News and Events

An alternative treatment using umbilical cord blood cells may eventually replace bone-marrow transplants for children, a U study says.

Date: 06. 2007

Source: Maura Lerner, Star Tribune (Minneapolis-St. Paul); Published June 8, 2007-12:03am

For the first time, scientists have shown that there's an effective alternative to giving bone-marrow transplants to children with advanced leukemia. And it comes from something that's routinely thrown away -- umbilical cords. The study was led by Dr. John Wagner, a University of Minnesota transplant specialist. He found that umbilical cord blood cells work just as well at fighting a deadly form of childhood leukemia with fewer side effects than bone-marrow transplants. An advantage of using cord cells, Wagner said, is that they are easier to obtain than bone marrow, and don't need to be a perfect biological match in order to work. "The results are tremendously encouraging," said Wagner, who coauthored the study, appearing in today's issue of the Lancet, a high-profile weekly British medical journal. "What this means is we can find donors for almost anyone," he said. Wagner said using umbilical cord blood could benefit thousands more patients and eliminate the need to wait months or longer for matching donors. Both the cord blood and marrow are rich in healthy immune cells that can fight off leukemia and other abnormalities, Wagner said. Greater availability needed About 35,000 new cases of leukemia are diagnosed annually in the United States, according to the Leukemia & Lymphoma Society. Approximately 3,400 are in children younger than 19. Leukemia is the most common form of childhood cancer. Only a small percentage of these young patients, however, fail traditional treatments and need a transplant. Nationwide, many patients die waiting for a suitable bone marrow donor. An estimated 15,000 people are awaiting bone-marrow transplants now, he said, because they can't find a suitable donor. That's especially true for members of minority groups, who are underrepresented in bone-marrow registries. Until now, most transplant centers have viewed cord-blood transplants as a last resource if no matching bone-marrow donor is available. But this study could change that, said Deborah Banker, vice president of the Leukemia & Lymphoma Society, which is based in White Plains, N. Y. "I think there's a growing acceptance and excitement around that," Banker said. It could be a great advantage, she said, to "have something on a shelf waiting to go." Wagner, who heads one of the largest cord-blood transplant programs in the country, said that cord-blood transplants have all but replaced bone-marrow transplants for both adults and children at the University of Minnesota. Mothers donate the cords Currently, the main limitation to cord-blood transplants, experts say, is the small network of tissue banks that collect and store umbilical cords for public use. There are approximately 240,000 cord-blood units banked globally and available for public use, said Mary Halet, manager of cord-blood operations at the National Marrow Donor Program, based in Minneapolis. They are stored at tissue banks around the world, and are shipped frozen to wherever patients need them. Donations are collected from mothers who agree to donate their infant's umbilical cords. However, there are no collection sites currently operating in Minnesota. (Some private banks store umbilical cords for individual families, for a fee.) Three years ago, Congress approved $10 million to increase the number of public cord-blood banks. But Banker, of the Leukemia & Lymphoma Society, said they would have to double or triple the amount of blood collected to meet the need if cord-blood treatment becomes the norm. As part of the study, Wagner and his colleagues compared 503 children around the country who were treated for leukemia with cord blood, and another 282 children who received bone-marrow transplants. In both groups, the majority of children relapsed within five years. Less than half of both groups survived, Wagner said. However, survival rates are higher now, he said, in part because the transplant techniques improved during the eight-year period of the study, which began in 1995. Also, the cord-blood group had fewer long-term complications from treatment. Wagner believes that use of umbilical cord blood will become a "first-line therapy" at places other than the university. "Obviously, time will prove one way or another," he said. "I think this could change the practice of transplant medicine.