Assessment of CD34+ Cells and Total Nucleated Cells in Umbilical Cord Blood in a Tertiary Hospital South-south, Nigeria

Main Article Content

Matilda Adesuwa O. Ojo
Tomisin Matthew Adaja
Oluwafemi Adeyemi
Patrick Olanrewaju Osho
Ehigha Enabudoso
Godwin Nosakhare Bazuaye


Aim: Umbilical cord blood (UCB) contains sufficient number of haematopoietic stem cell and progenitor cells that can be used for autologous and allogeneic stem cell transplantation in children and adolescents. Our study assessed the CD34+ cells and total nucleated cells in umbilical cord blood stem cells in a tertiary institution in Nigeria.

Study Design: This is a cross-sectional study.

Place and Duration of Study: This study was conducted in University of Benin Teaching Hospital (UBTH), Benin City. Informed consent for UCB collection was obtained from healthy mothers with uncomplicated pregnancies, receiving care at the Department of Obstetrics between July and September, 2016.

Methodology: A total of forty umbilical cord bloods samples were collected from the placenta umbilical cord after delivery. CD34+ cells were enumerated using flow cytometer while haematology analyzer was used to assess total nucleated cell (TNC) count. Data was analysed using Statistical Package for Social Sciences (SPSS) version 21.

Results: CD 34+ cells count ranged between 2.0 - 6.99 x 104cells/ml with a mean value of 3.89 ± 1.48 x 104cells/ml (Recommended minimum value 2x105/kg). Mean value of TNC was 11.14 ± 4.47 x 106 cells/ml with a range of 4.80-21.10 x106 cells/ml (Recommended minimum value 2x 107 /kg). We observed a positive correlation between CD34+ cells and TNC count (r = 0.760, p=0.000).  In addition, maternal parity showed a significant inverse relationship with TNC and CD34+ cells.

Conclusion: CD34+cells and TNC count of UCB obtained from placentae of babies delivered at the University of Benin Teaching Hospital are within the acceptable values for haematopoietic stem cell transplantation. This is in keeping with recommendations by the World Marrow Donor Association, which stated that a minimum of 2 x107 TNC/kg or 2 x105 CD34+ cells/kg of body weight of recipient.

CD34 cells, umbilical cord blood, haematopoietic stem cell, placentae.

Article Details

How to Cite
O. Ojo, M. A., Matthew Adaja, T., Adeyemi, O., Olanrewaju Osho, P., Enabudoso, E., & Bazuaye, G. N. (2019). Assessment of CD34+ Cells and Total Nucleated Cells in Umbilical Cord Blood in a Tertiary Hospital South-south, Nigeria. International Journal of Research and Reports in Hematology, 2(4), 1-14. Retrieved from
Original Research Article


Broxmeyer HE: Colony assay of haematopoietic progenitor cells and correction to clinical situations. Critical Review of Oncology Hematology. 1984; 1(3):227-257.

Jeevani T. stem cell transplantation-types, risks and benefit. Journal of Stem Cell Research and Benefits. 2011;1:3-5.

Leventhal A, Chen G, Negro A, Boehm M. The benefit and risk of stem cell technology. Oral Disease. 2012;18(3):217- 222.

Stein L, Mc Guire H, Avdic S, Rizzetto S, Fazekas de St Groth B, et al. Mass cytometry for the assessment of immune reconstitution after Haemopoeitic stem cell transplantation. Immunol. 2018;9:1672.

Thoma MD, Huneke TJ, DeCook LJ, Johnson ND, Wiegand RA, et al. Peripheral blood lymphocyte and monocyte recovery and survival in acute leukemia postmyeloablative allogeneic hematopoietic stem cell transplant. Biology Blood Marrow Transplant. 2012;18(4):600-607

Kim DH, Sohn SK, Won DI, Lee NY, Suh JS, et al. Rapid helper T-cell recovery above 200 x 10 6/l at 3 months correlates to successful transplant outcomes after allogeneic stem cell transplantation. Bone Marrow Transplant. 2006;37(12):1119-28.

Armitage JO. Bone Marrow Transplantation. New England Journal of Medicine. 1994;300:827-838

Armson BA. Umbilical cord blood banking: Implication for Perinatal Care Providers. Journal of Obstetrics and Gynecology Canada. 2005; 156:263-274.

Barker JN, Wagner JE. Umbilical Cord Blood Transplantation for the Treatment of Cancer. National Review of Cancer. 2003: 526-532.

