Dr John Wagner, Division of Pediatric Haematology/Oncology and the Blood and Bone Marrow Transplant Programme, University of Minnesota, Minneapolis, USA, and colleagues studied 503 children under 16-years with acute leukaemia who had undergone transplantation with umbilical cord blood, and compared their outcomes with 282 children who had received bone marrow transplants.
The researchers found after transplants of umbilical cord blood HLA-mismatched for one or two antigens that survival rates for children after five years were similar to children who had received an allele-matched bone-marrow transplant.
For matched umbilical cord blood, survival rates appear greater – but although statistically significant, the number of children studied was small, and further study is required to confirm this finding.
They also concluded that early transplant-related mortality was more than twice as high in children who had been given umbilical cord blood HLA-mismatched for two antigens, regardless of the cell dose of blood given. For blood HLA-mismatched for one antigen, mortality rate was lower if higher cell doses were transplanted.
The authors conclude: “Our findings support the need for even greater investment in cord blood because of the importance of HLA matching and cell dose on survival. These data also support the practice of simultaneously searching accredited cord-blood banks and bone-marrow donor registries for all children with acute leukaemia who are eligible for transplantation of haemopoietic stem cells from unrelated donors. “
They conclude: “In the absence of a randomised trial, we cannot definitively state the relative efficacy of bone-marrow and blood-cord grafts, but the data support the use of cord-blood grafts in children with acute leukaemia.”
In an accompanying comment, Dr Vanderson Rocha and Dr Eliane Gluckman, Bone Marrow Transplant and Research Unit and Clinical Research Laboratory on Cell Therapy and Department of Haematology, Hôpital Saint Louis, Paris, France, say: “Wagner and colleagues data emphasise that an umbilical cord-blood graft should be searched for together with an unrelated allele-matched bone marrow. The decision to transplant cord blood or bone marrow is dependent on the time spent finding a suitable cord-blood graft or HLA-matched bone marrow, on the basis of cord-blood cell dose and HLA.
“Therefore, based on this study and others, we propose an algorithm to search for an alternative haemopoietic stem-cell donor.” (Please see full comment for algorithm)
Tony Kirby | alfa
Biofilm discovery suggests new way to prevent dangerous infections
23.05.2017 | University of Texas at Austin
Another reason to exercise: Burning bone fat -- a key to better bone health
19.05.2017 | University of North Carolina Health Care
Staphylococcus aureus is a feared pathogen (MRSA, multi-resistant S. aureus) due to frequent resistances against many antibiotics, especially in hospital infections. Researchers at the Paul-Ehrlich-Institut have identified immunological processes that prevent a successful immune response directed against the pathogenic agent. The delivery of bacterial proteins with RNA adjuvant or messenger RNA (mRNA) into immune cells allows the re-direction of the immune response towards an active defense against S. aureus. This could be of significant importance for the development of an effective vaccine. PLOS Pathogens has published these research results online on 25 May 2017.
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Physicists from the University of Würzburg are capable of generating identical looking single light particles at the push of a button. Two new studies now demonstrate the potential this method holds.
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We can refer to electrons in non-conducting materials as ‘sluggish’. Typically, they remain fixed in a location, deep inside an atomic composite. It is hence...
Two-dimensional magnetic structures are regarded as a promising material for new types of data storage, since the magnetic properties of individual molecular building blocks can be investigated and modified. For the first time, researchers have now produced a wafer-thin ferrimagnet, in which molecules with different magnetic centers arrange themselves on a gold surface to form a checkerboard pattern. Scientists at the Swiss Nanoscience Institute at the University of Basel and the Paul Scherrer Institute published their findings in the journal Nature Communications.
Ferrimagnets are composed of two centers which are magnetized at different strengths and point in opposing directions. Two-dimensional, quasi-flat ferrimagnets...
An Australian-Chinese research team has created the world's thinnest hologram, paving the way towards the integration of 3D holography into everyday...
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26.05.2017 | Life Sciences
26.05.2017 | Life Sciences
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