Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Cord blood outperforms matched, unrelated donor in bone marrow transplant


A University of Colorado Cancer Center study compared outcomes of leukemia patients receiving bone marrow transplants from 2009-2014, finding that three years post transplant, the incidence of severe chronic graft-versus-host disease was 44 percent in patients who had received transplants from matched, unrelated donors (MUD) and 8 percent in patients who had received umbilical cord blood transplants (CBT). Patients who received CBT were also more likely to no longer need immunosuppression and less likely to experience late infections and hospitalizations. There was no difference in overall survival between these two techniques. Results are published in the journal Bone Marrow Transplant.

"When you do an allogeneic transplant - when someone else is the donor - the new blood system has the potential to attack the patient. This is graft-versus-host disease, which can be debilitating and even fatal. Our results show that, long term, receiving a cord blood transplant is less likely than receiving a transplant from an unrelated, matched donor to result in graft-versus-host disease," says Jonathan Gutman, MD, investigator at the CU Cancer Center and Clinical Director of Allogeneic Stem Cell Transplantation at University of Colorado Hospital.

University of Colorado Cancer Center study shows reduced chronic graft-versus-host disease with cord blood, compared with blood from unrelated matched donor, three years after bone marrow transplant.

Credit: University of Colorado Cancer Center

A common treatment for blood cancers is to erase a patient's leukemic blood system and then regrow a new blood system using donor blood stem cells.

There are four possible sources of donor cells: a matched, related donor (commonly a close family member), a matched, unrelated donor (from a database of 25 million people who have agreed to donate), umbilical cord blood (from a bank of stored samples), and haploidentical transplant (a promising technique requiring only a half match with a related donor).

The closer the match between donor cells and a patient's blood system, the less chance the new blood system will attack the patient's tissues, i.e. the less chance of graft-versus-host disease.

A matched, related donor is the accepted first choice. Genetics dictate that siblings have a 25 percent chance of matching. Those without a matched, related donor have 70 percent chance for Caucasians or only 10 percent chance for other or mixed ethnicities of finding a matched, unrelated donor in databases of people who have agreed to give if needed. Cord blood is immature and thus does not need to be as closely matched to be acceptable as a donor source. (Haploidenical transplant is beyond the scope of this article.)

"Historically, doctors have reserved cord blood for patients without a match," Gutman says.

However, this flow of preference is increasingly questioned as data including the current study demonstrate that cord blood may be equal to or better than transplant from a matched, unrelated donor.

"A lot of centers reserved cord blood transplants for their worst cases, and so it got an early reputation for being less successful. It also costs a bit more - it takes cord blood cells a little longer to get going and so patients need to be supported a little longer. However, when you look past the first 100 days - a point at which many centers stop collecting data - there is clear evidence that cord blood outperforms cells from matched, unrelated donors," Gutman says.

Gutman also points out that bone marrow transplants require art as well as science. Centers like University of Colorado Hospital that are especially experienced with cord blood transplant have evolved systems to best support patients and optimize all transplant related issues, potentially leading to better outcomes than less experienced centers using similar treatment.

The current study, specifically, compared 51 consecutive patients receiving CBT with 57 consecutive patients receiving MUD. At 3 years post transplant, in addition to he above difference in severe chronic graft-versus-host disease (cGVHD), overall rates of cGVHD were 68 percent following MUD and 32 percent following CBT. Again at 3 years, patients receiving CBT had been off immunosuppression since a median 268 days from transplant; patients receiving MUD had not ceased immunosuppression to a degree that allowed researchers to determine the median.

"As a result, we have chosen to use cord blood as our first choice in cases where a matched, related donor is unavailable," Gutman says.

Garth Sundem | EurekAlert!

More articles from Health and Medicine:

nachricht Scientists develop tiny tooth-mounted sensors that can track what you eat
22.03.2018 | Tufts University

nachricht NIH scientists describe potential antibody treatment for multidrug-resistant K. pneumoniae
14.03.2018 | NIH/National Institute of Allergy and Infectious Diseases

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Researchers Discover New Anti-Cancer Protein

An international team of researchers has discovered a new anti-cancer protein. The protein, called LHPP, prevents the uncontrolled proliferation of cancer cells in the liver. The researchers led by Prof. Michael N. Hall from the Biozentrum, University of Basel, report in “Nature” that LHPP can also serve as a biomarker for the diagnosis and prognosis of liver cancer.

The incidence of liver cancer, also known as hepatocellular carcinoma, is steadily increasing. In the last twenty years, the number of cases has almost doubled...

Im Focus: Researchers at Fraunhofer monitor re-entry of Chinese space station Tiangong-1

In just a few weeks from now, the Chinese space station Tiangong-1 will re-enter the Earth's atmosphere where it will to a large extent burn up. It is possible that some debris will reach the Earth's surface. Tiangong-1 is orbiting the Earth uncontrolled at a speed of approx. 29,000 km/h.Currently the prognosis relating to the time of impact currently lies within a window of several days. The scientists at Fraunhofer FHR have already been monitoring Tiangong-1 for a number of weeks with their TIRA system, one of the most powerful space observation radars in the world, with a view to supporting the German Space Situational Awareness Center and the ESA with their re-entry forecasts.

Following the loss of radio contact with Tiangong-1 in 2016 and due to the low orbital height, it is now inevitable that the Chinese space station will...

Im Focus: Alliance „OLED Licht Forum“ – Key partner for OLED lighting solutions

Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology FEP, provider of research and development services for OLED lighting solutions, announces the founding of the “OLED Licht Forum” and presents latest OLED design and lighting solutions during light+building, from March 18th – 23rd, 2018 in Frankfurt a.M./Germany, at booth no. F91 in Hall 4.0.

They are united in their passion for OLED (organic light emitting diodes) lighting with all of its unique facets and application possibilities. Thus experts in...

Im Focus: Mars' oceans formed early, possibly aided by massive volcanic eruptions

Oceans formed before Tharsis and evolved together, shaping climate history of Mars

A new scenario seeking to explain how Mars' putative oceans came and went over the last 4 billion years implies that the oceans formed several hundred million...

Im Focus: Tiny implants for cells are functional in vivo

For the first time, an interdisciplinary team from the University of Basel has succeeded in integrating artificial organelles into the cells of live zebrafish embryos. This innovative approach using artificial organelles as cellular implants offers new potential in treating a range of diseases, as the authors report in an article published in Nature Communications.

In the cells of higher organisms, organelles such as the nucleus or mitochondria perform a range of complex functions necessary for life. In the networks of...

All Focus news of the innovation-report >>>



Industry & Economy
Event News

Virtual reality conference comes to Reutlingen

19.03.2018 | Event News

Ultrafast Wireless and Chip Design at the DATE Conference in Dresden

16.03.2018 | Event News

International Tinnitus Conference of the Tinnitus Research Initiative in Regensburg

13.03.2018 | Event News

Latest News

Modular safety concept increases flexibility in plant conversion

22.03.2018 | Trade Fair News

New interactive map shows climate change everywhere in world

22.03.2018 | Earth Sciences

New technologies and computing power to help strengthen population data

22.03.2018 | Earth Sciences

Science & Research
Overview of more VideoLinks >>>