Cord Blood Safely Replaces Bone Marrow Transplant in Children
Researchers in the Duke Pediatric Blood and Marrow Transplantation Program say there may be no need to wait for blood marrow donors to help children with cancer, leukemia, sickle cell anemia, and other life-threatening diseases. The group instead, recommends using unmatched cord blood rather than adult bone marrow to expedite treatment of deadly disease n children. Using cord blood would also reach more children, to include minorities who are often difficult to match with a bone marrow donor.
Vinod Prasad, MD, a pediatric oncologist at Duke says, "We have done a terrific job in this country of increasing the number of volunteer donors listed in the National Marrow Donor Program registry over the past several years…the fact remains that for many patients, finding a matched donor can be difficult. Ethnic and racial minorities have the hardest time finding a fully matched donor."
The study, funded in part by the National Institutes of Health, was presented February 13 in a presentation the American Society of Bone Marrow Transplantation in Tampa, Florida.
The scientists say cord blood is easier to obtain than is bone marrow, and can be given without adverse effects without donor matching. "Our study found that using cord blood can be effective, without increased complications, and can provide more matches for patients, including ethnic minorities", said Prasad.
Normally, bone marrow from donors is matched to the recipient based on a six-point comparison of genetic compatibility between the donor and recipient.
Dr. Prasad explains, "In this analysis of children whose donor units were matched at four of six points, the transplant was successful in many patients, with low incidence of complications. Results were similar to those seen in patients receiving closer matched transplants. Thus the use of the 4/6 matched donors improved access to transplant for patients, especially those of ethnic and racial minorities."
The researchers studied 314 patients age six months to 21 years suffering from both malignant and non-malignant conditions. The children were treated at Duke between 1993 and 2007.
The research was successful for treating the children who received cord blood instead of bone marrow, including minorities. The incidence of complications, including rejection from graft versus host was very low.
The findings have led the Duke researchers to recommend the use of easily attainable cord blood for treatment of children with malignancies who are in need of bone marrow transplant. Unmatched cord blood is now found to be a safe alternative that can also reach more minority children with sickle cell disease, cancer and leukemia, rather than waiting for a bone marrow donor match.