title: Recommendations for a standard UK approach to incorporating umbilical cord blood into clinical transplantation practice: an update on cord blood unit selection, donor selection algorithms and conditioning protocols.
abstract: Allogeneic haemopoietic stem cell transplantation offers a potentially curative treatment option for a wide range of life-threatening malignant and non-malignant disorders of the bone marrow and immune system in patients of all ages. With rapidly emerging advances in the use of alternative donors, such as mismatched unrelated, cord blood and haploidentical donors, it is now possible to find a potential donor for almost all patients in whom an allograft is indicated. Therefore, for any specific patient, the transplant physician may be faced with a myriad of potential choices, including decisions concerning which donor to prioritize where there is more than one, the optimal selection of specific umbilical cord blood units and which conditioning and graft-versus-host disease prophylactic schedule to use. Donor choice may be further complicated by other important factors, such as urgency of transplant, the presence of alloantibodies, the disease status (homozygosity or heterozygosity) of sibling donors affected by inherited disorders and the cytomegalovirus serostatus of patient and donor. We report UK consensus guidelines on the selection of umbilical cord blood units, the hierarchy of donor selection and the preferred conditioning regimens for umbilical cord blood transplantation, with a summary of rationale supporting these recommendations.
authors.affiliation: University College Hospital, London, UK.
authors.forename: Rachael
authors.initials: R
authors.lastname: Hough
authors.affiliation: NHSBT, Churchill Hospital, Oxford University, Oxford, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Danby
authors.affiliation: Nottingham University Hospital, Nottingham, UK.
authors.forename: Nigel
authors.initials: N
authors.lastname: Russell
authors.affiliation: Adult BMT Unit, University Hospitals Bristol NHS Trust, Bristol, UK.
authors.forename: David
authors.initials: D
authors.lastname: Marks
authors.affiliation: Great Ormond Street Hospital, London, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Veys
authors.affiliation: Froedtert & the Medical College of Wisconsin, CIBMTR, Wauwatosa, WI, USA.
authors.forename: Bronwen
authors.initials: B
authors.lastname: Shaw
authors.affiliation: Manchester Children's Hospital, Manchester, UK.
authors.forename: Rob
authors.initials: R
authors.lastname: Wynn
authors.affiliation: Sheffield Children's Hospital, Sheffield, UK.
authors.forename: Ajay
authors.initials: A
authors.lastname: Vora
authors.affiliation: Royal Free Hospital, London, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Mackinnon
authors.affiliation: University College Hospital, London, UK.
authors.forename: Karl S
authors.initials: KS
authors.lastname: Peggs
authors.affiliation: Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Charles
authors.initials: C
authors.lastname: Crawley
authors.affiliation: Queen Elizabeth Hospital, Birmingham, UK.
authors.forename: Charlie
authors.initials: C
authors.lastname: Craddock
authors.affiliation: King's College Hospital, London, UK.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pagliuca
authors.affiliation: St James University Hospital, Leeds, UK.
authors.forename: Gordon
authors.initials: G
authors.lastname: Cook
authors.affiliation: Sheffield Teaching Hospitals NHS Foundation Trust & University of Sheffield, Sheffield, UK.
authors.forename: John A
authors.initials: JA
authors.lastname: Snowden
authors.affiliation: Beatson West of Scotland Cancer Centre, Glasgow, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Clark
authors.affiliation: King's College Hospital, London, UK.
authors.forename: Judith
authors.initials: J
authors.lastname: Marsh
authors.affiliation: Anthony Nolan, London, UK.|Banc Sang i Teixits, Barcelona, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Querol
authors.affiliation: NHSBT, Oxford, UK.
authors.forename: Guy
authors.initials: G
authors.lastname: Parkes
authors.affiliation: Anthony Nolan, London, UK.
authors.forename: Henny
authors.initials: H
authors.lastname: Braund
authors.affiliation: NHSBT, Churchill Hospital, Oxford University and Eurocord, Oxford, UK.
authors.forename: Vanderson
authors.initials: V
authors.lastname: Rocha
mesh_terms: D000465:Algorithms; D002985:Clinical Protocols; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods / Q000592:standards*; D046148:Donor Selection; D006650:Histocompatibility Testing / Q000379:methods; D006801:Humans; D019172:Transplantation Conditioning / Q000379:methods*; D006113:United Kingdom
keywords: haematological malignancies; paediatric haematology; stem cell transplantation; umbilical cord blood