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What is the cord blood transplant dose?
In other words, how much cord blood is needed to be confident of a successful transplant? The crucial thing is not the volume of the blood sample, but the number of stem cells it contains. The simplest measure of these cells is the Total Nucleated Cell count, or TNC.
The "optimal (transplant) dose is about 20 million nucleated cells per kilogram of body weight" (one kilogram equals 2.2 pounds).
"...patients who received no more than 10 million nucleated cells per kilogram had a 75 percent probability of death, whereas recipients of at least 30 million nucleated cells per kilogram had a 30 percent probability of death." Reference: Editorial by Gluckman, E. NEJM 2001;344:1860
"...patients who received no more than 10 million nucleated cells per kilogram had a 75 percent probability of death, whereas recipients of at least 30 million nucleated cells per kilogram had a 30 percent probability of death." Reference: Editorial by Gluckman, E. NEJM 2001;344:1860
But, what is the concentration of nucleated cells in a typical cord blood collection? The answer to that question comes from a study of families participating in the Sibling Cord Blood Donor Program. In these 542 cases, the cord blood was collected by the family's personal OB/Gyn, at hundreds of different hospitals. This is a situation just like private cord blood banking. In their study, the mean cord blood volume and nucleated cell count were 103.1 mL (including anticoagulant) and 890 million, respectively. Reference: W Reed, et al, Blood 2003; 101(1):351
Thus, on average, a cord blood sample contains 8.6 million nucleated cells per millileter. Putting together the cell dose recommended by Gluckman and the average concentration found by Reed et al., one can calculate that....
The optimal transplant dose requires harvesting 1 millileter of cord blood for every pound of patient weight (1 ml and 1 cc are the same amount).
Last modified: 08.October 2008
Copyright 2000 - 2008 Frances Verter
Copyright 2000 - 2008 Frances Verter