Bone Marrow Transplant vs Cord Blood Transplant - Which is Better?

If you are a parent interested in banking your baby’s cord blood stem cells, you should know the difference between bone marrow and Cord Blood Transplants. There are numerous studies that compare cord blood and bone marrow transplants which highlight the pros and cons associated with both. Let us start from the basics. 

What Is Bone Marrow?

Bone marrow is a soft spongy tissue consisting of many blood vessels containing hematopoietic stem cells (an immature cell that can differentiate into any type of blood cell) present in the center of bones.¹ About 95% of the body’s blood cells are produced by our bone marrow.²

When the bone marrow is damaged it fails to produce healthy blood cells to keep up with the body's demands.³ This results in two conditions-⁴

• Fewer red blood cells - the hemoglobin levels drop resulting in anemia
• Fewer white blood cells - make you vulnerable to infections⁴

These conditions may arise due to severe bleeding disorders or life-threatening diseases like sickle cell anemia, leukemia, and lymphoma. The good news is that upon early detection, the conditions can be treated with a bone marrow transplant/ stem cell transplant.³

What is a Bone Marrow Transplant? 

A Bone Marrow Transplant, also known as stem cell transplant is a medical procedure where healthy stem cells are infused into your body to replace diseased or damaged stem cells inside your bone marrow.

There are different types of transplants including autologous transplant and allogeneic transplant. Autologous transplant is when the stem cells from your own body is used. Allogeneic transplant is when the stem cells from another donor are used. Finding a donor match for this type of transplant is important.⁵

What is Umbilical Cord Blood?

The blood in your baby’s umbilical cord and placenta is commonly known as cord blood. This blood remains in the umbilical cord and placenta even after delivery, albeit for a short time, and is often discarded post-delivery. However, cord blood has been found to be rich in blood-producing (hematopoietic) stem cells.⁶ These stem cells have regenerative properties and have immense potential in disease treatment

Bone Marrow Transplant Vs Cord Blood Transplant

Both Bone Marrow and Cord Blood Transplant can help regenerate new stem cells in the bone marrow. The new stem cells infused can help treat medical conditions such as acute leukemia, bone marrow failure, hemoglobinopathies, immune disorders and metabolic disorders.^6,7

Here are some evaluative criteria and transplant preferred for doctors and patients to decide what type of transplant is best suited.^{7, 8, 9, 10, 11}

Reducing the Cost of Post Transplant Care with Cord Blood

Since 1989, when the first Cord Blood Transplant was carried out, umbilical Cord Blood Transplant has become a viable and effective alternative for Bone Marrow Transplant in patients in need of a stem cell transplant. Especially in children, both related and unrelated Cord Blood Transplants have been successfully performed for various blood,immune 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.¹²

Why Umbilical Cord Blood Transplant Stands Out 

A recent study of Minnesota University Medical Center observed the healthcare burden after umbilical Cord Blood Transplants versus other sources of Hematopoietic stem cell transplant (HSCT).¹³

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 bone marrow, peripheral blood, 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 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, peripheral blood, and Bone Marrow Transplants.¹³

Important results from the Study

1. Number 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 had the least amount of medication prescribed in the initial days (0-100) compared to bone marrow, 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 peripheral blood stem cells.¹³

In Conclusion

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.