Effects of mild gestational diabetes mellitus on quality of umbilical cord blood hematopoietic stem cells procured at delivery
Hematopoietic stem cell (HSC) transplantation persists as the most successful and effective curative therapy for many haematological and non-haematological diseases, and cord blood HSCs have considerable advantages compared to other sources. The low number of cells harvested restricts their use a...
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Format: | Thesis |
Language: | English |
Published: |
2018
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Online Access: | http://psasir.upm.edu.my/id/eprint/83146/1/FPSK%28m%29%202019%2018%20-%20ir.pdf |
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Summary: | Hematopoietic stem cell (HSC) transplantation persists as the most successful and
effective curative therapy for many haematological and non-haematological diseases,
and cord blood HSCs have considerable advantages compared to other sources. The
low number of cells harvested restricts their use and hence successful engraftment is
highly dependent on the quality and quantity of stem cells and nucleated cells in cord
blood. Forasmuch, the higher costs of cryopreservation that is needed to store the
blood units, it is important to determine the maternal and neonatal factors, which
include maternal illnesses that influence the higher yield of hematopoietic stem cells
obtained from umbilical cord blood. Hence, a wise decision of storing UCB for the
definitive aim of successful cells engraftment can be made. This study evaluated the
effect of mild Gestational Diabetes Mellitus (mGDM) on the quality and quantity of
UCB parameters in terms of CD34+ cell count and viability, a total number of
nucleated cells and cord blood volume.
130 samples of umbilical cord blood collected from Malaysian women who delivered
their babies at Hospital Serdang between May 2016 and April 2017 were collected;
63 were mGDM and 67 were from healthy women. The harvesting of the umbilical
cord blood was performed via the in utero method. The UCB samples analysis include
the total UCB collected volume, total nucleated cell (TNC) count, and CD34+ cell
count by flow cytometry following the ISHAGE protocol and the measurement of the
viability resorting to the nucleic acid marker 7-amino actinomycin D.
There was a significant statistical association between the healthy group and mGDM
women group in terms of UCB unit volume and TNC number and viability. The mean
UCB volume for healthy women was 60.88 ± 18.16, while it was 54.06 ± 19.40 in
mGDM women (p = 0.041). The mean of TNCs was 54.84 ± 26.79, 44.42 ± 24.13 and
viability of TNCs was 53.71 ± 25.52, 42.88 ± 24.12 (p = 0.022 and 0.014) for healthy
women and mGDM women respectively. Nevertheless, the analysis of CD34+ count
and its viability between the two groups yielded no significant statistical difference.
On the other hand, the means of CD34+ percentage in mGDM (0.16 ± 0.19) was
statistically significant when compared to healthy group (0.11 ± 0.10) with p = 0.027,
which reflect that mGDM, yielded a higher % of CD34+. The correlation coefficients
for CD34+ indicated a significant and positive relationship between placental weight
and CD34+ cells counts (r = 0.572, p < 0.001), CD34+ viability (r = 0.279, p = 0.027),
and CD34+ percent (r = 0.422, p = 0.001). UCB volume and TNCs count and viability
are highly significantly related to the placental weight when r correlation coefficient
values were 0.438 (p < 0.0010), 0.3810 (p = 0.002), and 0.382 (p = 0.002) respectively.
On contrary, in the healthy group, placental weight only correlates to CB volume and
TNC number with r = 0.288 (p = 0.019) and 0.246 (p = 0.047) respectively. The study
revealed that gender has no significant impact on all UCB parameters regardless
mothers of mGDM group or healthy group as (p > 0.05). Infant’s birth weight in the
mGDM group has a positive correlation with UCB volume, TNC count and viability,
but not CD34+ parameters (count, viability and percentage) (p > 0.05). As compared
to neonates with normal birth weight (NBW) have higher blood volume, TNC count
and viability, than low birth weight (LBW) neonates (p = 0.007, 0.010, 0.013). In the
healthy group, all UCB parameters are not affected whether neonates are NBW or
LBW (p > 0.05). In conclusion, mGDM has a negative impact on the UCB volume and TNC count and
viability obtained from cord blood at delivery, but not on the yield of HSC. Placental
weight and neonatal birth weight are the most important factors influencing the
numbers of cord blood HSC. These findings would provide guidance to mothers who are GDM on diet control and to their health care providers in making the right decision regarding UCB stem cell collection and banking. |
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