Analysis of maternal and neonatal factors associated with hematopoietic reconstruction potential in umbilical cord blood units / 中国实验血液学杂志

ABSTRACT

Umbilical cord blood (UCB) is an alternative source of hematopoietic stem cells for transplantation with success being associated with the total nucleated cell (TNC) count, CD34(+) cells and colony-forming unit-granulocyte-macrophage (CFU-GM) content infused. This study was purposed to clarify the impact of maternal and neonatal factors on hematopoietic potential of UCB product. UCB samples were screened, processed, tested and cryopreserved according to the Standard Operation Procedure (SOP) of Guangzhou cord blood bank (GZCBB). Relationship of hematopoietic cell parameters with maternal and neonatal characteristics for 4615 UCB units was analyzed retrospectively. The results showed that both collected volume (Mean ± SD 95.23 ± 22.42 ml; Median 91.85 ml) and initial TNC [Mean ± SD (1.34 ± 0.49) × 10(9); Median 1.25 × 10(9)] correlated well with postprocessed TNC [Mean ± SD (1.21 ± 0.42) × 10(9); Median 1.14 × 10(9); p < 0.001], CD34(+)count [Mean ± SD (5.14 ± 4.55) × 10(6); Median 4.08 × 10(6); p < 0.001] and CFU-GM content [Mean ± SD (9.72 ± 8.66) × 10(5); Median 7.53 × 10(5); p < 0.001]. As for donor factors, only infant birth weight correlated strongly with volume collected and all hematopoietic cell parameters (p < 0.001). UCB samples from bigger babies had higher collected volume, TNC, CD34(+) count and CFU-GM content (p < 0.001). Mother's age had no correlation with all the above parameters. Gestational age correlated positively with initial/postprocessed TNC (p < 0.001) and negatively with CD34(+) count (p = 0.04), but no relation with collected volume and CFU-GM content. Cesarean section produced superior volume (Mean ± SD 97.05 ± 22.23 ml vs 92.53 ± 22.43 ml; Median 94.08 ml vs 88.82 ml; p < 0.001), but inferior cell count than vaginal delivery (p < 0.001). Male infants had more initial volume and CD34(+) count (Mean ± SD 96.41 ± 22.31 ml vs 93.95 ± 22.47 ml; Median 93.27 ml vs 90.14 ml; p < 0.001); [Mean ± SD (5.28 ± 5.04) × 10(6) vs (5.00 ± 3.94) × 10(6); Median 4.18 × 10(6) vs 3.94 × 10(6); p < = 0.042], but lower initial and postprocessed TNC than female ones [Mean ± SD (1.31 ± 0.50) × 10(9) vs (1.37 ± 0.47) × 10(9); Median 1.22 × 10(9) vs 1.28 × 10(9); p < 0.001]; [Mean ± SD (1.18 ± 0.42) × 10(9) vs (1.24 ± 0.41) × 10(9); Median 1.10 × 10(9) vs 1.17 × 10(9); p < 0.001], while no significant difference of CFU-GM were found between male and female infants. It is concluded that these data may be helpful to optimize the UCB donor selection and improve cost efficiency of UCB bank resource. The heavier infants after vaginal delivery should be selected and large-volume units with higher TNC should be chosen at first.