Optimizing Donor and Cord Blood Unit Selection for Banking and Transplantation
Graft failure and engraftment delays are barriers to the overall success of unrelated umbilical cord blood transplantation (UCBT). Cord blood potency—the likelihood of a given cord blood unit (CBU) to engraft in a timely fashion—is influenced by factors associated with cord blood donation, processing, and cell recovery at the time of thawing for transplantation. Postthaw colony-forming units (CFU), measured on the thawed CBU cryobag, have been shown to be the most sensitive predictor of engraftment after UCBT. Limited exploratory studies on cord blood segments have shown that CFU, viable CD34 + and expression of aldehyde dehydrogenase can serve as measures of cord blood potency. A composite scoring system, the Cord Blood Apgar, identifies those CBUs most likely to engraft. The current status of cord blood potency and its relationship to engraftment will be described in this chapter.
