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    Mismatched Cord Blood Can Save Kids

    Cord Blood Transplant as Good as Bone Marrow Transplant for Leukemia
    WebMD Health News
    Reviewed by Louise Chang, MD

    June 7, 2007 -- Kids with leukemia may need a bone marrow transplant from a matched donor. But they do just as well with mismatched cord blood, doctors find.

    About 30% of patients needing a transplant are lucky -- they have a brother or sister whose bone marrow is a perfect match for their own. But the other 70% of patients have to endure a desperate search for a matched stranger willing to undergo the painful donation process.

    Now a new finding is revolutionizing the field of bone marrow transplant. University of Minnesota researcher John E. Wagner, MD, and colleagues show that unmatched infusions of umbilical cord blood work as well as matched bone marrow transplants.

    "Seeing the lack of impact of matching was a surprise," Wagner tells WebMD. "No one would have thought this would have occurred. This is going to change the face of transplant medicine."

    The change already is under way. About half of children and 30% to 40% of adults who would previously have received bone-marrow transplants -- if they could find a donor -- are now getting cord blood infusions, says Gary Kleiner, MD, PhD, co-director of pediatric stem cell transplants at the University of Miami Miller School of Medicine.

    "Potentially, with cord blood, most patients who didn't have a donor before will now have someone," Kleiner, who was not involved in the Wagner study, tells WebMD. "After doing 1,000 cord blood transplants, I have never found a patient without a suitable cord-blood donor -- and it saves time, which often is of the essence."

    Moreover, when cord blood is a perfect match with the patient's tissues, it appears that cord blood transplants offer even better results than matched bone marrow transplants.

    "I think this is one of the most important pieces of medical information to come out of transplant medicine in a long time," Wagner says. "It has profound implications not only for individual patients but also for public policy."

    Why public policy? What's holding back more widespread use of cord blood is not lack of donors. Wagner and Kleiner say that donations -- taken from the umbilical cord and placenta after a healthy baby already is delivered -- are not hard to obtain.

    The problem is the expense of properly banking cord blood. Wagner says that Congress has already allocated $100 million for cord blood banking and that more public funds likely will become available as cord blood transplants become ever more common.

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