Abstract
The number of nucleated cells infused into the recipient of a cord blood (CB) transplant has emerged as the most important factor affecting the probability and speed of engraftment. At present, there is no international consensus on the procedure of CB collection in the maternity ward. In order to maximise the yield of viable cells in a CB unit, we aimed to investigate the efficiency of CB collection, with respect to the time of delivery of the placenta. We analysed stem and progenitor cells in terms of CD34+ cell content and colony-forming activities, lymphocyte subpopulations and the presence of macroscopic clots in 93 paired CB samples, collected before and after the delivery of the placenta. Our results demonstrated that the median concentrations of nucleated cells and total colony-forming unit (CFU) were significantly lower in CB collected after placenta delivery by 9.5% (P < 0.001) and 11.6% (P = 0.015), respectively, when compared to their counterparts collected before placental delivery. A reduction of granulocytes (P < 0.001), monocytes (P < 0.001) and CD19+ B lymphocytes (P = 0.031) was observed, with no significant change in the proportion of T cell subsets (CD4+, CD8+ cells) or activated T cells (CD25+, CD45RO+ cells) in samples collected after placenta delivery. The incidence of macroscopic clots was also higher in these samples (31% vs 1%, P < 0.001). The reduction of stem and progenitor cells correlated significantly with that of major cell populations, indicating a general cell loss, possibly due to clotting activities developed with time. Our study has documented strong evidence for recommending the collection of CB before the delivery of the placenta. Bone Marrow Transplantation (2001) 27, 133–138.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Rent or buy this article
Prices vary by article type
from$1.95
to$39.95
Prices may be subject to local taxes which are calculated during checkout
References
Gluckman E, Broxmeyer HA, Auerbach AD et al. Hematopoietic reconstitution in a patient with Fanconi's anemia by means of umbilical-cord blood from an HLA-identical sibling New Engl J Med 1989 321: 1174–1178
Cairo MS, Wagner JE . Placental and/or umbilical cord blood: an alternative source of hematopoietic stem cells for transplantation Blood 1997 90: 4665–4678
Lim F, Beckhoven J, Brand A et al. The number of nucleated cells reflects the hematopoietic content of umbilical cord blood for transplantation Bone Marrow Transplant 1999 24: 965–970
Rubinstein P, Carrier C, Scaradavou A et al. Outcomes among 562 recipients of placental-blood transplants from unrelated donors (see comments) New Engl J Med 1998 339: 1565–1577
Gluckman E, Rocha V, Boyer-Chammard A et al. Outcome of cord-blood transplantation from related and unrelated donors. Eurocord Transplant Group and the European Blood and Marrow Transplantation Group New Engl J Med 1997 337: 373–381
Broxmeyer HE, Kurtzberg J, Gluckman E et al. Umbilical cord blood hematopoietic stem and repopulating cells in human clinical transplantation Blood Cells 1991 17: 313–329
Turner CW, Luzins J, Hutcheson C . A modified harvest technique for cord blood hematopoietic stem cells Bone Marrow Transplant 1992 10: 89–91
Bertolini F, Lazzari L, Lauri E et al. Comparative study of different procedures for the collection and banking of umbilical cord blood J Hematother 1995 4: 29–36
Elchalal U, Fasouliotis SJ, Shtockheim D et al. Postpartum umbilical cord blood collection for transplantation: a comparison of three methods Am J Obstet Gynecol 2000 182: 227–232
Ballin A, Arbel E, Kenet G et al. Autologous umbilical cord blood transfusion (see comments) Arch Dis Child Fetal Neonatal Ed 1995 73: F181–F183
Navarrete C, Warwick R, Armitage S et al. The London Cord Blood Bank Bone Marrow Transplant 1998 22: (Suppl. 1) S6–S7
Dal Cortivo L, Marolleau JP, Gluckman E et al. The Paris Cord Blood Bank Bone Marrow Transplant 1998 22: (Suppl. 1) S11
Querol S, Gabarro M, Amat L et al. The placental blood program of the Barcelona Cord Blood Bank Bone Marrow Transplant 1998 22: (Suppl. 1) S3–S5
Pojda Z, Machaj E, Debski R et al. Organization of the cord blood bank in Warsaw, Poland: current status and future prospects Bone Marrow Transplant 1998 22: (Suppl. 1) S13
Jacobs HC, Falkenburg JH . Umbilical cord blood banking in The Netherlands Bone Marrow Transplant 1998 22: (Suppl. 1) S8–S10
Sutherland DR, Anderson L, Keeney M et al. The ISHAGE guidelines for CD34+ cell determination by flow cytometry. International Society of Hematotherapy and Graft Engineering J Hematother 1996 5: 213–226
Broxmeyer HE . Questions to be answered regarding umbilical cord blood hematopoietic stem and progenitor cells and their use in transplantation (see comments) Transfusion 1995 35: 694–702
Gluckman E, Rocha V, Chastang C . Cord blood banking and transplant in Europe. Eurocord Vox Sang 1998 74: (Suppl. 2) 95–101
Surbek DV, Schonfeld B, Tichelli A et al. Optimizing cord blood mononuclear cell yield: a randomized comparison of collection before vs after placenta delivery (letter) Bone Marrow Transplant 1998 22: 311–312
Lim FT, van Winsen L, Willemze R et al. Influence of delivery on numbers of leukocytes, leukocyte subpopulations, and hematopoietic progenitor cells in human umbilical cord blood Blood Cells 1994 20: 547–558
Anderson S, Fangman J, Wager G, Uden D . Retrieval of placental blood from the umbilical vein to determine volume, sterility, and presence of clot formation Am J Dis Child 1992 146: 36–39
Acknowledgements
We wish to thank the nurses at the Department of Obstetrical and Gynecology, Prince of Wales Hospital, Hong Kong for helping with the collection of CB. This work was financially supported by the Children Cancer Fund and the Industrial Support Fund, Government of Hong Kong Special Administrative Region. The antibodies were partially sponsored by Becton Dickinson Ltd.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Wong, A., Yuen, P., Li, K. et al. Cord blood collection before and after placental delivery: levels of nucleated cells, haematopoietic progenitor cells, leukocyte subpopulations and macroscopic clots. Bone Marrow Transplant 27, 133–138 (2001). https://doi.org/10.1038/sj.bmt.1702757
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bmt.1702757
Keywords
This article is cited by
-
Umbilical Cord Blood Transplant for Malignancies: A Hope or Hype
The Indian Journal of Pediatrics (2013)
-
Comparison between two strategies for umbilical cord blood collection
Bone Marrow Transplantation (2003)