Optimization of the criteria for cord blood unit selection for transplantation in recipients of the different age groups: current view and prospects in Ukraine
Umbilical cord blood has been widely used to treat both malignant and non-malignant hematological diseases for over 30 years. During this time, more than 40 000 successful hematopoietic stem cells (HSCs) transplantations of umbilical cord blood have been performed. However, today in Ukraine there is no public umbilical cord blood bank established for unrelated HSCs transplantation to patients with oncohematological diseases (both children and adults). In this regard, the HSCs units must be purchased abroad or the patients are sent to foreign clinics for high-cost treatment.
The establishment of a public umbilical cord blood bank in Ukraine would help in a short time to meet the needs of patients with oncohematological diseases for donor of HSCs for unrelated transplantation and save significant funds for the treatment of patients abroad. According to the experience of the world’s leading oncohematological centers, when it is impossible to find either a related or haploidentical donor or unrelated transplant in all available registries, the search continues in the registers of public cord blood banks and an umbilical cord blood unit that matches the criteria is usually found. The optimal choice of umbilical cord blood unit is crucial to maximize the likelihood of successful transplant engraftment and recipient survival after the transplantation, so the criteria for cord blood unit selection for unrelated transplantation are a bit broader than those used when matching donor-recipient pairs.
The review presents the main criteria for cord blood unit selection according to the assessment of its quality, cell dose, HLA matching for unrelated transplantation to recipients of different age groups in accordance with international guidelines developed by the National Marrow Donor Program (NMDP), Center for International Blood and Marrow Transplant Research (CIBMTR), in collaboration with the NMDP Council Advisory Group, as well as in accordance with the American Society for Transplantation and Cellular Therapy (ASTCT) and the 7th Edition of the NetCord-FACT International Standards for Cord Blood Collection, Banking, and Release for Administration.