Cord Blood Transplantation

Hi ALL,

Cord Blood Transplantation is an alternate means of transplanting healthy stem cells into the thalassemia patient's body. Instead of harvesting stem cells from a donor's bone marrow or blood, stem cells are taken from the "cord blood" found in the umbilical cord and placenta of a newborn sibling.

Cord blood is taken from the umbilical cord and placenta immediately following birth and then frozen and stored at a cord blood center for later use in stem cell transplantation.

The advantage of using cord blood is that, unlike "regular" bone marrow transplantation, the stem cells taken from cord blood do not have to be a perfect genetic match. As such, there appears to be a lower instance of rejection in cord blood transplantation.

I found this on the site of Childresn's Hospital Oakland Reasearch Institute,is it true that cord blood transplant does not require a perfect genetic match??and it has lower rate of rejection and is more successful?can this be a possible option for my daughter ?any information u have would be appreciated.

THANX

ZAINI.

Hi Zaini.

Please refer to :

http://www.thalassemiapatientsandfriends.com/index.php?topic=405.msg2991#msg2991

Furthermore you can also read the reply from Singapore General Hospital to my question for patients as old as I am:

http://www.thalassemiapatientsandfriends.com/index.php?topic=127.msg615#msg615

I hope that the odds are better for your daughter since she is quite young.

Take care, Peace!

Hi Zaini,

The information that I have on CBT is that the best outcome is with a matched sibling, which can be matched with preimplantation diagnosis and IVF.  Of course this would be an enourmous undertaking for the parents and they must be willing to go through IVF and to have another child.  Of course there are ongoing studies suggesting that the outcome CBT can be done with unrelated donors with fewer complications than BT.  All the best in finding more information and statistics on this!  If I come accross anything I'll be sure to let you know.

Sharmin

hi sajid and sharmin,

thanx for ur replies,sajid ur links were really helpful,can u give me the email of Dr William YK Hwang??Sharmin i feel really stupid but plrase wt's preimplantation diagnosis and IVF?? are u referring to CVS?? i know having another child is a tough decision,especially when we had a child after our daughter and he was not a perfect genetic match.

thanx again 

ZAINI.

Hi Zaini

Actually your concern was mine two ot three months ago as my case is like yours, so i guess i can answer some of your questions.

When i discussed transplantations with the specialist he did agree that cord BT is truely the least to be matched compared to BMT or unrelated donors. But he meant by the ''least'' is 8 antigenes out of 10. To me this is not the meaning of ''least''.  The only concern he said with the cord blood is that sometimes after transplantations and due to complications or rejection from the patient body he may want to induce more stem cells from the donor to the patient and this is easy if the donor is an adult either in unrelated donor or sibling. But in cord BT it is difficult because stem cells are taken once since they are already few in the cord blood which is used only once so it is a one chance transplantation.

As Sharmin mentioned the safest is the CBT of a  matched sibling in order to ensure high success rate and to cover the drawback that i have mentioned above since it is easy to have more stem cells in case you need.

IVF:  is when you concieve out side the uterus where conception occurs in a tube in the lab and then transfered to the uterus where pregnancy continues.

PGD: Before you transfer the embroys to the uterus a PGD specialist takes the embroys ( usually in IVF, you normally have from 15 to 20 embroys ) and make biopsy for these embroys ( biopsy of the polar body or the blastomere depending on the case ) and the embroys that are suitable ( in your case,  it will be an embryo that matches  the HLA of your daughter and with no thal or thal minor ) will be transfered to the uterus to continue the pregnancy.

Usually the sucess rate of each embryo to continue the pregnancy is 30% and in some really good centers it can reach 45-50% and by the way this is the normal percentage if some one concieved normally . That is why in IVF you find many twins or triples because each one has his 30% and a twin makes it 60% and so on

If pregnancy went well you do a CVS or aminosenthesis ( definetly the spelling is wrong) to confirm the PGD results. The success rate of PGD in thal and HLa type is up to 98%

Concerning the embroys, you have 3 suitable ones ( matched HLA and tha minor or no thal ) every 16 embroys

Zaini, i have contacted a well known center concerning this issue (the good ones are found in chicago and was recommended by many doctors)  and they gave me all the info and all the prices, so if you need them just PM me and i will forward them to you.

Sorry for answering Sharmin question. Please Sharmin add anything i forgot

Manal

Hi Zaini,

I corresponded with him via SGH's Intermational Medical Service department (IMS):

ims@sgh.com.sg

You can visit the SGH web site through: www.sgh.com.sg

Take care, Peace!

Hi Manal,

You've done a great job covering the topic. 

If PGD and IVF is an option for anyone, and it works for that family then storing the cord blood is a great option.  I wish that my little girl was a match for my son, but an amnio before she was born indicated that while she was free from thalassemia - she was not a match for our son. 

I am hoping for better treatment options and hopefully a cure in the near future, but for those people for whom storing cord blood is an option I think it's additional assurance.

Sharmin

Hi Guys,,

u people are the best thing ever happened to me, thanx sajid for ur links,Manal u did an awesome job,i now understand wt's IVF,and PGD,Thanx Sharmin,I love u guys.

ZAINI.