Words of the President

Major improvement has been observed in the field of hematopoietic stem cell transplantation for malignant and non-malignant hematological diseases, including prevention and treatment of complications and reducing toxicity with new conditioning regimens. The development of adult unrelated bone marrow donor registries has contributed to the increased use of hematopoietic stem cell transplant for patients who do not have an HLA identical sibling donor. Nowadays, more than two million donors have been included in international registries for exchange of donors all over the world. In 1988 HE Broxmeyer, AD Auerbach and E. Gluckman demonstrated, for the first time, that cord blood collected at birth contained enough stem cells to engraft in a patient, increasing the hematopoietic stem cell transplantation donor pool. Since the first human cord blood transplant, cord blood banks have been established worldwide for collection and cryopreservation of cord blood for allogeneic hematopoietic stem cell transplant. Umbilical cord blood (UCB) has now become a commonly used source of hematopoietic stem cells for allogeneic transplantation. To date, a global network of cord blood banks and transplant centers has been established with a common inventory including aproximately 600.000 UCB banked and an estimated 30.000 UCB units distributed worldwide for adults and children with severe hematological diseases. Several studies have shown that the number of cells is the most important factor for engraftment, while some degree of HLA mismatches is acceptable. The absence of ethical concern and the unlimited supply of cells explain the increasing interest of using cord blood for stem cell therapy.

This year, through an active international cooperation, a worldwide network for blood and marrow transplantation analyzed and published results of a total of one million patients treated with allogeneic hematopoietic stem cell transplant. These results guidegrant decisions, help improving donor infrastructure and to limit overuse by defining risk , adapted indications for hematopoietic stem cell transplant as an efficient and cost effective approach for life-threatening, potentially curable diseases.

Much has been learned in a relatively short time on the properties of cord blood hematopoietic progenitors and their clinical applications. There is still many opportunities for development, to improve results, and find new indications of cord blood use. First, several methods of improvement of the speed of engraftment and decreasing transplant related mortality are investigated such as, the increase of donor pool to decrease the number of HLA mismatches or the use of double cord blood transplants. Other methods are currently being investigated such as cord blood intra-bone infusion, ex-vivo expansion with cytokine cocktails, use of homing factors and addition of mesenchymal stromal cells. In addition, innovative approaches using non-hematopoietic stem cells from cord blood and placenta could be used for treatment of autoimmune diseases and for regenerative medicine.

Eliane Gluckman - Cords For Life

Eurocord Monaco

MONACORD is a clinical research organisation, which has established at the Centre Scientifique de Monaco

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