What is cord blood?
Cord blood is collected from the umbilical cord and placenta of healthy newborns. It is donated by the baby’s parents at birth. Cord blood is rich in blood-forming stem cells. This makes it a good alternative source of blood-forming stem cells for people who do not have a readily available matched adult donor.
Why would someone need a cord blood transplant?
Only about one-quarter of the people who need an allogeneic (donor-provided) transplant to treat their cancer have a brother or sister who is a match and is able to donate stem cells. All the others need to find another donor so they can get a transplant.
People can receive bone marrow or blood stem cells that were donated by an adult who is not related to them. Volunteer donors are found through the Be the Match program or another donor registry. Unfortunately, many people who need a transplant are not able to find a matched donor from any of the registries.
Finding a donor is a particular challenge for people who have southern European, Asian, African, Hispanic, Middle Eastern, or mixed ethnic backgrounds. This is because they usually have more diverse tissue types. A person’s tissue type, also known as their HLA type, is inherited from their parents. More diverse tissue types are less common in registries. This can make it difficult or impossible for people of certain backgrounds to find a donor who is a match.
Also, even if a matched donor is identified, getting the cells from them may take months. This can cause a major setback when someone with cancer needs a transplant right away.
What are the advantages of cord blood transplants?
As a source of stem cells for people with cancer, cord blood has major advantages. Cord blood collections used for donor transplants are stored frozen in public cord blood banks. Because cord blood is in frozen storage, it is available right away. This makes the transplant easy to schedule. It is also good for people who need an urgent transplant.
Cord blood has another advantage. Because the immune system of a newborn baby is not yet fully developed, the match that’s required between the cord blood donation and the patient is less strict. This means that cord blood can safely be used even if the donor cells have a less than perfect match.
Cord blood cells are also very good at fighting cancer. This ability is called the graft-versus-leukemia effect. It can help prevent a person’s cancer from returning after their transplant.
MSK’s Cord Blood Transplant Program
Memorial Sloan Kettering has one of the most active and successful cord blood transplant programs in the world. We have performed more than 350 cord blood transplants in adults and children. More than half of the people who have had a cord blood transplant at MSK are of non-European ancestry. Thus, these transplants allow us to increase access to this curative treatment to many people with diverse backgrounds.
We have extensive experience in state-of-the-art methods for selecting the best cord blood to ensure that the new cells will successfully grow inside the patient’s body after the transplant. Using the new approaches we’ve developed to perform the transplants, we have found that the success of cord blood transplants in adults with acute leukemia is just as good as in those who get transplants from matched unrelated donors — the current standard treatment for people without a matched relative. We are now conducting further innovative clinical trials. In these studies, doctors test even better ways of doing cord blood transplants.
Clinical Trials and New Innovations
MSK has a number of new approaches to further improve the outcomes of people getting cord blood transplants.
We have developed an effective way to perform searches for unrelated donors and cord blood. These searches allow us to predict right away whether we will be able to find a suitable unrelated donor. If we are not, we can rapidly search for cord blood in public banks around the world and see how good the available cord blood is. We now routinely use this approach. It has proven to be highly effective.
Additionally, we have developed safer ways to perform the transplants. Our patient outcomes after cord blood transplants in adults are some of the best in the world. Many people have been cured of their blood and bone marrow cancers thanks to a cord blood transplant.
Our current clinical trials are investigating how to speed the recovery of the blood cells after a transplant. We are also looking at ways to prevent complications. Some of the most common complications after a transplant are infections and a condition known as graft-versus-host disease (GVHD). GVHD occurs when the donor’s blood cells attack a patient’s healthy tissues. It can happen after any donor transplant, including cord blood.