Utilization & Outcomes
The number of cord blood transplants using matched units from the New York Blood Center's National Cord Blood Program has grown more than 6-fold since the November 26, 1998 publication on the outcomes of its first 562 patients in the New England Journal of Medicine (NEJM). Outcome analysis of the recent transplants suggests the importance of both cell dose and HLA (human leukocyte antigen) matching for the outcome of cord blood transplants.
In addition to the NEJM report cited above, there have been many other reports about cord blood transplants involving thousands of patients, both children and adults. References can be found in the news and articles section of this website.
In a study conducted in collaboration with the International Bone Marrow Transplant Registry (now called the Center for International Blood and Marrow Transplant Research, or CIBMTR), young patients (under 16 years old) with leukemia or myelodysplasia had three-year survival rates after unrelated cord blood transplants (these data were presented by Dr. Mary Horowitz at the American Society for Hematology (ASH) in 2001, updated and published in Lancet, 2007, by Dr. Mary Eapen with IBMTR and NCBP co-workers). These data highlight the need for larger cord blood inventories so that every patient will have access to a cord blood unit that is at least a 5/6 or 6/6 match and a good cell dose.
Two studies using cord blood to treat adult patients appeared in the November 25, 2004 issue of the New England Journal of Medicine (NEJM). In one of these studies, another collaboration between NCBP and CIBMTR (Dr. Mary J. Laughlin, lead author), adult patients given cord blood with a 5/6 or 6/6 HLA match did as well as adults given bone marrow from unrelated donors when the HLA match was 5/6. This study involved 600 adult patients and concluded: “HLA-mismatched cord blood should be considered an acceptable. “Outcomes after Transplantation of Cord Blood or Bone Marrow from Unrelated Donors in Adults with Leukemia” can be found in NCBP Scientific Publications.
The second report was a European study similar in scope, involving 682 adult patients with acute leukemia who received a hematopoietic stem cell transplant from an unrelated cord blood or bone marrow donor. This study reported similar findings. (“Transplants of Umbilical Cord Blood or Bone Marrow from Unrelated Donors in Adults with Acute Leukemia”).
The 2005 Patient Statistics Report on Cord Blood Transplants Worldwide (noted on the NCBP homepage) shows that more than 500 NCBP cord blood transplant recipients (27%) fall into the “age18+” category, so far. Nearly one third of that age 18+ group (147 patients) were age 40 or older (ages ranged between 40 and 69).
Dr. Juliet Barker, then at the University of Minnesota, reported, at the 2003 ASH meeting, on the strategy to compensate for the lower number of progenitor cells available in cord blood transplants: two cord blood units were transplanted after patients were given reduced-intensity conditioning regimen in preparation for the transplant. Based on the data, adults in this Minnesota study appeared to have better than 60% survival at two years. This study was subsequently published in Blood (2003).
Using cord blood as a potential alternative source to search for and find a stem cell match continues to allow a growing number of patients, whose HLA types occur infrequently in the current inventories, to proceed to transplant. In 2005, NCBP doubled the number of patients who got cord blood transplants from NCBP --more than 350 units shipped. The rate of units shipped to patients worldwide remained high in 2006 and reached over 400 in 2009. You can read some of our patients’ own inspiring words in Patients’ Stories noted at the top of this webpage.
NCBP Reference Page: RESOURCES FOR PATIENTS, FAMILIES AND CAREGIVERS
These resources should be especially helpful to patients (and their families and caregivers) who may be considering a stem cell transplant.
The Leukemia & Lymphoma Society
The Leukemia & Lymphoma Society is the world's largest voluntary health organization dedicated to funding blood cancer research, education and patient services. Their Website offers extensive online patient support resources, printed materials and current information on blood cancer diseases, treatments, clinical trials and research.
The Bone Marrow Foundation
The mission of The Bone Marrow Foundation is to improve the quality of life for bone marrow and stem cell transplant patients and their families by providing financial aid, education and emotional support. The Foundation was created in 1992 to respond to the critical gap in financial coverage for patient support services. It's Resource and Education Center provides support and encouragement to patients and families dealing with the challenge of a life-threatening disease.
(Blood & Marrow Transplant Information Network)
If a stem cell, bone marrow or cord blood transplant is in your future, BMT InfoNet can help. Since 1990, BMT InfoNet has provided quality information and support to more than 100,000 transplant patients, survivors and their families and caregivers. This link also provides an excellent Transplant Center Directory.
National Bone Marrow Transplant Link (NBMTLINK)
This organization will help BMT patients, their caregivers and families understand and deal with the emotional and practical aspects of BMT's and post-transplant concerns.
National Transplant Assistance Fund (NTAF)
National Transplant Assistance Fund (NTAF), established in 1983, is a private, nonprofit (501(c)3) organization which offers modest medical assistance grants to eligible candidates to help offset immediate treatment related costs. NTAF also counsels patients regarding the location and cost of transplant centers, other possible sources of financial assistance and fundraising opportunities within their communities. The organization acts as trustee for locally raised funds and assures fiscal accountability and appropriate distribution of those funds for medically associated expenses. In the past 14 years, NTAF has assisted over 2,700 patients in every state, and the need for services is increasing. This is most evident in the recent decision by the Board of Directors to extend its area of service beyond heart and lung patients to those in need of other organs.
HHS/HRSA/HSB/Division of Transplantation (DoT)
The Division of Transplantation provides Federal oversight and funding support for the nation's organ procurement, allocation, and transplantation system; coordinates national organ and tissue donation activities and funds research to learn more about what works to increase donation; and administers the national bone marrow registry program.
National Marrow Donor Program® (NMDP) Office of Patient Advocacy
NMDP's Office of Patient Advocacy (OPA) provides support, assistance and advocacy services to patients seeking unrelated bone marrow transplants.