A new study published in the New England Journal of Medicine confirms that stem cells derived from the umbilical cords of newborn babies are a viable and effective transplant source for thousands of leukemia patients who have no other treatment option.
"As many as 16,000 leukemia patients diagnosed each year require a bone marrow transplant, but have no matched relative or can't find a match in the national bone marrow registry," says Mary J. Laughlin, MD, lead author on the study and hematologist oncologist at Case Comprehensive Cancer Center and University Hospitals of Cleveland Ireland Cancer Center. "Umbilical cords that are normally discarded after birth could provide real hope for these patients."
Dr. Laughlin led an international team of researchers in collaboration with the International Bone Marrow Transplant Registry and the New York Blood Center National Cord Blood Program. They conducted an analysis and comparison of treatment results in more than 500 adult leukemia patients undergoing transplant.
Researchers directly compared patients who had cord blood stem cell transplants with two groups: patients who had fully-matched unrelated bone marrow transplants and patients who had one antigen-mismatched unrelated bone marrow transplants. The study included patient's ages 16 to 60 years who underwent transplants in the United States during a six-year period ending in 2001.
Survival rates were highest (33 percent) for those bone marrow transplants with matched unrelated donors. Survival rates were the same (22 percent) for cord blood and one antigen-mismatched unrelated bone marrow transplant patients--results that clearly indicate the efficacy of cord blood stem cells when bone marrow donors are unavailable, according to Dr. Laughlin, an Associate Professor of Medicine at Case Western Reserve University School of Medicine.
"These are very high risk patients who undergo cord blood transplants only as a last resort effort to stay alive," Dr. Laughlin says. "Even with a cord blood transplant, these patients often suffer from life-threatening infections. But the fact is, without attempting this innovative therapy, none of them would survive."
"Techniques that extend the availability of stem cell transplantation to those patients in desperate need are an important and valuable step in the right direction," said Marshall Lichtman, MD, The Leukemia & Lymphoma Society's Executive Vice President. "Dr. Laughlin's study gives renewed hope to adult patients without a sibling stem cell donor. Continued research is needed, however, to improve the outlook for the large proportion of patients who do not yet benefit from these approaches." The Society helped fund the study.
Cord blood transplantation provides leukemia patients with stem cells, enabling them to produce healthy blood cells in a procedure previously shown to be highly effective in children with the disease. As a stem cell source, umbilical cord blood is not controversial and readily available; in fact, cord blood is normally discarded after a baby's birth.