FRIDAY, June 8 (HealthDay News) — Transplanted blood cells from
umbilical cords appear to give better results than the bone marrow
emergency medicine news that have been standard for leukemia patients, a new study
finds.
“From my point of view, it now medicine hat news paper
that cord blood can be
considered a first-line therapy and not an medicine hat news classifieds
,” said lead
researcher Dr. John E. Wagner, director of the bone marrow transplant
program at the University of Minnesota.
His team published its findings in the June 9 issue of The
Lancet.
One way to treat various leukemias is to wipe out the old blood cell
system and replace it with a new one via transplant. This study of 785
children under 16 who got such transplants found essentially equal
five-year survival rates for the 503 patients who underwent
transplantation with umbilical cord blood and the 282 who got bone marrow
transplants.
That held true even when the transplanted blood cord cells did
not match the immunological system of the recipients, a mismatch
that can lead to severe side effects or rejection of the transplant,
Wagner said.
“With bone marrow, you have to match eight antigens,” he said. “In cord
blood, you need to look at only six, and only need four matches.”
Indeed, five-year survival was identical for recipients of perfectly
matched bone marrow and cord blood recipients with two mismatches, Wagner
said. That matching flexibility could expand the field considerably,
because right now bone marrow matches cannot be found for half of all
leukemia patients who need transplants, he said.
“With cord blood you can find a match for most patients, where with
marrow you cannot,” Wagner said. “The take-home message is that when cord
blood is so promising, it should have an impact on public policy.”
And yet the system for extracting and storing cord blood cells still
has many gaps, he said. For example, “there is no cord banking effort”
in Wagner's home city of Medicine news
, he said.
Cord blood transplants, originally done only in children, now are
performed routinely for adults with leukemia, Wagner added. “Of the 8,000
transplants done to date, half have been in adults,” he said. “Our next
study will be to look at the outcome in adults.”
Other studies also are needed, Wagner said, including those that
compare the cost of the two types of transplant. “There is no economic
analysis comparing bone marrow and cord blood transplants,” he said. “We
also need to look at the quality of life.”
The federal government is financing a major effort to expand cord blood
banking, said Dr. Pablo Rubinstein, director of the New York Blood Bank,
the first in this country to store cord blood. The center, which
participated in this study, started cord blood banking back in 1993 and
now collects 8,000 units a year. It currently has an inventory of 40,000
units. The New York Blood Bank has provided material for more than 2,500
transplants, Rubinstein said.
The system being financed by the federal government “will have a
national point of access, where all transplant physicians can go to
fulfill their needs,” he said.
There also is commercial activity, with some for-profit organizations
urging parents to pay to store cord blood from their children's births,
Rubinstein said. However, such storage “is extremely unlikely to be
useful,” he said, since if a child is found to have a blood problem,
physicians would hesitate to use cells that might well be the source of
that problem.
More information
Find out more about cord blood storage at the National
Marrow Donor program.
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