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Cord blood transplantation now a viable option for adult leukemia patients
Medical Research News

Stem cell transplantation using umbilical cord blood is a standard treatment
option for blood disorders in children, but not for adults, due to the
difficulty of obtaining a sufficiently large dose of cells.
To solve this problem, researchers from the University of Minnesota examined
a new technique that combines two cord blood units from different donors for
transplantation into adult or adolescent leukemia patients. Their study is
to be published in the February 1, 2005, issue of Blood, the official
journal of the American Society of Hematology.

Twenty-three patients with high-risk acute and chronic leukemias were
studied for up to two and a half years. As is often the case, a suitably
matched volunteer donor could not be found for these patients, and without
an exact match, a transplant would likely be unsuccessful.

Cord blood is more tolerant of differences between patient and donor, making
it possible to perform cord blood transplants without an exact match. Though
a single cord blood unit with a satisfactory dose could not be found for
these patients, senior study author John Wagner, M.D., Scientific Director
of Clinical Research of the University of Minnesota's Blood and Marrow
Transplantation Program and Stem Cell Institute, theorized that they could
still have successful transplants if two partially-matched units were used
for each patient.

"Currently, many adult leukemia patients are not eligible for an umbilical
cord blood transplant due to the inability to find a single unit of blood
with enough cells for transplantation. With this new technique of increasing
the dose by combining two units, this procedure could be made available to
thousands more patients and has the potential to save many lives," said
Juliet N. Barker, M.B., B.S., Assistant Professor of Medicine at the
University of Minnesota and co-author of the study.

While two patients with acute leukemia in relapse died from infection
shortly after the transplant, in the remaining 21 patients, the transplanted
stem cells completely incorporated themselves in the patient's body and
began to produce normal, healthy cells. Disease-free survival was 57 percent
at one year and, for those who received the transplant while their cancer
was in remission, the success rate was even higher at 72 percent.

"The results of this study are heartening, but further investigation of this
approach in larger clinical trials is needed to determine the full impact of
this transplant procedure for adults and larger adolescents," said George Q.
Daley, M.D., Ph.D., Associate Director of the Stem Cell/Developmental
Biology research program at Children's Hospital Boston.

http://www.hematology.org/


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