The first successful cord blood stem cell transplant was performed in Paris, France in 1988. Since then it has become commonplace in the world of stem cell transplants and has saved thousands of lives. As a matter of fact there are some possible advantages for some patients.
POSSIBLE ADVANTAGES
Availability
Cord blood is stored in a public cord blood bank. Prior to being frozen for storage it has already been screened and tested therefore making it immediately available for a patient in need. A marrow or peripheral donor must be located and tested for donor suitability which can take several months and even if proved suitable there always remains a chance the donor may back out.
Tissue Type Matching/ Human Leukocyte Antigen (HLA) Matching
HLA matching between donor and patient is usually critical for patient survival. A close match improves the possibility of engraftment as well as reduces the possibility of graft-vs-host disease (GVHD). Although a close HLA match between donor and patient is preferred the match does not have to be as close as it would for a marrow or Peripheral blood donor.
Graft-Versus-Host Disease (GVHD)
GVHD is a complication that can occur after transplantation where the donor’s immune cells (the graft) attack the patients healthy tissue/organs (the host) such as skin, lungs, eyes, kidneys, mouth, etc. This condition can be debilitating and often fatal. Studies show that Cord blood transplants result in fewer and less complicated cases of GVHD.
Diversity
Due to efforts to diversify the cord blood banks more minorities have had access to a transplant than they would if they had to rely solely on marrow and peripheral blood donors. For example in 2010 just over half of African American transplant recipients received a cord blood transplant as opposed to a marrow or peripheral blood transplant.
Infectious Disease Transmission
Cord blood stem cell transplants carry less risk of transmission of infectious diseases compared with stem cells from the peripheral blood or marrow of related or unrelated donors.
POSSIBLE DISADVANTAGES
Age of Clinical Data
Despite the success of cord blood transplants the procedure is still considered fairly new compared to marrow donors. This means that some long term results and possible long term issues have yet to be studied or observed.
Long Term Storage
It is not known how long cord blood can be frozen and stored before it loses its effectiveness. However cord blood units have been preserved for as long as 10 years and have still been successfully transplanted.
Unit Size
The number of cells required to successfully engraft in a host varies depending on the size and disease status of the patient. Cord blood unit size is usually limited since only a certain amount of cells can be extracted from an umbilical cord. Therefore it may take longer for the transplanted cells to engraft, meanwhile leaving the patient vulnerable to infections. In many cases two cord blood units have been used, however this requires the availability of two matching or semi-matching units.
