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Low stem cell yield is a significant issue following cord stem cell transplant for haematological conditions....

Low stem cell yield is a significant issue following cord stem cell transplant for haematological conditions. Discuss the methods that have been implemented and those that are currently under investigation to improve outcome following cord stem cell transplantation in relation to improvements in the CD34+ cell dose provided.

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Stem cell transplantation has three different rich sources such as umbilical cord blood, bone marrow and peripheral blood. Umbilical cord blood is an alternative hematopoietic stem cell source for patients with hematologic diseases.The first umbilical cord blood transplantation was done in october 1988. Umbilical cord is one of the richest sources of stem cells and is isolated from the infant during birth without damaging the umbilical cord. Based on the age, weight, disease status of the patient the number of cells to be engrafted for successful transplant are decided.

A cord blood unit might contain too few stem cells for the recipient’s size. Due to the smaller number of stem cells in the cord blood unit, cord blood stem cell transplants engraft more slowly than stem cells from marrow or peripheral blood. Compared with bone marrow (BM) cells, CD34+/CD38? Umbilical cord blood cells proliferate more rapidly and generate larger numbers of progeny cell.

TNC and CD34+ are considered to be the best predictors of engraftment standard for selection of units.Total nucleated cell (TNC) and CD34+ cell doses in cord blood grafts are highly correlated with the rate of neutrophil and platelet engraftment, as well as the incidence of graft failure and early transplant-related complication. Critical cell-dose thresholds have been established and outcomes for patients receiving less than the generally accepted threshold of over 2.5 × 107 TNC/kg are significantly inferior in terms of engraftment, transplant-related mortality and overall survival.

Improvements are being made upon for the betterment of outcome of the stem cell transplant therapy.

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