[The cord blood bank at the Instituto Mexicano del Seguro Social]. / El banco de cordón umbilical del Instituto Mexicano del Seguro Social.

BACKGROUND: Hematopoietic stem cells have been used for over 50 years in the treatment of diverse diseases. Umbilical cord blood (UCB) has proved to be a viable source of hematopoietic stem cells for transplantation purposes. The aim was to report the contribution of the umbilical cord blood bank over the past 9 years, in the treatment of various diseases. METHODS: Since 2005 the number of units of blood from the umbilical cord and their use for transplantation in diverse disease were analyzed. A selection of volunteer pregnant women in labor was performed. Umbilical cord blood was obtained from them, which underwent processing, cryopreservation and validation, as well as compatibility test before using for transplantation. RESULTS: Ten thousand and ninety nine candidates to donation were assessed, from whom 2481 unit of UCB were collected. Of these, 893 unit were processed and cryopreserved for transplantation. In 65% of cases there was histocompatibility between the cord cell and the receptors. Transplantation was done in 87 patients, 67% had hematologic neoplasias, who have received 140 units of UCB in 102 transplants. This Bank of UCB ranks second in the world in productivity according to the rate of utility of units in transplantation (3.3%). CONCLUSIONS: Our bank of UCB has been able to develop a cell line (hematopoietic stem cells) with international quality standards and has been beneficial for patients served by our institution with need of a transplant mainly in hemato-oncologic patients.

Introducción: las células troncales hematopoyéticas se han empleado por más de 50 años en el tratamiento de diversas enfermedades. La sangre de cordón umbilical es una fuente viable de células troncales hematopoyéticas con fines de trasplante. El objetivo es informar la aportación clínica del banco de células de cordón umbilical (BCCU) en el tratamiento de diversas enfermedades.Métodos: desde 2005 a la fecha se analizó el número de unidades de sangre de cordón umbilical (SCU) y su empleo para el trasplante en diversas enfermedades. Se seleccionaron donadoras embarazadas voluntarias en trabajo de parto de quienes se recolectó SCU, la cual fue sometida a su procesamiento, criopreservación y validación, así como a estudios de compatibilidad previo a su uso para trasplante.Resultados: se evaluaron 10 099 candidatas a donación, de quienes se recolectaron 2481 unidades de SCU, de estas se procesaron y criopreservaron 893 unidades para trasplante. En 65 % de los casos hubo histocompatibilidad entre las células de cordón y el receptor. Se trasplantaron 87 pacientes (67 % neoplasias hematológicas), que recibieron 140 unidades SCU en 102 trasplantes.Conclusiones: nuestro Banco de CCU ha logrado desarrollar una línea celular (troncales hematopoyéticas) con estándares de calidad internacionales, y ha beneficiado a pacientes con necesidad de un trasplante, en especial los padecimientos oncohematológicos.

Cord blood banking and transplantation at the Mexican Institute of Social Security: the first 5 years.

BACKGROUND: In January 2005, the Cord Blood Bank (CBB) at the Mexican Institute of Social Security initiated activities. Herein, we describe the experience generated during this period (January 1, 2005-December 31, 2009). STUDY DESIGN AND METHODS: Good manufacturing practices and standard operating procedures were used to address donor selection, as well as umbilical cord blood (UCB) collection, processing, and cryopreservation. Based mainly on HLA and nucleated cell content, specific UCB units were thawed, processed, and released for transplantation. RESULTS: A total of 589 UCB units were stored, representing 54% of the total number of units collected. Forty-eight units (8.14% of the stored units) were released for transplantation of 36 patients. Twenty-six patients (72% of cases) corresponded to patients with acute leukemia, five (14%) to patients with marrow failure, and the rest (five; 14%) to patients with hemoglobinopathies and other syndromes. The median number of nucleated cells infused per patient was 6.71 × 10(7) /kg and the median number of CD34+ cells was 4.8 × 10(5) /kg. Current engraftment data indicate that engraftment occurred in 56%, and no engraftment in 44%, of cases. Engraftment was more frequent (59%) in patients that received more than 3 × 10(7) total nucleated cells (TNCs)/kg body weight, than in those receiving fewer than 3 × 10(7) TNCs/kg (40%). Myeloid engraftment was observed 7 to 54 days posttransplant (median, 23 days), whereas platelet engraftment was detected on Days 12 to 87 posttransplant (median, 38 days). To date, the disease-free survival rate was 41% and the overall survival was 47%, with survival periods of 126 to 1654 days. CONCLUSION: Although the experience presented herein is still limited and the period of analysis is still short, the results obtained during these 5 years are encouraging.