Preterm birth and the availability of cord blood for HPC transplantation

BACKGROUND: Cord blood from deliveries at term can be used for HPG transpla ntation. The objective of this study was to determine the amounts of cord b lood nucleated cells (NCs) and HPCs that were collectable from preterm deli veries. STUDY DESIGN AND METHODS: Cord blood collected from preterm deliveries betw een 22 and 36 weeks of gestation was compared with regard to volume, NC cou nt (/mL), CD34+ cell count (/mL), and the NC and CD34+ cell counts per cord blood sample and at different gestational ages. RESULTS: A correlation was found between gestational age and NC count (r = 0.52, p<0.001), and an inverse relation was found between gestational age a nd CD34+ cell count (r = -0.68, p<0.001). The CD34+ cell count per cord blo od sample was independent of gestational age (r = -0.13, p = NS), and no si gnificant difference between early (22-32 week) and late (33-36 week) prete rm deliveries was found (p = 0.870). Comparison with published data from co rd blood transplantations revealed that up to one-third of preterm samples contained at least as many NCs (or CD34+ cells) as the median cell dose tra nsplanted (calculated for the median recipient weight) in the respective st udy. Furthermore, 77 percent of all preterm samples contained at least 1 x 10(7) NCs (and 42% at least 1 x 10(5) CD34+ cells) per kg for transplantati on in a recipient of 20-kg body weight, which corresponds to the lower thre shold of cells per kg in the graft recommended by Eurocord. CONCLUSION: Preterm delivery should not be a reason to exclude cord blood c ollection if allogeneic cord blood transplantation in a sibling is planned.