Umbilical cord blood could help save thousands of adults with leukemia who can't find bone marrow donors, two large studies indicate. Umbilical cord blood is now used mostly to treat children with leukemia.
After treatment with chemotherapy or radiation, many patients with leukemia receive an infusion of bone marrow or umbilical cord blood to restore the immune system. Both products contain healthy stem cells capable of restoring the bone marrow's ability to produce blood cells. Cord blood stem cells are less likely to cause rejection problems than marrow cells, so donors and recipients needn't be close matches. But because umbilical cord blood contains far fewer stem cells than marrow, it hasn't been widely used for adults.
One study involving 682 patients found that adults who received cord blood were just as likely to be free from leukemia 2 years later as people who received human leukocyte antigen matched bone marrow. About one-third of patients in both groups were alive after 2 years.
A second study involving 601 patients found that one-third of those who received matched bone marrow were alive after 2 years, compared with about one-fifth of those who got either cord blood or unmatched bone marrow.
Currently, most cord blood is thrown away. A federal Institute of Medicine committee is evaluating the best way to set up a national cord blood supply and may issue a report in March.
Outcomes after transplantation of cord blood or bone marrow from unrelated donors in adults with leukemia, The New England Journal of Medicine, M Laughlin, et al., November 25, 2004; Transplants of umbilical-cord blood or bone marrow from unrelated donors in adults with acute leukemia, The New England Journal of Medicine, V Rocha, et al., November 25, 2004.