title: Stem cell comparison: what can we learn clinically from unrelated cord blood transplantation as an alternative stem cell source?
abstract: Allogeneic hematopoietic cell transplantation (HCT) is an important therapeutic option for a variety of malignant and non-malignant disorders (NMD). The use of umbilical cord blood transplantation (UCBT) has made HCT available to many more patients. The increased level of human leukocyte antigen disparity that can be tolerated makes UCBT a very attractive alternative source of hematopoietic stem cells; however, the increased risk of early death observed after UCBT remains an obstacle. Novel strategies such as ex vivo stem cell expansion are now becoming part of the standard clinical approach, and preliminary results are extremely encouraging with suggestion of reduction of early transplant-related mortality. Although there are no randomized studies that compare the risks and benefits of UCBT relative to those observed with related and unrelated donors both for malignant and NMD, several retrospective studies have compared outcomes between UCBT and other stem cell sources. In this review, we aim to describe and summarize the findings of the principal studies in this field. We hope that what we can learn from these studies and how we can use this information will improve the outcomes of HCT for patients with malignant and NMD.
authors: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA; Department of Medicine, University of Washington, Seattle, Washington, USA. Electronic address: fmilano@fhcrc.org.
authors: Filippo
authors: F
authors: Milano
authors: University Medical Center Utrecht, Pediatric Blood and Marrow Transplantation Program, Utrecht, The Netherlands; Laboratory Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Jaap Jan
authors: JJ
authors: Boelens
mesh_terms: D036101:Cord Blood Stem Cell Transplantation; D005312:Fetal Blood / Q000166:cytology; D006801:Humans; D008661:Metabolism, Inborn Errors / Q000628:therapy; D009369:Neoplasms / Q000628:therapy; D013234:Stem Cells / Q000166:cytology*
keywords: benign hematological disorders; cord blood transplantation; hematological malignancies; unrelated donor transplants