A prenatal prediction model for total nucleated cell count increases the efficacy of umbilical cord blood banking

作者：Manegold Brauer Gwendolin^*; Borner Barbara; Bucher Christoph; Hoesli Irene; Passweg Jakob; Gir**erger Sabine; Schoetzau Andreas; Gisin Simona; Visca Eva

来源：Transfusion, 2014, 54(11): 2946-2952.

DOI：10.1111/trf.12676

BackgroundThe most important factor for the selection of an umbilical cord blood unit (CBU) for hematopoietic stem cell transplantation is the total nucleated cell (TNC) count as a surrogate marker for stem cell content in the CBU. At present, about one in five donors can provide a CBU with a sufficient TNC count for umbilical cord blood (UCB) banking. It is labor-intensive to obtain consent of all eligible donors and optimization of the selection is needed. The purpose of this study was to investigate prenatal clinical predictors for TNC count that would help to identify successful UCB donors already on admission to the delivery unit. %26lt;br%26gt;Study Design and MethodsThis study was a retrospective analysis of 758 cryopreserved CBUs, collected from 2002 to 2006. Maternal and fetal factors analyzed were maternal age, gravidity, parity, weight, height, diabetes, premature rupture of membranes, gestational age, fetal sex, and birthweight. The impact on a high TNC count (%26lt;150x10(7) vs. 150x10(7)) of the CBU was modeled in a multivariate analysis model. %26lt;br%26gt;ResultsFetal birthweight was the strongest predictor (p%26lt;0.001) of TNCcount of at least 150x10(7). With a composite score of parity, gestational week, maternal weight and height, fetal sex, and birthweight, a nomogram was developed that increased banking rates from 22.7% to 31.9% while decreasing the number of banked CBUs from 149 to 79. %26lt;br%26gt;ConclusionsOur prenatal prediction model increases the efficacy of obtaining informed consent for UCB banking while still allowing relevant numbers of CBUs to be banked.

• 出版日期2014-11