The use of Umbilical Cord and Placental Blood in patients with Acute Lymphoblastic Leukemia: A Literature Review

Abstract

In clinical practice, Bone Marrow (BM) is frequently used in Hematopoietic Stem Cell Transplantation (HSCT), with its use in humans beginning in 1957. The shortage of donors and limitations of the method highlight the need for therapeutic alternatives, such as umbilical cord blood (UCB), which has proven to be a valuable source of hematologic progenitor cells. Leukemia is characterized by the accumulation of malignant cells in the bone marrow, with Acute Lymphoblastic Leukemia (ALL) being the most common in children. The initial treatment is chemotherapy, which may include HSCT in high-risk cases. HSCT, especially with UCB, has advantages such as a lower risk of graft-versus-host disease. This study aims to perform a literature review on the use of UCB in patients with ALL. A literature review was performed using databases such as PubMed, SciELO and Google Scholar. The review implies that UCB stands out because it does not require full Human Leukocyte Antigen (HLA) compatibility, which facilitates its use in transplants. They are young, not exposed to pathogens, resulting in a lower risk of complications and post-transplant rejections. However, the amount of cells collected may be limited, restricting donations to individuals weighing less than 50 kg. Studies show that UCB can lead to better survival rates compared to bone marrow, especially in patients without compatible donors. Despite the associated risks, UCB is a viable and affordable alternative. Research continues to investigate the efficacy of UCB in relation to other types of transplant, with promising results, especially in children and young adults. It is important that the choice of treatment be individualized, considering the characteristics of each patient and discussed with the medical team.