Cord blood transplants a viable option in leukemia
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Adult patients with leukemia fare just as well when they get stem cell transplants taken from a cord blood bank as they do from a well-suited adult donor, U.S. researchers said on Tuesday.
They said umbilical cord transplants are a viable option for adults with leukemia who urgently need a bone marrow transplant to replace cells destroyed by chemotherapy or radiation treatments, but cannot find a donor.
“What we found is when you look at the outcome of leukemia-free survival, which is the likelihood of a patient being alive without disease, it’s the same whether you are transplanting using an adult graft which is from an adult donor or a cord blood unit,” said Dr. Mary Eapen of the Medical College of Wisconsin, whose study appears in the journal Lancet Oncology.
Cord blood worked even if it was not a great match, Eapen said in a telephone interview.
Only about half of all white adult patients can find a suitable donor, and the odds are much lower if the patient is African American or Asian, Eapen said.
“In general ... if you don’t have an acceptable tissue match with a donor, your chances of having a complication are higher and it can result in death,” she said.
But that is less so with stem cells from umbilical cord blood. “The body is more tolerant to the cells in the placental blood, even though they are not a perfect match.”
Eapen and colleagues analyzed data from 216 transplant centers worldwide. They compared the results of 165 patients 16 or older with acute leukemia who had been received umbilical cord blood to 888 adults given unrelated stem cell transplants, and 472 who had been given unrelated donor bone marrow.
After two years, all the patient groups were equally likely to survive and be free of leukemia regardless of graft source.
“The beauty of umbilical cord blood is you can use that for transplant patients who are not a perfect match and still come up with an acceptable endpoint, which is leukemia-free survival,” Eapen said.
She said most transplants being done with cord blood use public cord blood banks, in which parents have donated blood from their infant’s umbilical cord.
These have undergone strict testing to ensure the cells are safe and well preserved.
Private cord blood banks, such as those run by Cord Blood America Inc, typically collect and store cord blood for private use for an individual or family member, she said.
In an accompanying comment, Paul Szabolcs of Duke University Medical Center in Durham, North Carolina, said the analysis should bolster efforts to increase donations to public cord blood banks, particularly by minorities, who have the most trouble finding a matched donor.
Public cord blood banks cover the costs to collect, test and store umbilical cord blood.
SOURCE: Lancet Oncology, online June 15, 2010.
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