Estimated fetal weight percentile as a tool to predict collection of cord blood units with higher cellular content: implications for prenatal selection of cord blood donors. Issue 7 (6th May 2018)

• Record Type: Journal Article
• Authors: Lin, Xinxin; Torrabadella, Marta; Amat, Lluís; Gómez, Susana; Azqueta, Carmen; Sánchez, Mar; Cuadras, Daniel; Martínez Lorenzo, Maria José; Brull, José María; Gayà, Antoni; Cemborain, Arantxa; Pérez Garcia, Cristina; Arroyo, JoséLuís; Querol, Sergi; Gómez Roig, Maria Dolores
• Is Part Of: Transfusion. Volume 58:Issue 7(2018)
• Page Start: 1732
• Page End: 1738
• Publication Date: 2018-05-06
• Subjects: Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; Blood Group Antigens -- Periodicals; Blood Preservation -- Periodicals; Blood Transfusion -- Periodicals; 615
• DOI: 10.1111/trf.14651
• Languages: English
• ISSNs: 0041-1132

Abstract

Abstract : BACKGROUND: The need for high‐cellular‐content cord blood units (CBUs) for allogenic transplantation is evident to improve clinical outcomes. In our environment and with current donation programs, very few collected units meet suggested clinical thresholds, making collection programs highly inefficient. To increase the clinical conversion rate, we have assessed factors influencing the cellular content of the cord blood collection and established the estimated fetal weight percentile (EFWp) as a tool to predict which deliveries will obtain higher cellular counts. STUDY DESIGN AND METHODS: We conducted a retrospective analysis of 11, 349 collected CBUs. An analysis of diagnostic efficiency (receiver operating characteristic [ROC] curve) was performed to establish the cutoffs of several obstetric and perinatal variables from which we would obtain more than 1500 × 10 6 total nucleated cells and 4 × 10 6 CD34 cells. We then calculated the optimal EFWp cutoff to increase efficiency. RESULTS: In the univariate analysis, factors positively and significantly associated were a greater neonatal and placental weight and longer weeks of gestation. In the multivariate analysis only neonatal and placental weight remain significant (p < 0.001). The ROC curve analysis showed that the optimal EFWp cutoff is 60, which has the maximum area under the curve. Applying this, donations meeting clinical cellular numbers will increase more than 30% with respect to not using any threshold. CONCLUSION: The EFWp predicts the quality of the collected CBUs and can be used to make a prenatal selection of the donors, therefore increasing the efficiency of umbilical cord blood collection programs.