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Prepublished online as a Blood First Edition Paper on August 8, 2002; DOI 10.1182/blood-2002-02-0394.
Submitted February 6, 2002
Accepted July 24, 2002
Comprehensive banking of sibling donor cord blood for children with malignant and non-malignant disease
William Reed*, Renee Smith, Florinna Dekovic, Joanna Y Lee, Julie D Saba, Elizabeth Trachtenberg, Joanna Epstein, Steffany Haaz, Mark C Walters, and Bertram H Lubin
Sibling Donor Cord Blood Program, Children's Hospital Oakland Research Institute, Oakland, CA, USA
Sibling Donor Cord Blood Program, Children's Hospital Oakland Research Institute, Oakland, CA, USA; Cryopreservation Laboratory, Alta Bates Summit Medical Center, Oakland, CA, USA
Sibling Donor Cord Blood Program, Children's Hospital Oakland Research Institute, Oakland, CA, USA; Division of Blood and Marrow Transplantation, Children's Hospital Oakland, Oakland, CA, USA
* Corresponding author; email: wmreed{at}lmi.net.
Background: 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 been investigated. Methods: Families were eligible for 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. Results: Five hundred forty families from 42 states enrolled. 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, non-malignant hematological conditions, and metabolic errors. Mean CB volume and nucleated cell count were 103.1 ml (including anticoagulant) and 8.9x108, respectively. Cell dose exceeded 1.5 x 107 nucleated cells per kilogram for 90% of banked units. Seventeen units (3.4%) have been transplanted. Sixteen of 17 CB allograft recipients had stable engraftment of donor cells. Conclusions: Remote-site collection of sibling-donor CB can be accomplished with a high success rate and in a cGTP-guided environment. The cellular products are utilized 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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