Guidelines for Cord Blood Unit Selection

American Society for Transplantation and Cellular Therapy Cord Blood Special Interest Group

Research output: Contribution to journalArticlepeer-review

Abstract

Optimal cord blood (CB) unit selection is critical to maximize the likelihood of successful engraftment and survival after CB transplantation (CBT). However, unit selection can be complex because multiple characteristics must be considered including unit cell dose, donor-recipient human leukocyte antigen (HLA) match, and unit quality. This review provides evidence-based and experience-based comprehensive guidelines for CB unit selection. Topics addressed include the use of both the TNC and the CD34+ cell dose, as well as the CD34+ cell to TNC content ratio to evaluate unit progenitor cell content and engraftment potential, the acceptable TNC and CD34+ cell dose criteria that define an adequate single-unit graft, and the indication and acceptable cell dose criteria for double-unit grafts. The acceptable criteria for 6-loci (HLA-A, -B antigen, -DRB1 allele) and 8-allele (HLA-A, -B, -C, -DRB1) donor-recipient HLA match, the evaluation of patients with donor-specific HLA antibodies, and the multiple determinants of unit quality are also reviewed in detail. Finally, a practical step-by-step guide to CB searches and the principles that guide ultimate graft selection are outlined.

Original languageEnglish (US)
Pages (from-to)2190-2196
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume26
Issue number12
DOIs
StatePublished - Dec 2020

Bibliographical note

Publisher Copyright:
© 2020 American Society for Transplantation and Cellular Therapy

Keywords

  • CB unit selection
  • CD34+ cell dose
  • HLA match
  • TNC dose

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