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Family-directed umbilical cord blood (UCB) collection and banking is indicated in women delivering healthy babies who already have a member of their own family with a disease potentially treatable with an allogeneic hematopoietic stem cell (HSCs) transplantation (HSCT). The rapid availability of UCB is an important issue in HSCs procurement particularly for recipients with acute leukemia who urgently need HSCT. The aims of this study were to assess the usage rate of family UCB collections directed to patients with acute leukemia and to investigate the factors influencing the usage rate. A total of 113 families were enrolled, 118 UCB units were successfully collected and one collection failed due to emergency occurred during delivery. Among these, 7 collections were required for children who were in urgent need of a transplant: three HLA-matched units were successfully transplanted, respectively after 2, 5 and 6 months from collection; three collections resulted HLA-mismatched, while HLA-typing is pending for one unit. The remaining collections were mostly required for potential future use, among these units only one was transplanted in a HLA compatible sibling after 3 years and 4 months from collection. After a median time of storage of 8.5 years (range 0.1-20 years) a total of 4/118 (3.4 %) collection has been transplanted. During this time interval, considering only patients who have had the need of a transplant, the main factor influencing low utilization rate of UCB collections was due to HLA disparity, indeed among typed UCB unit mostly (77 %) resulted HLA mismatched with the intended recipient. [ABSTRACT FROM AUTHOR]

Clinical diagnosis of acute foetal distress (AFD) is based on several parameters such as abnormal foetal heart rate (FHR) pattern and/or meconium liquid staining (MLS). Standards for cord blood (CB) banking indicate that AFD should be considered as exclusion criteria for CB collection, but precise guidelines on how to proceed with CB collection in the presence of AFD signs during labour are not available. We evaluated whether the presence of FHR abnormality and/or MLS during labour 1) reduced the CB collection activity; 2) were associated with the infant's acidaemia or asphyxia and 3) deteriorated the biological characteristics of CB units. Thirty-three units of CB were evaluated for biological parameters, gas values and newborn's Apgar score. The results were compared with a control group of 33 consecutive units previously banked. No differences were observed between the two groups and all but one newborn showed normal Apgar score and absence of metabolic acidaemia. The results showed that 1) AFD reduced the CB collection activity by 10% each year; 2) the majority of CB units collected in the presence of abnormal FHR and/or meconium have biological characteristics eligible for banking; 3) FHR alterations or meconium in the presence of normal gas analysis do not represent certain diagnosis of AFD. [ABSTRACT FROM AUTHOR]

Focuses on a procedure for red blood cell (RBC) depletion and different cryoprotective solutions with or without rate-controlled freezing in an attempt to develop an inexpensive and simple method for processing and cryopreserving umbilical cord blood (UCB) hemopoietic cells. Cooling rate and concentration of the cryoprotectant; Analysis of RBC depletion by double gravity sedimentation and hyroxyethyl starch; Implications for UCB banks.

BACKGROUND PBPC transplantation has become a widely accepted therapeutic option for patients with chemotherapy-sensitive malignancies. PBPCs facilitate even the transplantation of mismatched allogeneic cells, because of their better engraftment. PBPCs are harvested by leukapheresis after mobilization with G-CSF or chemotherapy and G-CSF. To improve the purity and yield of PBPC grafts, to ensure reproducibility of the procedure and to reduce platelet loss in the patient/donor, different fully automated PBPC collection systems were developed. We report here our experience with the new Amicus blood cell separator. METHODS From July 2000 to March 2001, 46 procedures were performed. Six donors underwent leukaphereses after G-CSF administration (10-12 microgr/Kg/day) beginning on day 4; 14 patients were harvested after chemotherapy and G-CSF or GM-CSF mobilization, when the peripheral CD34+ cell count was >20 cells/micrL. Peripheral venous access was preferred whenever possible, otherwise femoral or subclavian catheters were used. Complete cell counts and CD34+ cell evaluations were done both in patients and donors, before and after each procedure and in all the products of the apheresis. RESULTS A median of 8.959 L of blood (range 3.585-17.021 ) was processed with a duration of 315 minutes (range 215-400) at a blood flow rate of 40 ml/min (range 25-70). ACD was used at a ratio of 1:14. The products of apheresis had a median volume of 143 ml (range 70-306) and a Hct of 12.9% (range 1.6-21). Platelet contamination was low (722 × 10[sup 9]/L, range 55-1,620), according to a low collection efficiency (12%, range 2-34) and a low decrease of platelet level both in donors and patients (21 × 10[sup 9]/L, range 3-83); in contrast, CD34 + cell collection efficiency was high (59.5%, range 15-97). No adverse affects were observed. CONCLUSIONS Amicus blood cell separator has a high collection efficiency for PBPC collections and improves donor safety by reducing platelet loss. [ABSTRACT FROM AUTHOR]