Dall JH, Duval M, Moghrabi A, Wagner E, Vachon FM, Barrette S, et al. Results of An Unrelated Transplant Search Strategy Using Partially HLA – Mismatched Cord Blood as An Immediate Alternative to HLA Matched Bone Marrow. Bone Marrow Transplantation. 2004;33:605- 611.

Julia B, Boussiotis VA. Umbilical Cord Blood Transplantation Basic Biology and Clinical Challenges to Immune Reconstitution. Clinical Immunology. 2008; 127(3):286–297.

Gluckman E, Broxmeyer HE, Auerbach AD, Friedman HS, Douglas GW, et al. Haematopoietic Reconstitution In A Patient With Fanconi’sAnaemia by Means of Umbilical Cord-Blood from HLA identical Sibling. New England Journal of Medicine 1989;321:1174-1178.

Broxmeyer HE. Cord Blood Haematopietic Stem Cell Transplantation. Stem Brook 2010;1(52):1-4.

Nwannadi IA, Olayinka AO, Terrumun S, Elachi AF. Umbilical Cord Blood Donation and Banking: Awareness among pregnant women. In Makurdi, Nigeria. Journal of Dental and Medical Sciences. 2014;1(13): 16-19.

United Nations International Children's Emergency Fund. State of the World’s Children Report; 2007.
[Cited June 2014]

Akinyanju O. The national burden of sickle cell disorder and the way forwards; 2009. Available:
(Accessed October 19, 2019)

Ilesanmi OO, Sickle Cell Disease and Stem Cell Therapy (SCT): Implications for Psychotherapy and Genetic Counseling in Africa; 2013.
(Accessed October 19, 2019)

Bazuaye N, Nwogoh B, Ikponmwen D, Irowa O, OkugboS, et al. First successful allogeneic hematopoietic stem cell transplantation for a sickle cell disease patient in a low resource country (Nigeria). A Case Report. Annual Transplant. 2014; 19:210-213.

Joseph JJ, Abraham AA, Fitzhugh CD. When there is no match, the game is not over: Alternative donor options for hematopoietic stem cell transplantation in sickle cell disease. Seminary haematology. 2018;55(2):94-101.

Gluckman E, Cappelli B, Bernaudin F, Labopin M, Volt F, et al. Sickle cell disease: An international survey of results of HLA-identical sibling hematopoietic stem cell transplantation. Blood. 2016;10:1-23.

Guilcher GMT, Truong TH, Saraf SL, Joseph JJ, Rondelli D, et al. Curative therapies: Allogeneic hematopoietic cell transplantation from matched related donors using myeloablative, reduced intensity, and non myeloablative conditioning in sickle cell disease. Seminary haematology. 2018;55(2):87-93.

Abraham A, Cluster A, Jacobsohn D, Delgado D, Hulbert ML, et al. Unrelated umbilical cord blood transplantation for sickle cell disease following reduced-intensity conditioning: Results of a phase I trial biology of blood and marrow transplantation. 2017;23(9):1587-1592.

Allan D, Petraszko T, Elmoazzen H, and Smith S. A review of factors influencing the banking of collected umbilical cord blood unit. Stem Cells International. 2013;1155-1162.

Koen VB, Liu H, Jain N, Stock W, Artz A. Umbilical cord blood transplantation supported by third-party donor cells, rationale, results and applications. American society for biology and bone marrow transplantation. 2013;19(5):682-691.

Danish HQ, Syed TA, Mohammad PS, Tahseen K. Haematological Reference Values for Full Term, Healthy, Newborns of Karachi, Pakistan. Pakistan Journal of Physiology. 2009;5(2):152-156.

Kristin MP, Adam M, Brigid B, Stephen W, Kevin S, et al. Optimizing Donor Selection For Public Cord Blood Banking: Influence Of Maternal, Infant and Collection Characteristics on Cord Blood Unit Quality. Transfusion. 2014;54(2):340–352.

Mihaela C, Serban N, Camelia SI, Coralia B1, Irina A1, et al. Optimizing Donor Selection in Order to Establish A Cord Blood Banking Facility: Maternal and Obstetric Factors Impact. Central European Journal of Medicine. 2007;2: 180–189.

M-Reboredo N, Díaz A, Castro A, Villaescusa RG. Collection, Processing and Cryopreservation of Umbilical Cord Blood for Unrelated Transplantation. Bone Marrow Transplantation 2000;26:1263-1270.

Ballen KK, Wilson M, Wuu J, Ceredona AM, Hsieh C, et al. Bigger is better: Maternal and neonatal predictors of hematopoietic potential of umbilical cord blood units. Bone Marrow Transplantation 2001;27:7-14.

