bone marrow transplants can be a lifesaver, rebuilding the source of blood cells after radiation or chemotherapy destroyed. But for some patients with blood disease, no matching donor can be found. In tomorrow New England Journal of Medicine , the researchers report that umbilical cord blood transplants - which also contains immature blood cells - can be an effective alternative to bone marrow, even when the donor and the recipient are not related [
small studies have suggested that blood transplants cord could work, so Pablo Rubinstein, director of research at the New York blood Center, and his colleagues began a survey large. They collected information on 562 patients who received transplants of cord blood from unrelated donors since 1992. In more than 80% of the beneficiaries, the transplanted cells "transplanted" - have taken up residence in the bone marrow and began churning mature blood cells. Furthermore, less than a quarter of the patients suffered "disease of the graft against the host" severe or fatal disease (GVHD), a reaction in which the immune cells in the transplanted blood attack the recipient's body. (GVHD afflicts up to 35% of recipients of bone marrow.)
The results suggest that it is easier to find a successful match for cord blood transplants. To reduce the risk of GVHD, scientists try to match six types of cell surface proteins between donor and recipient. bone marrow transplants require at least five proteins for a game, but Rubinstein and his colleagues report that even in patients where only four matches, the cord blood cells can graft without triggering severe GVHD. Scientists have yet to settle whether some mismatches are better than others and how to determine an optimal dose cord blood for a given patient, said immunologist LeeAnn Jensen of the National Heart, Lung, and Blood Institute in Bethesda, Maryland.
The latest data are encouraging news for patients who can not find a matching bone marrow donor, said Eric Sievers at the Fred Hutchinson Cancer Center in Seattle. But he points out that up to 25% of cord over 12 years of blood of patients failed to engraft, which is often a death sentence. bone marrow transplants, secondly, to have a graft ratio of 97%. If the technique is to be useful for adult patients, he said, "clearly new ideas are needed."
0 Komentar