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11 Aug 2016 5 Comments

Reduced Complications Witnessed In Cord Blood Transplant

A study done at Colorado School of Medicine by Jonathan A. Gutman and colleagues proved umbilical cord blood transplantation to be safer than peripheral blood transplants from matched and unrelated donors with reference to reduced graft versus host disease and late infections.

Though most institutions prioritise on matched and unrelated donor transplantations, owing to various concerns such as adverse effects and delayed immune reconstitutions, the outcomes of this study proved umbilical cord blood to be a more potential source for transplant in patients.

Many institutions keep aside cord blood transplant for their worst cases and impart a prevalent notion subduing its success. But the real hidden reason behind the hesitation to use cord blood for transplant is the cost factor, preservation process, the duration it takes to make an impact within and the lag that makes the patient be supported a bit longer.

Generally, the frequent cause of mortality and morbidity in transplant survivors is chronic graft versus host disease (GVHD). Thus, Gutman and colleagues compared the incidence of Chronic GVHD, immunosuppression withdrawal and late infection rates between patients who underwent cord blood transplant and peripheral blood transplant.

Results of the comparative analysis:

The description of the patients who underwent umbilical cord blood transplant: No. of patients 51, age range -22 to73

The description of the patients who underwent peripheral blood transplant: No. of patients 57, age range- 18 to 72

The cumulative incidence of chronic GVHD after 3 years was 44% in patients with matched unrelated donor transplant & 8% in cord blood transplantation. The long-term cumulative incidence of Chronic GVHD in matched unrelated donor transplant was 68% and 32% in cord blood transplantation. Thus the result showed a remarkable reduction in GVHD in patients with cord blood transplant.

Withdrawal of immunosuppression happened rapidly in cord blood transplant within a median period of 268 days whereas immunosuppression was not weaned for matched unrelated donor group during the same span of time.

Only 1 death was reported in patients who underwent cord blood transplant due to GVHD, though the patient remained on immunosuppression during the time of death, whereas 5 patients with matched unrelated donor group witnessed death due to GVHD. 2 more patients of matched unrelated donor transplant also died due to relapse though were still subjected to immunosuppression at the time of death.

With relevance to late infections patients with cord blood transplants suffered very few infections and were hospitalised for a shorter duration. Relatively the patients with matched unrelated donor transplant witnessed more infections and remained in the hospital for long.

 Thus the results of this study proved that when patients are dependent on cord blood transplant for a longer term, it is less likely to use cord blood for transplant despite its lesser incidence of GVHD and infections. Thus, cord blood transplants can be the first choice for cases where matched related donor is unavailable.

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