Placental blood contains a very high concentration of hematopoietic stem cells and other precursors. The numbers of stem cells are sufficient to repopulate bone marrow and sustain hematopoiesis when given to bone marrow-ablated, conditioned, HLA-identical siblings. It is proposed to determine whether placental blood may by cryopreserved and stored for use by HLA-matched unrelated recipients. Placental bloods will be harvested in hospitals serving two large metropolitan areas to ensure adequate proportions of donors of diverse ethnic groups. All placental blood units will be HLA-A,-B and -DR typed and will be comprehensively tested for transmissible infectious agents, as will blood samples of mothers who consent. Leukocyte counts and other hematological indices will be determined. The numbers of colony-forming cells, an index of stem cell activity, will be measured and all results will be included in a computerized database. The placental blood units will be cryopreserved and stored for use in transplantation and aliquots will be preserved for pre-transplant testing. Cryopreserved units will be used as a pool for the selection of compatible hematopoietic tissue for bone marrow restoration in patients who do not have HLA-identical or well-matched related donors in our own and in two collaborating institutions. The expected number of transplants will be sufficient for preliminary comparisons to the results of unrelated bone marrow grafts. Cryopreserved units will also be made available for use by other bone marrow transplantation services. The data to be generated will be used to estimate the clinical, technical and financial feasibility of establishing similar programs on a national scale.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Demonstration and Dissemination Projects (R18)
Project #
1R18HL048031-01
Application #
3442340
Study Section
Special Emphasis Panel (SRC (FU))
Project Start
1992-09-30
Project End
1995-09-29
Budget Start
1992-09-30
Budget End
1993-09-29
Support Year
1
Fiscal Year
1992
Total Cost
Indirect Cost
Name
New York Blood Center
Department
Type
DUNS #
City
New York
State
NY
Country
United States
Zip Code
10065
Stevens, Cladd E; Carrier, Carmelita; Carpenter, Carol et al. (2011) HLA mismatch direction in cord blood transplantation: impact on outcome and implications for cord blood unit selection. Blood 118:3969-78
Jones, Johannes; Stevens, Cladd E; Rubinstein, Pablo et al. (2003) Obstetric predictors of placental/umbilical cord blood volume for transplantation. Am J Obstet Gynecol 188:503-9
Stevens, Cladd E; Gladstone, Jessica; Taylor, Patricia E et al. (2002) Placental/umbilical cord blood for unrelated-donor bone marrow reconstitution: relevance of nucleated red blood cells. Blood 100:2662-4
Migliaccio, A R; Adamson, J W; Stevens, C E et al. (2000) Cell dose and speed of engraftment in placental/umbilical cord blood transplantation: graft progenitor cell content is a better predictor than nucleated cell quantity. Blood 96:2717-22
Rubinstein, P; Carrier, C; Scaradavou, A et al. (1998) Outcomes among 562 recipients of placental-blood transplants from unrelated donors. N Engl J Med 339:1565-77
Scaradavou, A; Carrier, C; Mollen, N et al. (1996) Detection of maternal DNA in placental/umbilical cord blood by locus-specific amplification of the noninherited maternal HLA gene. Blood 88:1494-500
Kurtzberg, J; Laughlin, M; Graham, M L et al. (1996) Placental blood as a source of hematopoietic stem cells for transplantation into unrelated recipients. N Engl J Med 335:157-66
Rubinstein, P; Dobrila, L; Rosenfield, R E et al. (1995) Processing and cryopreservation of placental/umbilical cord blood for unrelated bone marrow reconstitution. Proc Natl Acad Sci U S A 92:10119-22
Kurtzberg, J; Graham, M; Casey, J et al. (1994) The use of umbilical cord blood in mismatched related and unrelated hemopoietic stem cell transplantation. Blood Cells 20:275-83;discussion 284
Rubinstein, P; Rosenfield, R E; Adamson, J W et al. (1993) Stored placental blood for unrelated bone marrow reconstitution. Blood 81:1679-90