CORD BLOOD

Cord Blood

Cord Blood

Cord blood is the residual placenta blood collected from the cord of the newborn; it is a rich source of haematopoietic stem cells which can be used to re-populate the bone marrow, consequently providing a source of healthy blood cells.

A literature search was carried out in order to review the field of cord blood. Most emphasis was placed on the use of cord blood in treatment, because treatment with bone marrow transplants is well established (Fernandez, 2007). Pub Med was searched using key words and a selection of the literature was summarised below and abstracts collated and attached at the end of this document. The publication type is listed at the end of the abstract; all abstract were taken from peer-reviewed journals.

Key words used in search in various combinations: bone marrow transplant, cord blood, treatment, children, child donors, thalassemia, matched, unmatched, leukaemia, HLA type, successful treatment, adult treatment, cord blood versus bone marrow transplant.

Successful treatment of diseases by use of cord blood transplantation

Matched cord blood transplant

Unmatched cord blood transplant

Adult treatment using cord blood

Technical issues of cord blood transplants

Potential adverse affects of cord blood transplants

Cord blood versus bone marrow transplants

Bone marrow transplant

Successful treatment of diseases by use of cord blood transplantation

Successful treatment of acute myeloid leukaemia (AML) was seen with unmatched cord blood transplant in children with poor prognosis and no HLA-matched sibling.

Children (N=39) with haematological malignancies (acute lymphoblast leukaemia, acute myelogenous leukaemia, chronic myelogenous leukaemia, refractory anaemia with myelodysplastic syndrome and juvenile myelomonocytic leukaemia) were treated with unmatched CBT; the study demonstrates that CBT is a feasible procedure to cure a significant proportion of children with Leukaemia if the treatment is administered in a favourable phase of the disease (Vawter, 2006).

Children (N=3) suffering from X-linked immunodeficiencies (X-linked lymphoproliferative syndrome and X-linked hypoimmunoglobulin-M syndrome) were treated with CBT to reconstitute the immune system. Two years after transplantation the children all had normal immune systems.

Thalassemia and Sickle cell disease (common diseases affecting several million children and young adults a year) have been treated using CBT from related donors with good success rates and low incidence of graft versus host disease.

Matched cord blood transplant

A patient suffering from Fanconi's anaemia was treated with a HLA-identical CBT from a sibling selected using PGD-HLA testing.

Chronic granulomatous disease is a disease that affects neturophils resulting in a compromised immune system, a patient presenting with this disease has been successfully with an HLA-identical sibling CBT.

Unmatched cord blood transplant

1 or 2 HLA- mismatched cord blood transplants resulted in 42 % leukaemia free survival. 0-3 HLA-mismatched cord blood transplants (CBT) and matched bone marrow transplants (BMT) were compared and it was concluded that, despite the reduced HLA matching of the cord blood, engraftment, graft versus host disease (GVHD) and survival were comparable between unmatched CBT and matched BMT.

Children (N=3) suffering from X-linked immunodeficiencies were treated with cord blood that was matched at five out of six of the HLA loci to reconstitute the immune ...