Mutlak BH, Mnati IM. An Experimental Study of Collection, Separation Enumeration and Cryopreservation of Umbilical Cord Blood Stem Cell. Ibn Al- Haitham. Journal For Pure and Apply Science . 2010;3:1-8

Nikos T, kokkona K, Vassilios k, Daryoush H, George K. Time and Temperature before Processing Influence the Recovery of Umbilical Cord Blood Haematopoietic Progenitors. Transfusion. 2007;3:177-181.

Kurtzberg J, Laughlin M, Graham ML, Smith C, Olson JF, et al. Placental blood as a source of hematopoietic stem cells for transplantation into unrelated recipients. New England Journal of Medical. 1996; 335:157-166.

Chandra T, Afreen S, Kumar A, Singh U. Correlation Of Umbilical Cord Blood Volume with CD34+ Cells Concentration. International Journal of Blood Transfusion and Immunohematology. 2011;1:12-16.

Aroviita P, Teramo K, Hiilesmaa V, Kekomäki R. Cord Blood Hematopoietic Progenitor Cell Concentration And Infant Sex. Transfusion. 2005; 45:613–621.

Vasiliki E, Lefteris B, Calliope K, Aikaterini F, Antonio V. Direct Measurement Of CD34+ Cord Blood Stem Cell Absolute Counts, Viability and WBC Using Flow Cytometry. Health Science Journal. 2011; 5: 306-319.

Petterson J, Moore CH, Palser E, Hearn JC, Dumitru D et al . Detecting primitive heamatopoitic stem cells in total nucleated and mononuclear cells fractions from umbilical cord blood segments and units. Journal of translational medicine. 2015; 13:94-110.

Isidro I, Ponce-Verdugo L, Hernández-Lamas M, Rodríguez-Pena R, Antúnez C, et al. Influence on Time to Cryopreservation in Umbilical Cord Blood Units. International Journal of Clinical Medicine. 2011; 2:399-403

Broxmeyer HE, Douglas GW, Hangoc G, Cooper S, Bard J, et al. Human Umbilical Cord Blood as A Potential Source of Transplantation; Proceedings National Academic of Science USA 1989; 86: 3828-3832.

Frans THL, Scherjon SA, Beckhoven JM, Falkenburg JHF, Brand A, et al. Association of stress during delivery with increased numbers of nucleated cells and hematopoietic progenitor cells in umbilical cord blood. American Journal of Obstetrics and Gynecology. 2000;183(5): 1144-1152.

Joseph P, Neerja K, Tathagata C, and Rajiv S. Optimizing Cord Blood Collections: Assessing the Role of Maternal and Neonatal Factors. Asian Journal Transfusion Science. 2015;9(2):163-167.

Nakagawa R, Watanabe T, Kawano Y, Kanai S, Suzuya H, Kaneko M, et al. Analysis of maternal and neonatal factors that influence the nucleated and CD34+Cell yield for cord blood banking. Transfusion. 2004;44:262–267.

Stanevsky A, Goldstein G, Nagler A. Umbilical cord blood transplantation: Pros, cons and beyond. Blood Reviews. 2009;10:1-6.

Jan RH, Wen SH, Shyr MH, Chiang BL. Impact Of Maternal And Neonatal factors on CD34+ Cell Count, Total Nucleated Cells, and Volume of Cord Blood. Paediatrist Transplant. 2008;12:868–873.

Choong SN, Ng YK, Kamalan A, Saraswathy S, Goh EH, Lee MJ, et al. Effect Of Maternal Age, Birth Weight And Infant Sex On Total Nucleated Cell (TNC) Count and Volume of Umbilical Cord Blood (UCB) Collected. Medical Journal of Malaysia. 2008;63:55–56.

Thame M, Osmond C, Bennett F, Wilks R, Forrester T. Fetal growth is directly Related to maternal anthropometry and placental volume. European Journal of Clinical Nutrition. 2004;58:894–900.

Sparrow RL, Cauchi JA, Ramadi LT, Waugh CM, Kirkland MA. Influence of Mode of Birth and Collection on WBC Yields of Umbilical Cord Blood Units. Transfusion. 2002;42:210–215.

Manegold-Brauer G, Meyer-Monard S, Tichelli A, Pauli D, Holzgreve W, et al. Cesarean section due to fetal distress increases the number of stem cells in umbilical cord blood. 2008 Transfusion 48(5):871-876.