Concise Review: Stem Cell-Derived Erythrocytes as Upcoming Players in Blood Transfusion§

Authors

  • Ann Zeuner,

    1. Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
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  • Fabrizio Martelli,

    1. Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
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  • Stefania Vaglio,

    1. National Blood Center, Istituto Superiore di Sanità, Rome, Italy
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  • Giulia Federici,

    1. Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
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  • Carolyn Whitsett,

    1. Kings County Hospital Center, Brooklyn, New York, USA
    2. Department of Hematology/Oncology, Tisch Cancer Institute, Mount Sinai School of Medicine, New York, New York, USA
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  • Anna Rita Migliaccio

    Corresponding author
    1. Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
    2. Department of Hematology/Oncology, Tisch Cancer Institute, Mount Sinai School of Medicine, New York, New York, USA
    • Department of Hematology/Oncology, Tisch Cancer Center, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1079, New York, New York 10029, USA
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    • Telephone: 212-2416974; Fax: 212-2414096


  • Author contributions: A.Z., F.M., S.V., G.F., C.W., and A.R.M.: wrote and reviewed the manuscript.

  • Disclosure of potential conflicts of interest is found at the end of this article.

  • §

    First published online in STEM CELLSEXPRESS May 29, 2012.

Abstract

Blood transfusions have become indispensable to treat the anemia associated with a variety of medical conditions ranging from genetic disorders and cancer to extensive surgical procedures. In developed countries, the blood supply is generally adequate. However, the projected decline in blood donor availability due to population ageing and the difficulty in finding rare blood types for alloimmunized patients indicate a need for alternative red blood cell (RBC) transfusion products. Increasing knowledge of processes that govern erythropoiesis has been translated into efficient procedures to produce RBC ex vivo using primary hematopoietic stem cells, embryonic stem cells, or induced pluripotent stem cells. Although in vitro-generated RBCs have recently entered clinical evaluation, several issues related to ex vivo RBC production are still under intense scrutiny: among those are the identification of stem cell sources more suitable for ex vivo RBC generation, the translation of RBC culture methods into clinical grade production processes, and the development of protocols to achieve maximal RBC quality, quantity, and maturation. Data on size, hemoglobin, and blood group antigen expression and phosphoproteomic profiling obtained on erythroid cells expanded ex vivo from a limited number of donors are presented as examples of the type of measurements that should be performed as part of the quality control to assess the suitability of these cells for transfusion. New technologies for ex vivo erythroid cell generation will hopefully provide alternative transfusion products to meet present and future clinical requirements. Stem Cells2012;30:1587–1596

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