Since 1989, when the first cord blood transplant was carried out, umbilical cord blood (umbilical cord blood) transplant has become a viable and effective alternative for bone marrow transplant (BMT) in patients in need of a stem cell transplant (1). Especially in children, both related and unrelated cord blood transplants have been successfully performed for various blood and metabolic disorders. It won’t be wrong to say that over the last 32 years, this field has seen significant advancements, improving transplant outcomes. Moreover, umbilical cord blood has enabled rapid availability and access to transplantation even in patients who belong to racial or ethnic minorities (1).

Let us now delve deeper to understand the nuances between umbilical cord blood transplant and bone marrow transplant as well as the benefits of the former.

About Stem Cells

Stem cells are special cells that can make copies of themselves and transform into various types of cells that your body needs. You would be surprised to know that different kinds of stem cells are found in different parts of our body at different times!

Sources

Stem cells can be derived from bone marrow, cord blood, amniotic fluid, adipose tissue (2). However, we would discuss more about bone marrow and cord blood which are considered rich sources of stem cells.

Bone marrow: It is a soft, spongy tissue found in the center of the bones. It is a rich source of haematopoietic (blood) stem cells, making it suitable for regenerative medicine.

Cord blood: The cord blood collected from the umbilical cord that connects the mother and the baby is a rich source of haematopoietic stem cells. When a baby is delivered, even if clamping of the umbilical cord is delayed, there is still blood remaining in the cord that is rich in stem cells and has medical value and life-saving properties. While cord blood stem cells are not embryonic, they are more immature than the stem cells in adults, because they have less exposure to illness or environmental factors. What is important to note here is that these cord blood stem cells can be collected without any risk to the baby or mother at the time of birth and successfully cryopreserved for many decades for future use.

The bone marrow transplant cost in India ranges from ₹ 15,00,000 ($20,929) to ₹ 40,00,000 ($55,816) depending on which transplant you are recommended. Whereas, the average cost of undergoing an HCST in the United States can range from $36,000 to $88,000 for a single autologous (using one’s own cells) transplantation to $200 000 or more for a procedure involving an unrelated donor.

The Power of Cord Blood Stem Cells

Cord blood stem cells are currently being used in the treatment of more than 80 life-threatening illnesses, including forms of blood cancers, immune deficiencies, and genetic disorders.

For more and more patients, cord blood is being used as the preferred alternative source of stem cells instead of bone marrow. However, the reasons for this choice vary as each case is different. Cord blood has several distinct advantages over bone marrow (3,4,5):

  1. It is easier to collect, store and access quickly for a transplant.
  2. There is significantly less risk of post-transplant complications including GvHD (Graft versus Host Disease) in patients who undergo stem cell transplants wherein one cord blood unit is used versus those who undergo a bone marrow transplant. In transplants where two cord blood units have been used, the risk of acute GvHD is comparable to that of bone marrow and the other sources. However, LifeCell contributed to a successful double cord blood transplant to save the life of a seven-year-old girl from Nasik suffering from aplastic anemia. Read more about that success story here!
  3. There is less risk of a relapse for certain diseases if the cord blood is used as a source of stem cells.
  4. It promotes engraftment, i.e. development of healthy red blood cells.
  5. Logistically, cord blood can be shipped easily and made available in days. This has become particularly important during the COVID-19 crisis.

What Does Science Say about Umbilical Cord Blood Stem Cells?

Let us understand what a recent study of Minnesota University Medical Center observed in terms of hospitalisation burden after umbilical cord blood transplants versus other sources of HSCT including peripheral blood (PB) and bone marrow (BM) (6).

Highlights of the study

  1. The study looked at services, procedures (including labs and imaging), medications prescribed, and relative value units billed to patients for professional services to estimate the healthcare burden among BM, PB, and umbilical cord blood transplant patients.
  2. It included 1077 allogeneic (from a donor) HSCT recipients more than 18 years old at the University of Minnesota Medical Center transplanted between 2000-2016.
  3. Patients were followed in three phases of the recovery post-transplant: Day 0-100 (early), Day 101-365 (intermediate), and Years 1-5 (late).
  4. The above factors were all combined to calculate a score to compare the healthcare burden of umbilical cord blood, PB, and BM transplants.

Important results from the Study

  1. No. of visits: For the patients who received umbilical cord blood transplant, fewer visits were required post-transplant and this number remained the lowest in continued years (one to five years) as well.
  2. Procedures: umbilical cord blood recipients had the lowest number of procedures in the intermediate and late stages, while bone marrow patients needed the greatest number of procedures.
  3. Medications: Patients who received peripheral blood stem cell transplant (PBSC) had the least amount of medication prescribed in the initial days (0-100) compared to BM, which had the highest amount of medication prescribed. umbilical cord blood was somewhere in between the two. However, when compared during days 101-365, umbilical cord blood patients experienced a significant decrease in the number of medications prescribed. Furthermore, in one to five years, umbilical cord blood retained the lowest medication count compared to PBSC.

All the outcomes of the study indicated that umbilical cord blood transplants show better outcomes including post-transplant recovery than other sources of HSCT. Post-transplant recovery, medications, and other expenses can be reduced in umbilical cord blood transplants.

To know more about the benefits of cord blood and the life-saving potential of cord blood banking, speak to our expert today!

Call 18002665533 or visit Cord Blood Banking

References:

  1. Ballen KK, Gluckman E, Broxmeyer HE. Umbilical cord blood transplantation: the first 25 years and beyond. Blood, The Journal of the American Society of Hematology. 2013 Jul 25;122(4):491-8.
  2. Bacakova L, Zarubova J, Travnickova M, Musilkova J, Pajorova J, Slepicka P, Kasalkova NS, Svorcik V, Kolska Z, Motarjemi H, Molitor M. Stem cells: their source, potency and use in regenerative therapies with focus on adipose-derived stem cells–a review. Biotechnology advances. 2018 Jul 1;36(4):1111-26.
  3. Kindwall‐Keller TL, Ballen KK. Umbilical cord blood: The promise and the uncertainty. Stem Cells Translational Medicine. 2020 Oct;9(10):1153-62.
  4. MacMillan ML, Weisdorf DJ, Brunstein CG, Cao Q, DeFor TE, Verneris MR, Blazar BR, Wagner JE. Acute graft-versus-host disease after unrelated donor umbilical cord blood transplantation: analysis of risk factors. Blood, The Journal of the American Society of Hematology. 2009 Mar 12;113(11):2410-5.
  5. Vander Lugt MT, Chen X, Escolar ML, Carella BA, Barnum JL, Windreich RM, Hill MJ, Poe M, Marsh RA, Stanczak H, Stenger EO. Reduced-intensity single-unit unrelated cord blood transplant with optional immune boost for nonmalignant disorders. Blood advances. 2020 Jul 14;4(13):3041-52.
  6. Garcia JG, Grillo S, Cao Q, Brunstein CG, Arora M, MacMillan ML, Wagner JE, Weisdorf DJ, Holtan SG. Low 5-year health care burden after umbilical cord blood transplantation. Blood Advances. 2021 Feb 9;5(3):853-60.