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Cord Blood Transplantations pp 71–85Cite as

Ex Vivo Cord Blood Manipulation: Methods, Data, and Challenges

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Abstract

Low cell content of umbilical cord blood (UCB) graft contributes to high risk of graft rejection, delayed engraftment, and poor immune reconstitution, consequently leading to risk of relapse and infections after UCB transplantation (UCBT). With ex vivo UCB graft expansion techniques, cell dose can be augmented exponentially. Many of these novel methods demonstrated significantly faster time to neutrophil and platelet engraftment as compared with unmanipulated UCBT. Other innovative methods are focusing on improving the inherent bone marrow homing defect of UCB progenitor cells, without actual expansion of the graft. Not only this, graft engineering techniques allow for expansion of UCB natural killer cells, T cells, and regulatory T cells to prevent or treat infections, disease relapse, and graft-versus-host disease, which are the most common causes of morbidity and mortality after UCBT. Herein, we review various graft manipulation methods and their clinical outcomes.

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  1. MD Anderson Cancer Center, Houston, TX, USA

    Rohtesh S. Mehta & Elizabeth J. Shpall

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  1. Rohtesh S. Mehta
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Correspondence to Rohtesh S. Mehta .

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  1. Duke Cancer Center, Duke University, Durham, North Carolina, USA

    Mitchell Horwitz

  2. Duke Cancer Center, Duke University, Durham, North Carolina, USA

    Nelson Chao

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Mehta, R.S., Shpall, E.J. (2017). Ex Vivo Cord Blood Manipulation: Methods, Data, and Challenges. In: Horwitz, M., Chao, N. (eds) Cord Blood Transplantations. Advances and Controversies in Hematopoietic Transplantation and Cell Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-53628-6_5

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  • DOI: https://doi.org/10.1007/978-3-319-53628-6_5

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