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.