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Cord Blood Transplant

  

Main  | Allogeneic | Autologous | Cord Blood | Mini | Harvesting Stem Cells | Graft vs Host Disease

Treatments > Bone Marrow Transplants > Cord Blood Transplant

Last update: 09/02/2008

TOPIC SEARCH: PubMed | Medscape 

 

Background:  A stem cell transplant* may sometimes be medically necessary for patients with lymphomas. 
 
With a stem cell transplant, the stem cells**  obtained from bone marrow, peripheral blood, or umbilical cord blood are given back to the patient following high dose treatment, which can damage or ablate (kill off) these vital cells.  The engrafted stem cells can then restore bone marrow function**  impaired or destroyed by the high dose conditioning therapy.

A stem cell transplant is sometimes called a bone marrow transplant.

*The terms stem cell transplant, infusion, rescue, engraftment, or support may be used interchangeably and essentially have the same meaning. 

** Stem cells are "immature cells known as hematopoietic or blood-forming stem cells. Hematopoietic stem cells divide to form more blood-forming stem cells, or they mature into one of three types of blood cells: white blood cells, which fight infection; red blood cells, which carry oxygen; and platelets, which help the blood to clot. Most hematopoietic stem cells are found in the bone marrow, but some cells, called peripheral blood stem cells (PBSCs), are found in the bloodstream. Blood in the umbilical cord also contains hematopoietic stem cells. Cells from any of these sources can be used in transplants" [in order to restore bone marrow function.] - cancer.gov

The different types of stem cell transplants are named from the origin of the stem cells:
   allogeneic -
stem cells harvested from donor (following reduced for full intensity therapy)
   autologous
- stem cells harvested from self
   syngeneic
- stem cells harvested from identical twin
   cord blood  - stem cells from saved cord blood, from self or donor

Cord blood is now being investigated as a source of stem cells for patients receiving high dose treatment for lymphoma and other cancers. 

How are umbilical cord stem cells obtained for transplantation? Cancer.gov

Resources:

Bone Marrow Transplantation (BMT) and Peripheral Blood Stem Cell (PBS) Transplantation: 
Questions and Answers - cancer.gov 
 1)  What are bone marrow and hematopoietic stem cells?  Cancer.gov
 2)  What are bone marrow transplantation and peripheral blood stem cell transplantation? Cancer.gov
 3)  Why are transplants used in cancer treatment?  Cancer.gov 
 4)  What types of cancer are treated? Cancer.gov 
 5)  How are the donor’s stem cells matched to the patient’s stem cells in allogeneic or syngeneic transplantation? Cancer.gov
 6)  How is bone marrow obtained for transplantation? Cancer.gov  
 7)  How are peripheral blood stem cells (PBSCs) obtained for transplantation? Cancer.gov 
 8)  How are umbilical cord stem cells obtained for transplantation? Cancer.gov 
 9) Are any risks associated with donating bone marrow? Cancer.gov 
10) Are any risks associated with donating PBSCs? Cancer.gov

11) How does the patient receive the stem cells during the transplant?  Cancer.gov 
12) Are any special measures taken when the cancer patient is also the donor (autologous transplant)? Cancer.gov 
13) What happens after the stem cells have been transplanted to the patient?  Cancer.gov 
14) What are the possible side effects of BMT and PBSCT? Cancer.gov 
15) What is a “mini-transplant”?  Cancer.gov 
16) What is a “tandem transplant”?  Cancer.gov
17) How do patients cover the cost of BMT or PBSCT? Cancer.gov 
18) What are the costs of donating bone marrow, PBSCs, or umbilical cord blood? Cancer.gov 
19) Where can people get more information about potential donors and transplant centers?  Cancer.gov
Cord blood banking, and overview: cancer.umn.edu/ 
Modified Bone Marrow Cells Engraft More Efficiently ~ Karla Gale - Medscape (free login req.)
Cord Blood Banking for Potential Future Transplantation: Subject Review AMERICAN ACADEMY OF PEDIATRICS Work Group on Cord Blood Banking - Recommendations aap.org 
Cord Blood Transplant Resources - GrannyBarb & Art's

Re-immunization after SCT

Research News:

Clinical outcome: StemEx to expand cord blood-derived stem cells

Transplantation of ex vivo expanded cord blood cells using the copper chelator tetraethylenepentamine: a phase I/II clinical trial  nature.com/bmt

One limitation of cord blood-derived stem cells is insufficient quantity of  stem cells from this source. This clinical study applied a new technology  (use of StemEx to expand the number of stem cells (cd34+)) with the goal of  making SCT feasible for people without a matched donor.
Trial of Interest: 

StemEx® Expanded Stem Cells Derived from Cord Blood to Treat Subjects With High Risk Hematologic Malignancies, Following Myeloablative Therapy (ExCell) 
Conditions
    NHL with induction failure or relapse and sensitive to last chemotherapy course, and
    MDS with intermediate 2- or high-risk IPSS score. 

Rationale and goal:  The purpose of this study is to determine the efficacy and safety of transplanting StemEx® in patients with certain hematological malignancies. For these patients, it is suggested that StemEx® can improve upon the outcome of transplanting a single, un-manipulated cord blood unit by significantly increasing the number of stem/progenitor cells available to the patient.. 
Clinical Need: Only 30% of patients who could benefit from this procedure have an HLA-matched sibling. The lengthy search for a matched donor may critically delay transplantation. In addition, far fewer patients of racial minorities find suitable HLA-matched donors. Umbilical cord blood (UCB) has been increasingly used as an alternative source of stem cells; however, its use in adults and adolescent patients is limited due to insufficient cell dose required for satisfactory hematopoietic reconstitution.

Sponsor's website: http://stemexstudy.com/  

 
TOPIC SEARCH Cord blood derived Stem Cell transplantation - PubMed

added December 12, 2007

Comparable results of umbilical cord blood and HLA matched sibling donor hematopoietic stem cell transplant after reduced-intensity preparative regimen for advanced hodgkin's lymphoma.
Blood. 2005 Dec 29; PMID: 16384924
Stem cells derived from the umbilical cords of newborn babies are a viable and effective transplant source for thousands of leukemia patients who have no other treatment option ~ EurekaAlert.org Nov 2004
 
 
Disclaimer:  The information presented on Lymphomation.org is not intended to be a substitute for 
professional medical advice or to replace your relationship with a physician.
For all medical concerns,  you should always consult your doctor. 
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