Singapore's Successful Double Cord Blood Stem Cell Transplant

Just when you've heard from other news sources that:
a) cord blood stem cells are useless;
b) that you'll never ever need it;
c) that cord blood units contain too little to be used in a transplant or;
d) that it is only used in cases of small children

Bravo to Singapore's marrow transplant doctors for their successful case of 19 year-old Nanyang Polytechnic student Candy Yeow. She had Philadelphia positive acute lymphoblastic leukemia which had very poor prognosis of survival. However, she was very lucky because the medical team was able to find 2 HLA matching (or near matching) units of cord blood stem cells from an overseas cord blood bank. Her transplant went well and at her one-year transplant anniversary, she's in complete remission and off all immuno-suppressants.

Her doctor at the Singapore General Hospital Dr. Mickey Koh was quoted as saying that a single unit of cord blood didn't have enough stem cells for the transplant and hence they went for two combined units in order to achieve the requisite number of stem cells for the patient.

Hence, if you're wondering whether cord blood stem cells can be used for an adult, it depends on how many stem cells were collected in the first instance and if it isn't, at least you're halfway there with one unit. The odds of finding one matching unit is challenging enough, but two matching units like what Candy has here is almost a miracle*.


*Apart from just finding the right matching cord blood stem cell units, the medical care provided to ensure successful recovery is equally important and not to be taken for granted.


WHY CANDY HAD TO HAVE A STEM CELL TRANSPLANT FOR HER CONDITION

From Blood Journal:

Philadelphia chromosome (Ph1)-positive acute lymphoblastic leukemia (ALL) has a poor prognosis when treated with conventional chemotherapy. We analyzed the outcome of 67 HLA-identical sibling bone marrow transplants (BMTs) for Ph1-positive ALL reported to the International Bone Marrow Transplant Registry (IBMTR). Twenty-one of 67 (31%) transplant recipients survived in continuous complete remission more than 2 years after transplant. Two-year actuarial probabilities (95% confidence interval) of leukemia-free survival were 38% (23% to 55%) for 33 patients transplanted in first remission, 41% (23% to 61%) for 22 patients transplanted after relapse, and 25% (9% to 53%) for 12 patients failing to achieve remission with conventional chemotherapy. These data indicate that transplants are effective treatment for Ph1- positive ALL.


Also for the record, there is little indication that propensity for ALL is passed on from parents to children.