Placental Blood as a Source of Hematopoietic Stem Cells for Transplantation into Unrelated Recipients.

TLDR: HLA-mismatched placental blood from unrelated donors is an alternative source of stem cells for hematopoietic reconstitution in children with a variety of malignant and non-malignant conditions.

Abstract: Background Transplantation of bone marrow from unrelated donors is limited by a lack of HLA-matched donors and the risk of graft-versus-host disease (GVHD). Placental blood from sibling donors can reconstitute hematopoiesis. We report preliminary results of transplantation using partially HLA-mismatched placental blood from unrelated donors. Methods Twenty-five consecutive patients, primarily children, with a variety of malignant and nonmalignant conditions received placental blood from unrelated donors and were evaluated for hematologic and immunologic reconstitution and GVHD. HLA matching was performed before transplantation by serologic typing for class I HLA antigens and low-resolution molecular typing for class II HLA alleles. In donor–recipient pairs who differed by no more than one HLA antigen or allele, high-resolution class II HLA typing was done retrospectively. For donor–recipient pairs who were mismatched for two HLA antigens or alleles, high-resolution typing was used prospectively to select ...