To understand the benefits of cord blood vs. bone marrow vs. peripheral blood, it is important to understand the use of each within HSCT. Hematopoietic stem cell transplantation (HSCT) is the transplantation of multipotent hematopoietic stem cells derived from bone marrow, peripheral blood, or umbilical cord blood. It is performed for patients with cancers of the blood or bone marrow, such as leukemia and multiple myeloma, making it the leading type of cell therapy performed worldwide.
Understanding the Benefits of HSCT
In this article:
- Common Sources of Stem Cells for HSCT
- Characteristics of Umbilical Cord Blood
- History of Cord Blood versus Bone Marrow and Peripheral Blood in HSCT
Common Sources of Stem Cells for HSCT
There are three sources of stem cells that are used within hematopoietic stem cell transplantation (HSCT), which are:
- Bone Marrow
- Peripheral Blood
- Umbilical Cord Blood
While cord blood, bone marrow, and peripheral blood can all be valuable sources of cells for use in HSCT, there are key differences between them.
Each is sourced from different tissues, has varying types and quantities of the cell and progenitor cells, and has demonstrated different treatment outcomes across hematological and non-hematological disorders.
Characteristics of Umbilical Cord Blood
Umbilical cord blood is a source of stem cells that are genetically unique to a newborn donor, potentially compatible for those who are closely related, and frequently a match for non-related members of the population. Both the versatility and availability of umbilical cord blood stem cells make them a potent resource for use in transplant medicine.
Currently, umbilical cord blood is the second most common source of stem cells for cellular therapy.[1]
Because cord blood is a rich source of highly primitive hematopoietic stem cells, umbilical cord blood has an enormous regenerative potential for stem cell-based therapy, both for the treatment of hematological and non-hematological disorders. This is evidenced by the increasing number of clinical trials that are utilizing umbilical cord blood for stem cell-based therapies.
However, with these advances come new standards that must be established, including standardization of criteria for the selection of umbilical cord blood units for stem cell-based therapies, outcome measures, and long-term follow-up.[2]
History of Cord Blood versus Bone Marrow and Peripheral Blood in HSCT
The first successful use of bone marrow for HSCT was performed in 1956 by Georges Mathé, a French oncologist, on five Yugoslavian nuclear workers whose marrow had been damaged by irradiation following the accident at the Vinca Nuclear Institute, but all of these transplants were rejected.[3] Mathé later pioneered the use of bone marrow transplants in the treatment of leukemia.[4]
It was not until 1986 when peripheral blood stem cell transplantation (PBSCT) was introduced as a clinical modality, although it has since replaced bone marrow transplant as the most common transplantation procedure performed in medicine.[5]
Two years later in 1988, the first successful use of cord blood for HSCT was performed in Paris, France, to regenerate blood and immune system cells in a six-year-old boy suffering from the blood disorder “Fanconi’s Anemia.” It is an interesting coincidence that the French contributed both bone marrow transplant and cord blood transplant to the medical community.
Introduction of Cord Blood vs. Bone Marrow vs. Peripheral Blood 
Today, all three cell sources are regularly utilized within HSCT. However, recent years have seen a decline in the number of cord blood units being used for transplant within the United States.
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Up Next: Why Has Utilization of Umbilical Cord Blood for Transplantation Declined?
[1] Ilic, D., Miere, C. and Lazic, E. (2012). Umbilical cord blood stem cells: clinical trials in non-hematological disorders. British Medical Bulletin, 102(1), pp.43-57.
[2] Ibid.
[3] McLaughlin et al. Radiation doses were intense, being estimated at 205, 320, 410, 415, 422, and 433. . Of the six persons present, one died and the other five recovered after severe cases of radiation sickness. .Available at: http://www.rtbot.net/ Criticality_accident. [Accessed 5 Nov. 2014].
[4] NYTime.com,(2014). [online] Available at: http://www.nytimes.com/ 2010/10/21/health/research/21mathe.html?_r=1 [Accessed 7 Nov. 2014].
[5] Korbling, M. and Freireich, E. (2011). Twenty-five years of peripheral blood stem cell transplantation. Blood, 117(24), pp.6411-6416.