Did You Know?

Red Blood Cells Can Be Included or Depleted From  Newborn Stem Cell Units

When processing a unit of cord blood stem cells prior to
storage, red blood cells are depleted (called red blood cell–
depleted units), partially depleted, or left alone (called red  blood cell–replete units). 23
 When a transplantation center is  considering the available cord blood stem cell units, one of
the factors to compare is the total nucleated cell dose, or
TNC count. If the potential units are replete with red blood
cells, application of a correction factor to the cell count may
be necessary to account for the higher reported nucleated
red blood cell and granulocyte content inherent in the red
blood cell–replete units. In order to accurately compare
the TNC count with that of units that have had red blood
cells depleted, transplant centers may correct the TNC
count of the red blood cell–containing unit downward by 25% to 30%. 23,24

 It is important to weigh all of the aspects
of processing to determine the optimal quality of newborn
stem cell products. The United States Food and Drug
Administration recommends that prior to cryopreservation,
the cord blood unit should be depleted of plasma and red blood cells. 25
 For cord blood units that were cryopreserved
as red blood cell–replete, the National Marrow Donor
Program recommends the unit be prepared by washing the red blood cells prior to infusion. Additionally, the Blood and
Marrow Transplant Clinical Trials Network requires washing
the units post-thaw and prior to infusion. 26
 The removal of  red blood cells is the preferred processing method used in  both family and public cord blood banking (Table 2).

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