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Background CC-chemokine ligand 28 (CCL28) was previously identified as a novel growth factor in vitro for hematopoietic stem cells (HSCs) from cord blood (CB). However, there is no report on the relationship between CCL28 and HSCs in a human body. Study Design and Methods To reveal the effect of CCL28 on hematopoietic cells in human CB at birth, we measured CCL28 in frozen CB plasma, which was preserved as a reference sample for cryopreserved CB units for HSC transplantation. We also evaluated the correlation of CCL28 level with CB components. Results A total of 81 cryopreserved nonconforming CB units for transplantation were selected. The level of CCL28 was 2540 ± 377 pg/mL. The CCL28 levels correlated with the number of CD34+ cells (r = 0.222, p = 0.047) and white blood cells (r = 0.254, p = 0.022) in the CB units. The CCL28 levels also correlated with hemoglobin levels (r = 0.221, p = 0.048) in fresh CB. Conclusion This finding of positive correlation between CCL28 level and CD34+ cell numbers in vivo, together with the previous report that CCL28 influences the proliferation of hematopoietic cells in CB in vitro, may give a clue for better understanding the variability in HSC content in CB that is cryopreserved for HSC transplantation.

Background The obstetrician's role in vitalizing cord blood (CB) banking is important in both informing donors and beginning CB processing. The aim of the study was to investigate obstetricians' understanding of CB and their roles in informing donors and collection management. Study Design and Methods Questionnaires examining the management and awareness of CB were distributed to collection centers, and we analyzed 57 respondents who had collection experience. Results All respondents were experienced, and 82.5% had CB collection experience of at least 4 years. If patients asked for information, one-third provided information about CB themselves, and two-thirds provided CB banks' (CBBs') contact information. Less than half of the respondents knew the legal regulations and had a collection manual. Regarding the awareness of transportation and storage of CB, 58% rated their knowledge as minimal, and respondents who knew the legal regulations rated their knowledge at a higher level. One-fifth of the participants felt that CB collection distracted the labor process, and 16% were concerned about delayed bleeding control. The probability of autologous CB transplantation was overestimated, and the matching probability in public CBBs was underestimated. Approximately 82.7% of the respondents correctly rated the therapeutic use of CB, and 54% rated their knowledge level about CB usefulness as average. Conclusion Obstetricians' understanding of CB was lower than expected, considering that they are associated with CB collection centers. Obstetricians who provide information and recognize regulations seem to collect CB in compliance with the regulations better. These results will be helpful in CB collection management and education planning for obstetricians.

Background The number of aldehyde dehydrogenase-bright (ALDH(br) ) cells has been suggested as a viable marker of hematopoietic stem cell function. We evaluated the suitability of ALDH(br) cell analysis in the quality assessment of postthaw cord blood (CB) units. Study design and methods A total of 245 CB units were obtained for estimating the numbers of total nucleated cells (TNCs), CD34+ cells, ALDH(br) cells, ALDH(br) cells among CD34+ cells (CD34+ALDH(br) cells), CD34+ cells among ALDH(br) cells (ALDH(br) CD34+ cells), colony-forming unit (CFU)-granulocyte-macrophages (GMs), and CFU-granulocyte-erythrocyte-macrophage-megakaryocytes (GEMMs). Simple linear regression analysis was performed to assess the correlation between the number of TNCs and CD34+ cells before and after crypreservation and CD34+ALDH(br) cells, ALDH(br) cells, and ALDH(br) CD34+ cells after cryopreservation and the number of CFU-GEMMS and CFU-GMs. Results The number of CFU-GMs was found to be significantly correlated with the number of CD34+ cells before and after cryopreservation (r = 0.418 and r = 0.359, respectively), CD34+ALDH(br) cells, ALDH(br) cells, and ALDH(br) CD34+ cells (r = 0.426, r = 0.455, and r = 0.469, respectively). The number of CFU-GEMMs was found to be significantly correlated with the number of TNCs and CD34+ cells before and after cryopreservation (TNCs, r = 0.251 and r = 0.250, respectively; CD34+ cells, r = 0.391 and r = 0.347, respectively), CD34+ALDH(br) cells, ALDH(br) cells, and ALDH(br) CD34+ cells (r = 0.297, r = 0.297, and r = 0.252, respectively). Conclusion The high correlation found between ALDH activity and CFU-GM number supports the suitability of ALDH analysis in the quality assessment of postthaw CB units.

