Immunoreactivity of umbilical cord blood and post-partum maternal peripheral blood with regard to HLA-haploidentical transplantation

Recent clinical reports have demonstrated that umbilical cord blood (CB) may be utilized as a source of transplantable hematopoietic stem cells when bone marrow is not available. However, it is not apparent that CB can be used to transplant partially HLA-matched siblings or matched, non-familial recipients. In this study the immunoreactivity of CB has been investigated within familial confines; 14 families were analyzed at the time of birth of their child and six of these families were reassessed at 6 months post-partum. In mixed lymphocyte reactions, CB was unable to significantly respond to stimulation with cells from either the mother or father. Furthermore, unlike adult peripheral blood, CB displayed depressed immune responses to alloantigen and T cell mitogen. At 6 months, the immune responses of the infant demonstrated normal development in terms of alloantigen and mitogen responses. However, at 6 months both the mother and the infant demonstrated a continued immune tolerance to one another. The data suggest that CB could be used in familial transplant situations when siblings are HLA-haploidentical if the donor/recipients are chosen based on the paternal haplotype. Furthermore, maternal bone marrow harvested during the 6 months immediately following delivery of a child also should be suitable as a stem cell graft in haploidentical situations.