Chances and Limits of Cord Blood Transplantation

Cord blood (CB) as a new source of grafting material has evoked great expectations. Because it is derived from the fetus, it contains immature cells with unusual properties: they possess higher proliferation capacity for regenerating the hematopoietic system after ablative treatment than does grafting material gained from adults, and they retain differentiation capacities for some non-hematopoietic tissues as well. The main application today is straightforward use as sibling or unrelated allograft during myoablative treatment of malignant disease. Important indications are also given in children with inherited blood cell diseases, hemoglobinopathies, immune deficiencies and other genetic diseases such as osteopetrosis and storage diseases; beside this, new perspectives for tissue replacement in the case of organ damage in adults open up, and both applications foster a family-centered strategy for CB storage.