Clinical Advancement and Challenges of ex vivo Expansion of Human Cord Blood Cells
- 10.2991/chi.d.191121.001How to use a DOI?
- Umbilical cord blood; UCB; Transplantation; Engraftment; HSPC; Expansion; Homing; Regulatory T cells
Apart from peripheral blood stem cell (PBSC), umbilical cord blood (UCB) is now a recognized source of stem cells for transplantation. UCB is an especially important source of stem cells for minority populations, which would otherwise be unable to find appropriately matched adult donors. UCB has fewer mature T lymphocytes compared with peripheral blood, thus making a UCB transplantation (UCBT) with a greater degree of HLA mismatch possible. The limited cell dose per UCB sample is however associated with delayed engraftment and a higher risk of graft failure, especially in adult recipients. This lower cell dose can be optimized by performing double unit UCBT, ex vivo UCB expansion prior to transplant and enhancement of the capabilities of the stem cells to home to the bone marrow. UCB contains naïve and immature T cells, thus posing significant challenges with increased risk of infections, graft versus host diseases (GVHD) and relapse following UCBT. Cell engineering techniques have been developed to circumnavigate the immaturity of the T cells, and include virus-specific cytotoxic T cells (VSTs), T cells transduced with disease-specific chimeric antigen receptor (CAR T cells) and regulatory T cell (Tregs) engineering. In this article, we review the advances in UCB ex vivo expansion and engineering to improve engraftment and reduce complications. As further research continues to find ways to overcome the current challenges, outcomes from UCBT will likely improve.
- © 2019 International Academy for Clinical Hematology. Publishing services by Atlantis Press International B.V.
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- This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).
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TY - JOUR AU - Oluwadunni E. Emiloju AU - Rashmika Potdar AU - Vinicius Jorge AU - Sorab Gupta AU - Gabor Varadi PY - 2019 DA - 2019/12/04 TI - Clinical Advancement and Challenges of ex vivo Expansion of Human Cord Blood Cells JO - Clinical Hematology International SP - 18 EP - 26 VL - 2 IS - 1 SN - 2590-0048 UR - https://doi.org/10.2991/chi.d.191121.001 DO - 10.2991/chi.d.191121.001 ID - Emiloju2019 ER -