What diseases can be treated with cord blood? In general, stem cells present in the cord blood are used to treat blood diseases that are mostly cancers, such as leukaemia’s or lymphomas.
Stem cells in cord blood have the advantage of being adaptive, that is to say, they generate potentially fewer immunological complications after the transplant than during a bone marrow transplant. However, cord blood cannot be indicated in all cases because it has other characteristics that are sometimes less favourable than bone marrow.
In which cases is the practice of cord blood transplantation?
When a patient needs a bone marrow transplant, the transplant doctor looks for a compatible donor in the patient’s family because the chances are much higher. Indeed, the probability of being compatible with a brother or sister is one in four.
If no one is compatible with the family, the transplant doctor then interrogates the registry medical marrow transplant, to find a bone marrow donor compatible with the patient. Bone marrow contains – like cord blood – hematopoietic cells, which produce blood cells. In parallel and in the absence of a compatible donor, he also interrogates the registry to see if compatible cord blood is available.
Placental blood is a complementary source of hematopoietic stem cells. It is not a substitute for bone marrow donation. It represents an additional chance of healing for the sick. Doing a cord blood donation is, therefore, more likely to cure people with serious blood diseases.
A history of the practice
The first cord blood transplant took place in 1988, at which time only children could benefit. Today, this practice has become a real therapeutic choice. Because placental blood requires less compatibility between donor and recipient than during a bone marrow transplant, the number of placental blood transplants has been steadily increasing, particularly since 2005. At that time, medical studies have shown that it was possible to perform a placental blood transplant for adults with similar results to bone marrow transplants, in very specific indications such as acute leukaemia. Every year, in the country, nearly 2,000 patients suffering from serious blood disease need a hematopoietic stem cell transplant (blood precursor cells present in the bone marrow or cord blood).
How is cord blood transplantation going to occur?
Cord blood transplantation is considered by physicians when bone marrow transplantation is not possible for a patient because of a lack of donor identified in the family or in international registries. It constitutes a real additional resource available for the sick.
When a placental blood graft is sought for a patient in the country doctors first call on the transplant registry. If they do not find compatible plugins in the medical register, they address the international registers. Conversely, when a patient needs a placental blood graft in the world, the medical registry is questioned to participate in international solidarity. The registries are all interconnected to offer patients anywhere in the world the best chance of finding the graft that may be able to save them.
The more immature character of the immune cells contained in the cord blood decreases the risk of immunological complication in the transplanted patient compared to the cells of the bone marrow. These cells are more easily accepted by the body of the patient. The compatibility requirement between the recipient and the graft is, therefore, less important with the cord blood banking.
Due to the small amount of cells within the graft, the use of cord blood was initially restricted to children. Today, it becomes possible to use two units of cord blood to graft an adult.