Any info on chances of success of unrelated cord blood transplants in infants?

I was just scrolling though the various posts on this forum and came across a few that talked about cord blood transplantation.

Since my daughter does not have any siblings (she is our first child and with the fact that both my wife and I are b-thal carriers, we are afraid to go down this path again), I was wondering what are the options and chances of success of unrelated cord blood transplantation (provided there is a acceptable HLA antigen match) as a possibilty for my daughter, who is just 2 months old. I know that it might take forever to get an unrelated cord blood match (it may not even happen), but then again, one can hope. Where does one enquire about this information (one place is my daughter's hematologist, but I was hoping to line up some more sources too).

Also, if we have to go down the transfusion path for my daughter, I was wondering how easy or difficult is it to get blood (with the requisite antigen match) for people from the Indian sub-continent in USA?

Hi all,

I came across the following abstract when surfing the web (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=Display&DB=pubmed). The paper was published in 2004 in the Journal of Pediatric Hematology/Oncology.

It seems that Duke University Medical Center had successfully done a CBT on an infant (at two months old). The patient was 5 yr old at the time of the publication.

I am not sure what this means in the long run, but it did seem encouraging (and at the same time did answer my initial question that I had posted). Any comments?

Regards,

Bostonian_04

-----------------------------
J Pediatr Hematol Oncol. 2004 Jun;26(6):382-5.

    Unrelated umbilical cord blood transplantation for an infant with beta-thalassemia major.

        * Hall JG,
        * Martin PL,
        * Wood S,
        * Kurtzberg J.

    Pediatric Bone Marrow and Stem Cell Transplant Program, Duke University Medical Center, Durham, North Carolina 27710, USA. hall0089@mc.duke.edu

    BACKGROUND: beta-thalassemia major, one of the most prevalent hemoglobinopathies throughout the world, can be cured by allogeneic stem cell transplantation therapy. Many patients, however, lack a suitably matched related donor. Unrelated umbilical cord blood can be used as an alternative stem cell source for some of these patients. This report describes the successful transplantation of a 2-month-old infant with beta-thalassemia major using partially HLA-matched unrelated umbilical cord blood.

    METHODS: After cytoreduction with busulfan, cyclophosphamide, and antithymocyte globulin (ATG), the patient underwent transplantation at the age of 2 months with a 4/6 HLA matching umbilical cord blood unit from an unrelated donor.

    RESULTS: The patient engrafted promptly with 100% donor chimerism. His only major complication was an autoimmune hemolytic anemia that resolved 2 years after transplantation. He is currently surviving, event-free, 5 years after transplantation with normal growth and cognitive development and full donor chimerism without evidence of beta-thalassemia.

    CONCLUSIONS: Umbilical cord blood transplantation from related and unrelated donors should be considered for patients with beta-thalassemia major who lack traditional bone marrow donors. As most newborns undergo screening for hemoglobinopathies, those with disease could be transplanted early in life before experiencing the morbidity and mortality caused by transfusion therapy, alloimmunization, and iron overload, increasing the likelihood of successful transplantation therapy.

    PMID: 15167353 [PubMed - indexed for MEDLINE]
---------------------------------

Hello,

You might want to check out the following posts

http://www.thalassemiapatientsandfriends.com/index.php?topic=217.0
Omega (one of our site members got her daughter's unrelated cord blood transplant in Malaysia)

Also, Sajid got in touch with Singapore General Hospital regarding Unrelated Cord Blood Transplant
http://www.thalassemiapatientsandfriends.com/index.php?topic=127.0

-Narendra

Hello Bostonian_04,

Singapore General Hospital has done unrelated CBT successfully for Thal. They have also done it on an adult and I saw the documentary of that man on TV. This man was not Thal. but he was suffering from other diseases which require BMT (hemophilia or aplastic anemia, sorry I forgot)

In any case cure of these diseases is same as Thal. which is BMT or CBT. So I think you should get in touch with SGH if you decide to go for an unrelated CBT.

Take care. Peace!