Comprehensive banking of sibling donor cord blood for children with malignant and nonmalignant disease.
Level 4 - case-series / case-control
Prospective single-arm case series and registry analysis without a comparator group
PubMed 12393579 · doi:10.1182/blood-2002-02-0394
What was done
The authors evaluated a directed-donor cord blood (CB) banking protocol under current good tissue practices (cGTP) across 42 US states. Families caring for a child with a condition treatable by hematopoietic stem cell transplantation and expecting a full sibling were enrolled. CB was collected remotely at local delivery hospitals, shipped, processed, and stored centrally. Key metrics included collection volumes, total nucleated cell counts, and initial engraftment rates among units that were transplanted.
What was found
A total of 540 families were enrolled. The mean CB volume was 103.1 mL, with a mean nucleated cell count of 8.9 x 10^8. The nucleated cell dose exceeded 1.5 x 10^7 cells/kg for 90% of banked units. Seventeen units (3.4%) were transplanted, resulting in stable engraftment of donor cells in 16 of the 17 recipients.
Why it matters
This study demonstrates the feasibility of decentralized collection and centralized cGTP-guided banking of directed sibling cord blood. It confirms that standardized operating procedures can yield adequate graft cell doses to support sibling hematopoietic stem cell transplantation.
Limits
The study is an uncontrolled observational report with no comparator arm. Only 17 of the 540 banked units (3.4%) were utilized for transplantation, providing a very small sample size to assess clinical outcomes. The abstract does not report details on graft-versus-host disease, time to engraftment, or long-term recipient survival.
Cited by
- supports Children's Hospital Oakland developed the clinical use of sibling umbilical cord blood transplantation to treat leukemia, sickle cell disease, and thalassemia.