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Cord blood results surpass bone marrow transplant outcomes for leukemia

After analyzing clinical data from transplant centers around the country, University researchers reported in June that umbilical cord blood transplants may offer blood cancer patients better outcomes than bone marrow transplants, previously considered the gold standard.

The study, which appeared in the June 9, 2007, issue of The Lancet, compared outcomes of pediatric leukemia patients who received bone marrow transplants from unrelated donors with those who received umbilical cord transplants. While all bone marrow donors were matched, nearly all cord blood donors were mismatched.

Investigators found that mismatched cord blood performed as well as matched bone marrow, as measured by leukemia-free survival rates, as long as the degree of mismatch was limited and the number of cord blood cells available was sufficient.

Participants who received matched cord blood had a 20 percent higher survival rate than matched bone marrow recipients, although the number of matched cord blood transplants was small.

“This study suggests that cord blood need not be considered a second line of therapy,” says lead investigator John E. Wagner, M.D., professor of hematology-oncology and blood and marrow transplantation at the University. “Today, leukemia patients can wait months for an appropriately matched bone marrow donor, during which time their disease might return. Now, the timing of transplantation can be dictated by the patient’s needs as opposed to the availability of matched bone marrow.”

The study involved extensive analysis of clinical data reported by U.S. transplant centers to the Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, and the New York Blood Center. The analysis included transplant outcomes in 785 children younger than 16 who had been diagnosed with acute lymphoblastic leukemia or acute myeloid leukemia.

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