To understand the benefits of cord blood vs. bone marrow vs. peripheral blood, it is important to understand the use of each for hematopoietic stem cell transplantation (HSCT).
Hematopoietic stem cell transplantation (HSCT) is the transplantation of multipotent hematopoietic stem cells, usually derived from bone marrow, peripheral blood, or umbilical cord blood. It is performed for patients with cancers of the blood or bone marrow, such as leukemia and multiple myeloma, making it the leading type of cell therapy performed worldwide.
The three most common sources of stem cells for HSCT are:
- Bone Marrow
- Peripheral Blood
- Umbilical Cord Blood
Characteristics of Umbilical Cord Blood
Umbilical cord blood is a source of stem cells that are genetically unique to a newborn donor, potentially compatible for those who are closely related, and frequently a match for non-related members of the population. Both the versatility and availability of umbilical cord blood stem cells make them a potent resource for use in transplant medicine.
Currently, umbilical cord blood is the second most common source of stem cells for cellular therapy. Because cord blood is a rich source of highly primitive hematopoietic stem cells, umbilical cord blood has enormous regenerative potential for stem cell-based therapy, both for the treatment of hematological and non-hematological disorders.
This is evidenced by the increasing number of clinical trials that are utilizing umbilical cord blood for stem cell-based therapies. However, with these advances come new standards that must be established, including standardization of criteria for the selection of UCB units for stem cell-based therapies, outcome measures, and long-term follow-up.
History of Cord Blood versus Bone Marrow and Peripheral Blood in HSCT
The first successful use of bone marrow for HSCT was performed in 1956 by Georges Mathé, a French oncologist, on five Yugoslavian nuclear workers whose marrow had been damaged by irradiation following the accident at the Vinca Nuclear Institute, but all of these transplants were rejected. Mathé later pioneered the use of bone marrow transplants in the treatment of leukemia.
It was not until 1986 when peripheral blood stem cell transplantation (PBSCT) was introduced as a clinical modality, although it has since replaced bone marrow transplant as the most common transplantation procedure performed in medicine.
Two year later in 1988, the first successful use of cord blood for HSCT was performed in Paris, France to regenerate blood and immune system cells in a six-year-old boy suffering from the blood disorder “Fanconi’s Anemia.” It is an interesting coincidence that the French contributed both bone marrow transplant and cord blood transplant to the medical community.
To summarize, cord blood, bone marrow, and peripheral blood can all be valuable cell sources for use in HSCT.
Nonetheless, there are key differences between cord blood vs. bone marrow vs. peripheral blood. Each is sourced from different tissues, has varying types and quantities of cell and progenitor cells, and has demonstrated slightly different treatment outcomes across hematological and non-hematological disorders.
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