Little info on cord blood transplants

What is Umbilical Cord Blood Transplantation?
Blood-forming stem cells circulate in the unborn baby and placenta and home to the bone marrow within hours of birth. Stem cells captured in the cord and placenta are collected and stored by Cord Blood Banks around the world. These stem cells are now available for transplantation, making transplant therapy available for almost anyone, especially for those with rare HLA types.

Compared to using an unrelated bone marrow donor, the use of cord blood for transplantation has a number of advantages:
Less need for a perfect tissue type HLA match
More rapid availability
Low risk of contamination of cord blood with common viruses
Lower risk of graft-versus-host disease (GVHD)
Easy to harvest without risk to the newborn donor or mother

Umbilical cord blood (UCB) is collected from healthy newborns at birth, frozen and stored in cord blood banks worldwide. Information about the cord blood unit is placed on a registry. If it matches a patient needing transplant, it can be shipped to University of Minnesota Medical Center, Fairview (formerly Fairview-University Medical Center) for transplant. After thawing, it is infused into the patient much like a blood transfusion.

Preimplantation genetic diagnosis is another exciting technique being pioneered by John Wagner, M.D., Professor, Department of Pediatrics at the University of Minnesota and one of the world’s leading experts on cord blood transplantation, to identify healthy sibling donors for patients. This may be used for patients with Fanconi Anemia, thalassemia, sickle cell disease, Hurler's syndrome, adrenoleukodystrophy and a number of other inherited diseases. It is being considered by families who have children with leukemia. It is important to consult with a transplant physician about this option to determine whether it is an appropriate option for the individual patient.

Umbilical Cord Blood Transplant ResearchUniversity physicians are researching a number of strategies in the transplantation of adult patients with cancers using UCB. Adults experience more complications after transplantation than children and develop more severe GVHD after BMT. UCB is an attractive stem cell source for adult patients as it may cause less GVHD and pose a lower risk of infection than unrelated donor bone marrow.

However, a major obstacle with cord blood transplantation in larger children and adults has been the limited number of stem cells in the cord blood collection. If too few cells are available, there is a greater chance of life-threatening complications. Dr. Claudio Brunstein, Assistant Professor, Department of Medicine, is investigating the transplantation of two partially matched cord blood collections from different donors to increase the number of stem cells transplanted to adult patients.

Another approach involves a lowerdose chemotherapy and radiation treatment prior to UCB transplant for patients who cannot tolerate the high doses of chemotherapy and radiation used in conventional transplants. These two studies show very promising results with high rates of engraftment and a low incidence of graft-versus-host disease.

Fairview-University Blood and Marrow Transplant Program
Affiliated with the University of Minnesota
Since the first bone marrow transplant was performed by University of Minnesota physicians in 1968, our program has continually developed new ways to improve outcomes of patients undergoing blood and marrow transplantation (BMT). Our physicians have performed increasing numbers of umbilical cord blood transplants since 1994, making our program one of the largest cord blood transplant centers in the world. In 2000, we performed the world’s first related UCB transplant using preimplantation genetic testing to ensure a perfect tissue match. We are now pioneering unique treatment strategies to improve the effectiveness of UCB transplantation, particularly for adults who are at high risk for complications after unrelated donor marrow transplant. Our patients are treated by a team of experts specializing in UCB, applying leading-edge research developed by University of Minnesota Physicians.

We individually tailor our care to meet the unique needs of each patient and family.
Dr. John Wagner, Professor, Department of Pediatrics at the University of Minnesota and one of the world’s leading experts on cord blood transplantation, performed the first cord blood transplant for leukemia in 1990 and has continued his leadership in the field since coming to the University of Minnesota in 1991. He established the International Cord Blood Transplant Registry in 1992. Wagner, who is also scientific director of clinical research of the Blood and Marrow Transplant Program and Stem Cell Institute, was instrumental in the creation of the Midwest’s first public umbilical cord blood bank in 1999 — a joint effort of the University of Minnesota, Fairview Health Services and the American Red Cross.

Claudio Brunstein, M.D., Assistant Professor, Department of Medicine, is leading research at the University of Minnesota that explores transplantation of two partially HLA-matched umbilical cord blood units from different donors to increase the cell dose — a factor shown to predict survival outcomes.