International Journal of Hematology

DOI: 10.1007/s12185-019-02670-6 Pages: 50-58

Current and future perspectives on allogeneic transplantation using ex vivo expansion or manipulation of umbilical cord blood cells

1. Duke University School of Medicine, Hematology and Medical Oncology Fellow

2. Duke University School of Medicine, Adult Blood and Marrow Transplant Program

Correspondence to:
Ko K. Maung
Email: KoKo.Maung@duke.edu

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Abstract

In patients with hematologic malignancies, the outcome of umbilical cord blood transplantation has improved and is now comparable to that of matched unrelated donor transplantation. However, the limitation of using umbilical cord blood has been a delay in both hematopoietic and immunologic recovery. Strategies have been proposed to overcome these limitations. One strategy involves ex vivo expansion of the umbilical cord blood unit prior to transplantation. A second strategy involves exposure of the umbilical cord blood graft to compounds aimed at improving homing and engraftment following transplantation. Many of these strategies are now being tested in late phase multi-center clinical trials. If proven cost effective and efficacious, they may alter the landscape of donor options for allogeneic stem cell transplantation.

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