Umbilical cord-derived haemopoietic stem cells (UCDSCs) were first shown to be capable of supporting sustained engraftment approximately 30 years ago, but their role as a transplant source has been slow to develop. Recent work, however, suggests an increasing future use of UCDSCs in both children and
adults. The transplantation of UCDSCs is feasible, and concerns around cell dose and poor engraftment have been partly addressed with the use of double-cord donation. Other developments in this area include the potential for ex vivo expansion of UCDSCs and, intriguingly, the direct transplantation of UCDSCs into the marrow cavity. Clinical studies have confirmed the utility of UCDSCs and suggest that they have a particular role in patients who do not have an available sibling or fully matched unrelated donor. Given the potential availability of UCDSCs and the less stringent requirements for human leukocyte antigen matching to the recipient, the use of UCDSCs is likely to increase. This could, in theory, allow near-universal access to allogeneic transplantation for those patients who may benefit from the procedure.