Background The inventory size for cord blood (CB) depends on the ethnic diversity of human leukocyte antigen (HLA) and the size estimation is important for public health in each ethnicity. Study Design and Methods We estimate the CB inventory size in Koreans with stored CB units (CBUs) and patients who underwent allogeneic hematopoietic stem cell transplantation. Two-digit HLA specificities were determined using intermediate DNA typing. From 17,508 stored Korean CBUs, 1460 haplotypes with a frequency greater than 0.001% were used for reconstitution of the HLA. A total of 1002 transplanted patients' HLA was used for matching probability calculation. Results The best probability for 6/6 matching is 47% in 500,000 hypothetical size. Ninety-five percent probability is achieved with 51,000 CBUs in 5/6, and 2150 in 4/6 matching condition. Because 4/6 matched CB is rarely selected in the Korean situation, 51,000 units is the lowest limit of CBUs required and the number will be adjusted depending on the cell number required for patients and the resolution of HLA typing. Conclusion Approximately 51,000 units could provide the minimum requirement for hematopoietic transplantation in Korea.

BACKGROUND: We analyzed neonatal factors that could affect hematopoietic variables of cord blood (CB) donated from Korean neonates. STUDY DESIGN AND METHODS: The numbers of total nucleated cells (TNCs), CD34+ cells, and CD34+ cells/TNCs of CB in neonates were compared according to sex, gestational age, birth weight, birth weight centile for gestational age, and ABO blood group. RESULTS: With 11,098 CB units analyzed, blood group O CB showed an increased number of TNCs, CD34+ cells, and CD34+ cells/TNCs compared with other blood groups. Although TNC counts were lower in males, no difference in the number of CD34+ cells was demonstrated because the number of CD34+ cells/TNCs was higher in males. An increase in the gestational age resulted in an increase in the number of TNCs and decreases in the number of CD34+ cells and CD34+ cells/TNCs. The numbers of TNCs, CD34+ cells, and CD34+ cells/TNCs increased according to increased birth weight centile as well as birth weight. CONCLUSION: CB with blood group O has unique hematologic variables in this large-scale analysis of Korean neonates, although the impact on the storage policies of CB banks or the clinical outcome of transplantation remains to be determined.

BACKGROUND: The aim of the study was to investigate the knowledge of cord blood (CB) and attitudes toward CB banking among high-potential donors (i.e., well-educated pregnant Koreans) because their voluntary donation is indispensable to the success of unrelated CB transplantation. STUDY DESIGN AND METHODS: Questionnaires examining perspectives on CB were distributed to and completed by 1001 women attending a maternity education program from April to October 2008; 863 women answered that they had heard of CB. We analyzed the 863 questionnaires to identify the sources of information, the plan for CB, the reasons for decisions, beliefs about the potential uses of CB, and knowledge about current therapeutic uses. RESULTS: Most subjects received information from promotional materials distributed by CB banks and the media; however, minimal information was obtained from obstetricians. More than 90% of women who planned to donate cited “altruism,” and 75.0% of the “private preservation” group indicated that a desire to “safeguard for the future” was the reason for their decision. The probability of autologous CB transplantation (p = 0.001) and current usefulness were significantly overestimated in the private preservation group (p = 0.02). In addition, 56% of subjects underestimated the probability of identifying a matched CB in the public bank, and the overall rate of correct answers about current usefulness was 57.4%. CONCLUSIONS: A considerable portion of educated pregnant Korean women has more than minimal knowledge of CB, but the levels of knowledge regarding the potency of the public bank and the current usefulness and limitations of CB are generally low; in addition, obstetricians play insignificant roles in disseminating knowledge. Providing accurate and detailed information to pregnant women not only via brochures and the media and/or Internet but also by obstetricians would encourage CB donation.

