Umbilical CBT more effective than MUD bone marrow transplants for patients with leukemia -
results A study by the University of Colorado Cancer Center compared the leukemia patients receiving bone marrow transplants from 09-2014, found that three years after the transplant, the incidence of severe chronic graft against the host was 44 percent among patients receiving matched transplants, donors not Related (MUD) and 8 percent in patients who received umbilical cord blood transplants (CBT). Patients who received CBT were also more likely not to need immunosuppression and less likely to experience infections and late hospitalizations. There was no difference in overall survival between the two techniques. The results are published in the journal Bone Marrow Transplant
"When you make an allogeneic transplant. - When someone else is the donor. - The new blood system has the potential to attack the patient this is the graft against the host, which can be debilitating and even fatal. Our results show that, in the long term, a cord blood transplant is less likely to receive a transplant of an independent, compatible donor to lead against the host graft disease, "says Jonathan Gutman, MD, a researcher at the CU Cancer Center and clinical Director of allogeneic stem cell transplantation at the University of Colorado Hospital.
a common treatment for blood cancers is to clear the leukemic blood system of a patient and then push a new blood system using blood stem cells from the donor There are four possible sources of donor cells. a matched related donor (usually a close family member), a match, unrelated donor (from a database of 25 million people who have agreed to donate), the umbilical cord blood (from a bank of stored samples) and haploidentical transplant (a promising technique requiring only a half-game with a related donor). More the match between the donor cells and the blood system of a patient, the less chance the new blood system will attack the patient's tissues, namely the less chance of the disease graft against the host.
A matched, related donor is the first choice accepted. Genetics dictate that siblings have a chance of matching 25 percent. Those without a matched related donor have a 70 percent chance for Caucasians or only a 10 percent chance of other races or mixed to find a match, unrelated donor in the database of people who agreed to give, if necessary. Cord blood is immature and therefore does not need to be as closely matched to be acceptable as a donor source. (Registry Haploidenical is beyond the scope of this article.)
"Historically, physicians have booked the cord blood for the match without patients," Gutman said.
However, the flow preferably is increasingly questioned as data, including the study show that cord blood can be equal or greater than transplanting a matched, unrelated donor .
"he got a large number of centers dedicated cord blood transplants for their worst, and so an early reputation for being less successful it also costs a little more -. It takes blood cells cord a bit longer to get there and that patients should be cared for a little longer, however, when we look beyond the first 100 days. - a point at which many centers stop collecting data -. it is clear that the cord blood surpasses the matched cells, unrelated donors, "says Gutman
Gutman also points out that bone marrow transplants require the art and science centers. including University of Colorado Hospital who are particularly experienced with cord blood transplants have evolved systems to better support patients and optimize all transplantation-related issues, which may lead to better results than less experienced centers using treatment similar.
The current study, in particular, against 51 consecutive patients receiving CBT with 57 consecutive patients receiving MUD. At 3 years after transplantation in addition it above difference severe chronic graft against the host (cGVHD), overall rates of cGVHD was 68 percent after MUD and 32 percent after CBT. Again 3 years, patients receiving CBT had been out immunosuppression from a median of 268 days after transplantation; patients receiving immunosuppression MUD had stopped at a level that allowed the researchers to determine the median.
"Consequently, we have chosen to use the cord blood as our first choice in cases where a correspondence, related donor is unavailable," says Gutman.
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