Concise review: umbilical cord blood transplantation: past, present, and future.
Allogeneic hematopoietic stem cell transplantation is an important treatment option for fit patients with poor-risk hematological malignancies; nevertheless, the lack of available fully matched donors limits the extent of its use. Umbilical cord blood has emerged as an effective alternate source of hematopoietic stem cell support. Transplantation with cord blood allows for faster availability of frozen sample and avoids invasive procedures for donors. In addition, this procedure has demonstrated reduced relapse rates and similar overall survival when compared with unrelated allogeneic hematopoietic stem cell transplantation. The limited dose of CD34-positive stem cells available with single-unit cord transplantation has been addressed by the development of double-unit cord transplantation. In combination with improved conditioning regimens, double-unit cord transplantation has allowed for the treatment of larger children, as well as adult patients with hematological malignancies. Current excitement in the field revolves around the development of safer techniques to improve homing, engraftment, and immune reconstitution after cord blood transplantation. Here the authors review the past, present, and future of cord transplantation.
Department of Hematology-Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona, USA; Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA; Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Hospital System, and Department of Pediatrics and Department of Microbiology, Immunology and Tropical Medicine, George Washington University, Washington, D.C., USA.
Javier
J
Munoz
Department of Hematology-Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona, USA; Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA; Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Hospital System, and Department of Pediatrics and Department of Microbiology, Immunology and Tropical Medicine, George Washington University, Washington, D.C., USA nshah@mdanderson.org.
Nina
N
Shah
Department of Hematology-Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona, USA; Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA; Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Hospital System, and Department of Pediatrics and Department of Microbiology, Immunology and Tropical Medicine, George Washington University, Washington, D.C., USA.
Katayoun
K
Rezvani
Department of Hematology-Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona, USA; Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA; Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Hospital System, and Department of Pediatrics and Department of Microbiology, Immunology and Tropical Medicine, George Washington University, Washington, D.C., USA.
Chitra
C
Hosing
Department of Hematology-Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona, USA; Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA; Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Hospital System, and Department of Pediatrics and Department of Microbiology, Immunology and Tropical Medicine, George Washington University, Washington, D.C., USA.
Catherine M
CM
Bollard
Department of Hematology-Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona, USA; Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA; Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Hospital System, and Department of Pediatrics and Department of Microbiology, Immunology and Tropical Medicine, George Washington University, Washington, D.C., USA.
Betul
B
Oran
Department of Hematology-Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona, USA; Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA; Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Hospital System, and Department of Pediatrics and Department of Microbiology, Immunology and Tropical Medicine, George Washington University, Washington, D.C., USA.
Amanda
A
Olson
Department of Hematology-Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona, USA; Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA; Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Hospital System, and Department of Pediatrics and Department of Microbiology, Immunology and Tropical Medicine, George Washington University, Washington, D.C., USA.
Uday
U
Popat
Department of Hematology-Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona, USA; Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA; Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Hospital System, and Department of Pediatrics and Department of Microbiology, Immunology and Tropical Medicine, George Washington University, Washington, D.C., USA.
Jeffrey
J
Molldrem
Department of Hematology-Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona, USA; Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA; Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Hospital System, and Department of Pediatrics and Department of Microbiology, Immunology and Tropical Medicine, George Washington University, Washington, D.C., USA.
Ian K
IK
McNiece
Department of Hematology-Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona, USA; Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA; Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Hospital System, and Department of Pediatrics and Department of Microbiology, Immunology and Tropical Medicine, George Washington University, Washington, D.C., USA.
Elizabeth J
EJ
Shpall
D000328:Adult; D064591:Allografts; D036101:Cord Blood Stem Cell Transplantation / Q000266:history / Q000379:methods* / Q000639:trends*; D018572:Disease-Free Survival; D019337:Hematologic Neoplasms / Q000401:mortality / Q000628:therapy*; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D015996:Survival Rate; D019172:Transplantation Conditioning / Q000379:methods*
Graft versus host disease; Hematopoietic stem cell transplantation; Leukemia; Lymphoma; Transplant related mortality; Umbilical cord blood transplantation