PITTSBURGH--Early research into umbilical cord blood (UCB) transplantation
for cell reconstitution indicates that unrelated UCB transplantation
is feasible in children.
Speaking at the Fifth Annual Pittsburgh Cancer Conference, Joanne
Kurtzberg, MD, reported on five children who have received unrelated
UCB transplants at Duke, where she is co-director of the Medical
Center's Pediatric Bone Marrow Transplant Program, and director
of the Pediatric Bone Marrow Laboratory. She also indicated that
studies to determine its suitability for adult transplant patients
are soon to begin.
Unrelated transplantation is feasible, she said, because UCB-derived
stem and T cells may be more tolerant of disparate host HLA antigens
than bone marrow-derived cells, and the risk of graft-versus-host
disease (GVHD) may be less than with unrelated bone marrow transplants.
Related Cord Blood Transplants
In 1988, a young boy with aplastic anemia became the first patient
to undergo transplantation with related UCB donated by his sister.
"The child's marrow grafted much as one would expect with
bone marrow; he experienced no GVHD and survives today in excellent
condition," Dr. Kurtzberg said.
Approximately 55 related UCB transplants have now been performed
worldwide in children aged 0.8 to 16 years.
Recovery of white blood cells, absolute neutrophil count (ANC),
and platelets is delayed with UCB transplants, compared with allogeneic
bone marrow transplants, Dr. Kurtzberg said, and growth factor,
administered to half the patients in the related UCB registry,
has no obvious influence.