapy*; D010865:Pilot Projects; D012189:Retrospective Studies; D014184:Transplantation, Homologous / Q000379:methods*