title: Low usage rate of banked sibling cord blood units in hematopoietic stem cell transplantation for children with hematological malignancies: implications for directed cord blood banking policies.
abstract: Directed sibling cord blood banking is indicated in women delivering healthy babies who already have a sibling with a disease that is potentially treatable with an allogeneic cord blood transplant. We evaluated the effectiveness of a national directed cord blood banking program in sibling HLA-identical stem cell transplantation for hematological malignancies and the factors influencing the usage rate of the stored cord blood units. Fifty families were enrolled from which, 48 cord blood units were successfully collected and 2 collections failed due to damaged cord/placenta at delivery. Among enrolled families 4 children needed transplantation; however, only one was successfully transplanted using the collected cord blood unit containing 2×10(7) nucleated cells/kg in conjunction with a small volume of bone marrow from the same HLA-identical donor. Two children received grafts from matched unrelated donors because their sibling cord blood was HLA-haploidentical, while the fourth one received bone marrow from his HLA-identical brother, since cord blood could not be collected due to damaged cord/placenta at delivery. With a median follow-up of 6 years (range, 2-12) for the 9 remaining HLA-matched cord blood units, none from the prospective recipients needed transplantation. The low utilization rate of sibling cord blood in the setting of hematopoietic stem cell transplantation for pediatric hematological malignant diseases necessitates the development of directed cord blood banking programs that limit long-term storage for banked cord blood units with low probability of usage such as non-HLA-identical or identical to patients who are in long-term complete remission.
authors.affiliation: Stem Cell Transplant Unit, Aghia Sophia Children's Hospital, Thivon and Papadiamantopoulou, 11527 Athens, Greece. evgoussetis@gmail.com
authors.forename: Evgenios
authors.initials: E
authors.lastname: Goussetis
authors.forename: Ioulia
authors.initials: I
authors.lastname: Peristeri
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Kitra
authors.forename: Andreas C
authors.initials: AC
authors.lastname: Papassavas
authors.forename: Maria
authors.initials: M
authors.lastname: Theodosaki
authors.forename: Eftichia
authors.initials: E
authors.lastname: Petrakou
authors.forename: Antonia
authors.initials: A
authors.lastname: Spiropoulos
authors.forename: Anna
authors.initials: A
authors.lastname: Paisiou
authors.forename: Alexandra
authors.initials: A
authors.lastname: Soldatou
authors.forename: Catherine
authors.initials: C
authors.lastname: Stavropoulos-Giokas
authors.forename: Stelios
authors.initials: S
authors.lastname: Graphakos
mesh_terms: D001771:Blood Banks; D002648:Child; D036101:Cord Blood Stem Cell Transplantation / Q000706:statistics & numerical data*; D005190:Family; D005260:Female; D005312:Fetal Blood; D005333:Fetus; D006115:Greece; D006680:HLA Antigens / Q000276:immunology; D019337:Hematologic Neoplasms / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000706:statistics & numerical data*; D006648:Histocompatibility / Q000276:immunology; D006801:Humans; D007223:Infant; D008297:Male; D011247:Pregnancy; D035781:Siblings; D014019:Tissue Donors / Q000706:statistics & numerical data
chemical_list: D006680:HLA Antigens