Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Cord blood outperforms matched, unrelated donor in bone marrow transplant

27.07.2016

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 Discovery shows promise for treating Huntington's Disease
05.08.2020 | Ecole Polytechnique Fédérale de Lausanne

nachricht Carbon monoxide improves endurance performance
05.08.2020 | Universität Bayreuth

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: ScanCut project completed: laser cutting enables more intricate plug connector designs

Scientists at the Fraunhofer Institute for Laser Technology ILT have come up with a striking new addition to contact stamping technologies in the ERDF research project ScanCut. In collaboration with industry partners from North Rhine-Westphalia, the Aachen-based team of researchers developed a hybrid manufacturing process for the laser cutting of thin-walled metal strips. This new process makes it possible to fabricate even the tiniest details of contact parts in an eco-friendly, high-precision and efficient manner.

Plug connectors are tiny and, at first glance, unremarkable – yet modern vehicles would be unable to function without them. Several thousand plug connectors...

Im Focus: New Strategy Against Osteoporosis

An international research team has found a new approach that may be able to reduce bone loss in osteoporosis and maintain bone health.

Osteoporosis is the most common age-related bone disease which affects hundreds of millions of individuals worldwide. It is estimated that one in three women...

Im Focus: AI & single-cell genomics

New software predicts cell fate

Traditional single-cell sequencing methods help to reveal insights about cellular differences and functions - but they do this with static snapshots only...

Im Focus: TU Graz Researchers synthesize nanoparticles tailored for special applications

“Core-shell” clusters pave the way for new efficient nanomaterials that make catalysts, magnetic and laser sensors or measuring devices for detecting electromagnetic radiation more efficient.

Whether in innovative high-tech materials, more powerful computer chips, pharmaceuticals or in the field of renewable energies, nanoparticles – smallest...

Im Focus: Tailored light inspired by nature

An international research team with Prof. Cornelia Denz from the Institute of Applied Physics at the University of Münster develop for the first time light fields using caustics that do not change during propagation. With the new method, the physicists cleverly exploit light structures that can be seen in rainbows or when light is transmitted through drinking glasses.

Modern applications as high resolution microsopy or micro- or nanoscale material processing require customized laser beams that do not change during...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

“Conference on Laser Polishing – LaP 2020”: The final touches for surfaces

23.07.2020 | Event News

Conference radar for cybersecurity

21.07.2020 | Event News

Contact Tracing Apps against COVID-19: German National Academy Leopoldina hosts international virtual panel discussion

07.07.2020 | Event News

 
Latest News

Rare Earth Elements in Norwegian Fjords?

06.08.2020 | Earth Sciences

Anode material for safe batteries with a long cycle life

06.08.2020 | Power and Electrical Engineering

Turning carbon dioxide into liquid fuel

06.08.2020 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>