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Adults Now Qualify for Cord-Blood Transplants

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Hematology

A year after she got her college degree, a UW Hospital patient learned she had leukemia, a blood cancer.

 

More bad news came a few months later when she found out she needed a transplant of blood-forming stem cells, but her brother wasn't a match. Nor were any adults on the donor registry.

 

She finally received good news. Doctors at UW Hospital and Clinics determined the patient could become the first adult patient at UW to receive a transplant of umbilical-cord blood. It contains stem cells that grow into blood cells. This procedure has been previously given only to children because their smaller bodies require a cord from just one baby.  Adult patients need two cords and didn't qualify.

 

"Transplants of stem cells from donors are used to treat leukemia, lymphoma and other life-threatening conditions," said Dr. Mark Juckett, of UW Hospital.

 

Cord-blood transplants began in the 1990s, using donated umbilical cords. The cords usually contain fewer stem cells than marrow or blood, but they carry an advantage. Their immune systems are naïve, so they're less likely to cause rejection.

 

"You get pure cells, without the other trappings of life we acquire as we grow and get exposed to various things," said Carla Moore, a transplant coordinator at UW Hospital.

 

That means donors and recipients don't have to match as well. Patients who do not match adult donors can usually find suitable cord blood, Moore said.

 

But studies in adult patients showed cord-blood transplants, using two cords, were as effective or nearly so as bone marrow transplants. UW Hospital has joined other medical centers to further study the issue in a clinical trial.

 

While adult patients need two cords to allow the transplants to jump-start their new immune systems, only one cord eventually takes hold, Juckett said.

 

"One of the units wins and becomes the dominant source over time," he said.