CC-chemokine ligand 28 (CCL28) was previously identified as a novel growth factor in vitro for hematopoietic stem cells (HSCs) from cord blood (CB). However, there is no report on the relationship between CCL28 and HSCs in a human body.To reveal the effect of CCL28 on hematopoietic cells in human CB at birth, we measured CCL28 in frozen CB plasma, which was preserved as a reference sample for cryopreserved CB units for HSC transplantation. We also evaluated the correlation of CCL28 level with CB components.A total of 81 cryopreserved nonconforming CB units for transplantation were selected. The level of CCL28 was 2540 ± 377 pg/mL. The CCL28 levels correlated with the number of CD34+ cells (r = 0.222, p = 0.047) and white blood cells (r = 0.254, p = 0.022) in the CB units. The CCL28 levels also correlated with hemoglobin levels (r = 0.221, p = 0.048) in fresh CB.This finding of positive correlation between CCL28 level and CD34+ cell numbers in vivo, together with the previous report that CCL28 influences the proliferation of hematopoietic cells in CB in vitro, may give a clue for better understanding the variability in HSC content in CB that is cryopreserved for HSC transplantation.

The number of aldehyde dehydrogenase-bright (ALDH(br) ) cells has been suggested as a viable marker of hematopoietic stem cell function. We evaluated the suitability of ALDH(br) cell analysis in the quality assessment of postthaw cord blood (CB) units.A total of 245 CB units were obtained for estimating the numbers of total nucleated cells (TNCs), CD34+ cells, ALDH(br) cells, ALDH(br) cells among CD34+ cells (CD34+ALDH(br) cells), CD34+ cells among ALDH(br) cells (ALDH(br) CD34+ cells), colony-forming unit (CFU)-granulocyte-macrophages (GMs), and CFU-granulocyte-erythrocyte-macrophage-megakaryocytes (GEMMs). Simple linear regression analysis was performed to assess the correlation between the number of TNCs and CD34+ cells before and after crypreservation and CD34+ALDH(br) cells, ALDH(br) cells, and ALDH(br) CD34+ cells after cryopreservation and the number of CFU-GEMMS and CFU-GMs.The number of CFU-GMs was found to be significantly correlated with the number of CD34+ cells before and after cryopreservation (r = 0.418 and r = 0.359, respectively), CD34+ALDH(br) cells, ALDH(br) cells, and ALDH(br) CD34+ cells (r = 0.426, r = 0.455, and r = 0.469, respectively). The number of CFU-GEMMs was found to be significantly correlated with the number of TNCs and CD34+ cells before and after cryopreservation (TNCs, r = 0.251 and r = 0.250, respectively; CD34+ cells, r = 0.391 and r = 0.347, respectively), CD34+ALDH(br) cells, ALDH(br) cells, and ALDH(br) CD34+ cells (r = 0.297, r = 0.297, and r = 0.252, respectively).The high correlation found between ALDH activity and CFU-GM number supports the suitability of ALDH analysis in the quality assessment of postthaw CB units.

The inventory size for cord blood (CB) depends on the ethnic diversity of human leukocyte antigen (HLA) and the size estimation is important for public health in each ethnicity.We estimate the CB inventory size in Koreans with stored CB units (CBUs) and patients who underwent allogeneic hematopoietic stem cell transplantation. Two-digit HLA specificities were determined using intermediate DNA typing. From 17,508 stored Korean CBUs, 1460 haplotypes with a frequency greater than 0.001% were used for reconstitution of the HLA. A total of 1002 transplanted patients' HLA was used for matching probability calculation.The best probability for 6/6 matching is 47% in 500,000 hypothetical size. Ninety-five percent probability is achieved with 51,000 CBUs in 5/6, and 2150 in 4/6 matching condition. Because 4/6 matched CB is rarely selected in the Korean situation, 51,000 units is the lowest limit of CBUs required and the number will be adjusted depending on the cell number required for patients and the resolution of HLA typing.Approximately 51,000 units could provide the minimum requirement for hematopoietic transplantation in Korea.