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Prepublished online as a Blood First Edition Paper on August 8, 2002; DOI 10.1182/blood-2002-02-0394.
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Blood, 1 January 2003, Vol. 101, No. 1, pp. 351-357
TRANSPLANTATION
Comprehensive banking of sibling donor cord blood for children
with malignant and nonmalignant disease
William Reed,
Renée Smith,
Florinna Dekovic,
Joanna Y. Lee,
Julie D. Saba,
Elizabeth Trachtenberg,
Joanna Epstein,
Steffany Haaz,
Mark C. Walters, and
Bertram H. Lubin
From the Sibling Donor Cord Blood Program, Children's
Hospital Oakland Research Institute, Oakland, CA; the Division of Blood
and Marrow Transplantation, Children's Hospital Oakland, Oakland, CA;
and the Cryopreservation Laboratory, Alta Bates Summit Medical Center,
Berkeley, CA.
Banking of cord blood (CB) for unrelated hematopoietic stem cell
(HSC) transplantation is well established. However, directed-donor banking of CB for siblings in a current good tissue practices (cGTP)
environment has not previously been investigated. Families were
eligible for the present study if they were caring for a child with a
disorder treatable by HSC transplantation and expecting the birth of a
full sibling. We devised standard operating procedures and policies to
address eligibility, donor recruitment, donor and recipient evaluation,
CB collection, shipping, graft characterization, storage, and release
of CB from quarantine. Many of these policies are distinctly different
from those established for unrelated-donor CB banks. We enrolled 540 families from 42 states. Collections occurred at several hundred
different hospitals. No family was deferred on the basis of health
history or infectious disease testing, but departures from standard
donor suitability criteria were documented. Disease categories for
sibling recipients included malignancy, sickle cell anemia,
thalassemia major, nonmalignant hematological conditions, and metabolic
errors. Mean CB volume (including anticoagulant) was 103.1 mL; mean
nucleated cell count was 8.9 × 108. Cell dose exceeded
1.5 × 107 nucleated cells per kilogram for 90% of
banked units. Seventeen units (3.4%) have been transplanted. Sixteen
of the 17 CB allograft recipients had stable engraftment of donor
cells. Remote-site collection of sibling donor CB can be accomplished
with a high success rate and in a cGTP-guided environment. The cellular
products have been used successfully for transplantation; their number and characteristics should be adequate to support the first prospective clinical investigations of sibling CB transplantation.
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