Certain patients with acute leukaemia or myelodysplastic syndrome also have a condition called minimal residual disease (MRD). MRD occurs when a patient has a small number of leukaemic cells that survive the patient’s cancer treatment. These cells can cause the patient’s cancer to return after they have gone into remission.
Researchers in the United States have discovered that patients with MRD have better medical outcomes if they are treated with a cord blood transplant. The researchers looked at the medical outcomes of 582 patients who had received a cord blood transplant, HLA-matched transplant or HLA-mismatched transplant from unrelated donors.
In patients with MRD, the death rate was higher for the HLA-matched group and significantly higher for the HLA-mismatched group compared to the cord blood recipient group. The senior author of the study, Dr. Colleen Delaney says of the findings: “this brings home the point that cord blood should not be called an alternative donor source.” Having a cord blood transplant may be a “better” option for many patients.
The data was obtained from 582 unrelated hematopoietic cell transplants that occurred at the Fred Hutchinson Cancer Research Center. The paper was recently published in The New England Journal of Medicine.
The researchers followed patients who were being treated for acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL) or myelodysplastic syndrome over a 9-year period. Of the 582 patients, minimal residual disease was present in 45 (33%) of 137 patients receiving a cord blood transplant, 35 (39%) of the 90 patients receiving an HLA-mismatched transplant and 104 (31%) of the 331 patients receiving an HLA-matched donor transplant.
While the researchers found that cord blood transplants provided better outcomes for patients with MRD, they found no difference in outcomes for patients without MRD. The results suggest that cord blood should be used more frequently for patients with this condition.
Source: In MRD, Cord Blood Posed As Best Transplant Option
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