When there are no adult donors available
Many of you are aware that my husband PC opted for a mini-allo stem cell transplant using umbilical cord blood as the source of stem cells. You can read details of his transplant journey by clicking on the link for Harvey’s Journal. (“Harvey” was the thinly disguised pseudonym for PC, to protect his privacy while he was alive.)
While PC did not survive his cord blood transplant, I am still deeply convinced that cord blood and transplants using them are a tremendous resource for patients who need transplants for treating aggressive CLL. Far too many patients who need transplants cannot get them because they do not have matched sibling donors or matched unrelated adult donors (“MUD”). This is particularly true for patients whose ethnicity is other than Western European, or those of mixed ethnicity. Heck, even the new US president is a self-proclaimed ‘mutt’.
Cord blood transplants for adults are coming of age. Many of the transplant centers now offer this option for patients who cannot find adult donors. University of Minnesota continues to be a leader in the field, their double cord program (where stem cells from two umbilical cords are used per adult patient) has become the industry standard.
As you might guess, I have read just about everything written about the subject. If you want to get hold of the latest literature on the subject send me a personal email and I will try to help you. Another excellent source of information is the Cord Blood Forum. Below is the summary of essential facts published by this non-profit site. Interested patients and scientists can also sign up for the forum’s free newsletters. If a cord blood transplant may be in your future I strongly urge you to visit and explore this very useful and credible site.
Summary of Essential Facts
Approximately 10,000 umbilical cord blood transplants have been performed since the first transplant was performed twenty years ago.
Cord blood has become a proven source of stem cells for transplantation, and the procedure is no longer considered “experimental.”
These transplants have been done for all of the same diseases, approximately 70 in all, for which bone marrow transplants are performed.
These are particularly leukemias, lymphomas, other malignant blood disorders and congenital blood disorders.
Patients who lack a matched related donor in their family or matched unrelated donor in any of the donor registries, such as the National Marrow Donor Program, can be transplanted with cord blood stem cells.
There must be a very close match between the patient and the donor when using stem cells from bone marrow or peripheral blood. For a transplant using cord blood stem cells, however, the matching need is not as precise so that an adequately matched cord blood unit can be found even though a matched adult unit is not available.
Since cord blood transplants can be performed even when no bone marrow donor can be found, a large majority of the recipients could not have been treated and possibly cured if it were not for the existence of cord bloods.
No patient who needs a stem cell transplant should be informed that it is not feasible because of a lack of a donor unless cord blood registries have been searched.
Although some transplant centers do not have experience with cord blood, there are many transplant centers in the United States and throughout the world where numerous such transplants have been performed.
A list of transplant centers with experience performing cord blood transplants can be found on-line at www.cordbloodforum.org.
Cord blood has become the most frequent source of stem cells for transplantation in children in the United States, and is gaining increased usage in adults.
This is a contrast to the early days of cord blood transplantation when it was only performed as an alternative to bone marrow transplants when an adult matched related or unrelated donor could not be found.
Development of the technique of double cord blood transplantation expands use of cord blood transplant into adults.
It was previously thought that cord blood transplants were of value only for children because of the limited number of stem cells in an umbilical cord blood sample.
Cord blood can be obtained very quickly if a transplant is needed urgently, which is frequently true in patients with malignant blood disorders.
Obtaining stem cells from other sources, including bone marrow, usually takes many weeks.
Computerized searches quickly identify cord blood units in banks throughout the world, which can then be quickly transported for transplant.
Also, because cord blood is rapidly available, transplantation can be scheduled almost entirely according to patient needs rather than donor availability.
Some medical centers use cord blood stem cells almost to the exclusion of bone marrow or peripheral blood transplants because of their proven effectiveness and because they can be obtained rapidly.
Graft-versus-host disease, an adverse effect of stem cell transplantation which causes significant mortality, is less common after cord blood transplantation than after transplants using adult stem cells.
This is particularly true when compared with transplants performed using stem cells that are obtained from the peripheral blood of donors.