For years, umbilical cord blood (UCB) transplant was considered an acceptable alternative unrelated donor graft for the treatment of leukemia including reconstituting a patient’s immune system. Typically UCB transplants could be performed without the worry of precise patient-donor HLA-compatibility.
To date, more than 35,000 cord blood transplants have been conducted worldwide. As use of the therapy has expanded to include genetic disease, such as bone marrow failure syndromes, hemoglobinopathies, immunodeficiencies and inborn errors of metabolism, transplant physicians have come to recognize the benefit of more precise HLA-matching for UCB transplant.
Recent work by researchers from the CIBMTR® (Center for International Blood and Marrow Transplant Research®) in collaboration with Eurocord and the European Group for Blood and Marrow Transplant (EBMT), suggests that precise HLA-matching is far more important to the success of UCB transplant procedures than previously thought. The team analyzed the outcomes of 1,200 children who received UCB transplants over a 12-year period for non-malignant disorders. Results of the study, published in the Lancet Haematology, show a clear connection between the level of HLA-match and survival.
In the study, 79% of patients were alive at 5 years after UCB transplantation when their donor match was considered an HLA-match (8 of 8 HLA allele level). The percentage drops to 70% with two mismatched alleles, and 49% with four or more.
“Cord blood transplant remains an excellent option for treating children with a wide-range of genetic diseases but these data support increased emphasis on HLA-matching to lessen the risk of graft failure and extend survival,” says Mary Eapen, MD, lead author of the study and senior scientific director for research operations at the CIBMTR.
CIBMTR is a research collaboration between our parent company, the National Marrow Donor Program®/Be The Match®, and the Medical College of Wisconsin.
