ADVERTISEMENT Life Saving Stories Cord Blood for Leukemia in Children Jennifer Willert MD
Clinical Professor Pediatrics Blood and Marrow Transplant UCSF Benioff Children's Hospital
IC is one of the patients who received a successful transplant by using an umbilical cord blood (UCB) from StemCyte’s public cord blood bank inventory in February 2013. This life-saving UCB unit was collected in December 2001 and processed under StemCyte’s proprietary plasma depletion method (MaxCell) IC was a 6 year old Latina female with a history of relapsed Acute Lymphoblastic Leukemia (ALL). She achieved remission and then proceeded to have a matched unrelated cord blood unit stem cell transplant. Her sibling was not an appropriate HLA match for her and a donor search through National Marrow Donor Program (NMDP) registry failed to identify any candidate for unrelated donor stem cell transplant (SCT). She did however, have cord blood units available and the unit chosen for her was 6/6 HLA matched with an excellent cell dose. It was one of few units identified for her and very likely found as a result of efforts within California (as well as nationally) to increase the ethnic diversity of the cord blood donor pool. She engrafted early at day 17 and had some of the usual complications associated with cord blood transplant including viral infection and delayed overall immune-reconstitution. DD is another 6 year old boy with relapsed high risk Acute Myelogenous Leukemia (AML) who also received a single 6/6 cord blood unit from StemCyte public bank. Though he had many 10/10 unrelated donors, time was of the essence to move to transplant as soon as possible and to avoid toxicity of further therapy and risk of relapse. He had an excellent recovery post-transplant and though he went into transplant with low level active AML, at day 30 and 60 post SCT he was in full remission with NO evidence of leukemia demonstrating the powerful graft vs leukemia (Graft-versus-Leukemia, GVL) effect of cord blood. He has thus far suffered no Graft- versus-host disease (GVHD). Both patients were discharged in good condition from the hospital within a reasonable period of time. IC remains in full remission now 3 years out from her trans- plant and she returned to school and regular activities at around 6 months post her transplant. The anti-leukemic effects of the cord blood transplant likely contribute to both maintained remissions. Thankfully, both patients have not have any acute graft vs host disease nor cgvhd. IC is a thriving, bright, vibrant courageous little girl. DD is likewise an active playful young boy happy to be this far cured of his very high risk leukemia.
Cord Blood Overall:
In the field of Pediatric Hematology/Oncology/ Immunology, there are many indications for SCT. In
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general, we search first within the family/siblings to see if there is an appropriate HLA-identical donor when transplant is indicated. When HLA-identical siblings are not available, we then turn to the NMDP/International Marrow and Cord Blood Donor inventories. Often, for patients of non-Caucasian ethnicity, the only options for them are cord blood units since a lower degree of match is allowed with similar to decreased rates of GVHD. For patients with leukemia, sometimes even when an unrelated marrow donor is identified, since cord blood is readily available and remission status crucial to success, cord blood may be considered as the stem cell source in these settings. We have worked hard towards supporting and lobbying for legislation in California (AB52) that supports public cord blood banking in our state specifically because we have such an ethnically diverse donor population. With efforts over the past 5-7 years to increase this inventory, the chance for finding a cord blood unit that matches patients has improved dramatically. Many factors are carefully considered when deciding upon a stem cell source (Cord blood vs marrow vs Haplo-identical marrow or PBSCs), but cord blood continues to provide a rich stem cell source that is available especially for patients of non-Caucasian ethnicity.
We appreciate the efforts of the collection centers in the state of California especially, the cord blood bank employee collectors and OB-GYN and Labor and Delivery teams that continue to support these efforts. We also give many thanks to the families who donated their cord blood, the NMDP and WMDP for their crucial registries and continued support and efforts to expand the donor inventory so that a stem cell source may now be identified for nearly any patient who needs it.
About StemCyte:
StemCyte is a global leading cord blood therapeutic company with more than 2000 successful cord blood transplants performed by over 300 transplant centers worldwide. Stemcyte offers public and private cord blood banking to all family in need. Visit
www.stemcyte.com for more information.
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