Abstract
Since the first cord blood transplantation performed by Gluckman and colleagues (1988), there have been many medical indications that have been proven for this stem cell therapy in the last two and half decades. Besides the standard hematological indications for bone marrow transplantation, such as leukemias, lymphomas, SCIDs, and aplastic anemia, cord blood transplantation has also been a proven curative therapy for non-hematological indications such as Krabbe's, osteopetrosis etc... As transplant related mortality, overall survival and disease-free survival for cord blood transplantation continue to improve with optimal conditioning regimens, better GvHD and infection prophylaxis and treatment, closer HLA matching and optimal cord blood product selection afforded by larger inventories, double cord blood transplantation and the availability of high cell dose cord blood products, the utility of this stem cell source will expand to certain indications which in the past, rarely used related or unrelated cord blood transplantation. For patients, families, referring and transplant physicians to accept allogeneic cord blood transplantation for indications such as thalassemia, sickle cell disease, severe autoimmune diseases or HIV, the benefit-risk ratio has to be significantly improved so that it is worthwhile for patients to take a chance on a risky procedure in order to prolong lifespan or improve quality of life. We review in this Chapter some of the efforts to improve clinical outcome of related and unrelated cord blood transplantation for thalassemia through increasing infused cord blood nucleated and CD34+ cell dosage using a combination of three strategies - (1) cord blood products manufactured using technologies that maximize cell dosage recoveries, (2) double cord blood transplantation whenever appropriate, and (3) the no-wash thaw and direct infusion method advocated by Chow et al. (c) 2014 Nova Science Publishers, Inc.
| Original language | English |
|---|---|
| Title of host publication | Thalassemia |
| Subtitle of host publication | Causes, Treatment Options and Long-Term Health Outcomes |
| Publisher | Nova Science Publishers, Inc. |
| Pages | 1-36 |
| Number of pages | 36 |
| ISBN (Electronic) | 9781631179556 |
| ISBN (Print) | 9781631179549 |
| State | Published - 01 07 2014 |
| Externally published | Yes |
