Umbilical-cord blood transplantation for the treatment of cancer

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Abstract
Allogeneic bone-marrow transplantation is the best treatment for patients with haematological cancers. This procedure, however, is limited by lack of suitable donors, as well as the complications of graft-versus-host disease (GVHD) and opportunistic infection. Umbilical-cord blood is an excellent source of haematopoietic stem cells. It has the advantages of speedy availability and reduced incidence of causing GVHD. This allows for transplantation of grafts with limited HLA disparity, and thereby extends the donor pool. The main determinants of successful umbilical-cord blood transplant are the number of cells that are available for transplantation and HLA matching. Cord blood transplantation has been validated as an alternative to bone-marrow transplantation for the treatment of leukaemia in children. A number of approaches are being developed to improve the efficacy of cord blood transplantation in adults, such as multiple-unit transplantation and reduced intensity of chemo-radiation therapy.