Augmented Cord Blood Stem Cell Collection, Making Adult Single Cord Transplant a Reality?

For over 25 years, cord blood stem cell collection and clinical use as a viable stem cell source for hematologic reconstitution has continued to receive increased acceptance and more diverse applications. Recently, the utilization of cellular sub-types and differentiated populations from cord blood has been employed for a variety of conditions including those resulting from cellular and organ dysfunction or damage. Unfortunately, the usefulness of cord blood derived stem cells for these varieties of applications has been limited by the stem cell number constraints of a typical cord blood collection, as compared to other sources of stem cells such as bone marrow, peripheral blood and tissue-derived stem cells. Clearly, cord blood stem cells have been recognized to have unique advantageous characteristics, such as the ready availability of a discarded, almost limitless resource; being intrinsically and relatively free of pathogens and prior infectious burdens and sequelae and demonstrating significant pluripotential capability while demonstrating improved graft versus host tolerance. Attempts to improve the useful number of cord blood derived stem cells for a particular indication have included combined multiple cord transplants, a variety of methods to expand stem cell populations and techniques to increase the stem cell yield from a placenta and umbilical cord. Methodologies to increase cord blood collection volume and cell yield have included placental expression, perfusion techniques and placental and cord tissue maceration and cellular separation. Although some of these techniques have demonstrated potential limited usefulness, they have lacked reproducibility, routine procedural practicality and have intrinsic specific risks including infection potential, cellular byproducts and the use of non-approved pharmaceuticals. If possible, the collection of sufficient number of cord blood stem cells from a single cord blood collection, which would be suitable for either a pediatric or adult transplantation, would be of great value. Additionally, the value of the use of an abundant, low cost stem cell source such as cord blood for general use for either hematopoietic or mesenchymal cell application for all potential recipients in need is obvious. However, the procurement of such an invaluable resource needs to be reliable, reproducible and simplistic by nature, avoiding specialized equipment, facilities or expertise at the time of collection. This presented technology represents such a procedure which can result in the collection of a two part stem cell product which can provide for the needs of both an adult stem cell transplant requirements as well and serve as a biologic resource for other stem cell applications such as mesenchymal cell indications. This described technique allows for the standard primary cord blood collection, followed by the placental administration of physiologic vasodilators and stem cell releasing factors in a solution which is both nutritive and cell supportive in nature. The second augmented collection immediately follows which results in a combined and increased stem cell volume that is two to three times the typical mononuclear cell yield. Transportation of a two part collection to the processing facility is standard in nature and requires no subsequent modification in the mononuclear separation procedure prior to storage. The percent CD34+ cell population is significantly elevated in the second collection volume, demonstrating effective mobilization of marginating placental stem cells. Additionally, the procedure is technically reliable and reproducible by any experienced collector and requires only a minor modification in a standard cord blood collection procedure without the use of cumbersome equipment or materials. Disclosures: No relevant conflicts of interest to declare.