Bone marrow transplants – Good news

Finding a compatible bone marrow donor can be a heartbreaking process. Even if family and friends come forward they are not always an ideal match and the wait for the perfect donor can sometimes be longer than the time available to the patient.

Now there is good news from the American Society for Blood and Marrow Transplantation which can effectively bypass the bone marrow route in appropriate cases by using a unit of mismatched blood from umbilical cords.

This work was presented by Duke University Medical Center who reported on a ten year study on children with malignant and genetic disorders, including leukaemia. Using cord blood for transplants offers some advantages over bone marrow because it is more widely available, has more immature cells, involves fewer complications, and donor match is not as important.

The study found that there was a four of six HLA matches of blood given to children and this meant low rates of failure and graft-related disease from the patient’s own body. Survival rates over one, three and ten years were also impressive for this type of patient, being 54.8%, 46.6%, and 43%, respectively which is comparable to those achieved with unmatched bone marrow transplants and substantially better than if the patients had not received transplants at all. In many cases the patients would have died without a transplant and although there was a failure rate in 6.7% of the patients, a slightly higher figure than the norm for bone marrow transplants, this is still low. Nor is that the end of the road for those patients as in many cases they can get a second transplant, something that is rarely available with bone marrow.

The time element is also an important factor and for patients who need an urgent transplant it could be a lifesaver. On average it takes two to three months for an unrelated bone marrow donor to become available and only about two weeks for an unrelated cord blood donor.

This breakthrough opens up the possibility of transplant to many more patients and although considered to be at a preliminary stage will make surgery available for those who previously were unable to find a matched donor.