| Bone Marrow/Peripheral Blood |
Cord Blood |
| Donation requires surgery under general anesthesia. Donors may experience temporary discomfort and/or pain. Long-term consequences of growth factors used in peripheral blood stem cell donations are uncertain. |
When obtained from the delivered placenta and umbilical cord, donation poses no risk to mother or infant. |
Requires donation of a quart or more of bone marrow (mixed with blood) for transplant. |
A few ounces can be used for transplantation. |
| Large dose of stem cells. Rapid engraftment. |
Smaller dose of stem cells. Slower engraftment. |
After a formal search is begun, takes an average of 4 months to transplant, if a donor is available. |
When a match is found, can take only a few days for confirmatory and special testing and shipment to the Transplant Center (less than 24 hours in an emergency). |
| Potential donors may no longer be available or may have withdrawn consent. Donor must be found and retested to confirm the HLA typing and infectious disease results and to confirm that the donor is still willing and able to donate bone marrow. Significant donor attrition. |
Once frozen, a cord blood unit is available until used. Otherwise, no donor attrition. |
Donor may be available to give a second transplant or to donate T-cells if necessary. |
Donor is not available for a second donation. |
| Bone marrow must be used fresh (shelf-life measured in hours). Peripheral blood stem cells stored for short term (days to a few months). |
Frozen cord blood has been transplanted successfully after up to 10 years in storage. |
Patient must begin conditioning before the bone marrow harvest. Coordination between donation and transplant is critical and complex. |
Can be shipped to the transplant center before the patient enters the hospital and begins conditioning for transplantation. Coordination is simple. Cord blood units are shipped on demand. |
| Latent viral infection in the donor common (i.e. CMV > 50% in U.S. adult donors). |
Latent viral infection in the cord blood donor rare (i.e. CMV <1% in U.S.). |
No risk of transplanting a genetic disease. |
Cord blood has a small risk that a rare, unrecognized genetic disease affecting the blood or immune system will be given with the transplant.
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| Severe graft vs host disease (GvHD) common. |
GvHD less frequent and usually less severe and easier to treat. |
Generally requires a perfect match between donor and recipient for 6/6 HLA-A, -B and -DRB1 antigens. Additional HLA factors (HLA-C, -DQ and -DP) increasingly used to improve prognosis. |
HLA-mismatched cord blood transplants are possible, making it easier to find a suitable match. Role of HLA-C, -DQ and -DP are not yet known. |
