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Transplantation With 2 Units of Umbilical Cord Blood Significantly Reduces Risk of Leukaemia Recurrence MINNEAPOLIS/ST. PAUL, Minn -- November 16, 2009 -- A new study shows that patients who have acute leukaemia and are transplanted with 2 units of umbilical cord blood (UCB) have significantly reduced risk of the disease returning. This finding has the potential to change the current medical practice of using 1 unit of UCB for treatment of patients who are at high risk for recurrence of leukaemia and other cancers of the blood and bone marrow. The results are published in the current issue of the scientific medical journal Blood. Michael Verneris, MD, and John Wagner, MD, both from the Division of Hematology-Oncology, Blood and Marrow Transplantation, the Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, who specialise in research and treatment of children with cancer, led the research team on this breakthrough study. Dr. Verneris and colleagues studied 177 patients treated at the University of Minnesota Medical Center, Fairview, and the University of Minnesota Amplatz Children’s Hospital, Minneapolis, Minnesota, between 1994 and 2008. The average age of the patients in this study was 16 years. Eighty-eight patients had acute lymphoblastic leukaemia (ALL) and 89 had acute myeloid leukaemia (AML). “Our analysis showed that patients in first or second remission from the leukaemia had a significantly lower likelihood of leukaemia recurrence if they were transplanted with 2 UCB units than if they were transplanted with 1 (19% vs 34%),” said Dr. Verneris. “We believe our finding provides evidence that using 2 units of UCB for transplantation may be more effective in preventing leukaemia relapse and gives hope to patients with haematological malignancies so that they may live cancer-free,” he said. Blood and marrow stem cell transplantation has been a mainstay treatment for patients with high-risk leukaemia and other haematological malignancies for the past 30 years. In the last decade, the blood in the placenta and umbilical cord has been collected and banked for public use. Now, UCB is routinely used throughout the world as an alternative to bone marrow transplantation. However, because of the limited number of cells in UCB, this stem cell source has been reserved for young children and small adults. The practice of using 2 UCB units (from 2 different individuals) was pioneered at the University of Minnesota approximately 10 years ago. By using 2 UCB units, nearly all patients can now use this stem cell source for transplantation. Previous research studies have also shown that about 25% to 30% of patients suffer leukaemia relapse after transplant. The relapse or disease recurrence rates are similar regardless of whether the stem cells used for transplantation are from bone marrow, peripheral blood, or umbilical cord blood. Dr. Verneris and his colleagues compared the outcomes of patients who were transplanted with 1 versus 2 UCB units. Forty-seven percent of the patients received 1 unit of UCB; the remaining patients received 2 units. The choice to receive 1 versus 2 units was based on the number of stem cells contained in the UCB. Since the number of stem cells needed for a successful transplant varies with the patient’s weight, older patients and those who weigh more need more stem cells than infants and young children. “Given that adult patients were more likely to receive 2 UCB units and that they tend to have more aggressive leukaemia, we think that the lower relapse rates with 2 UCB units is remarkable,” said Dr. Verneris. He noted that while promising, these results will have to lead to a national study comparing 1 versus 2 cord blood units in children with leukaemia. “Prior to the research done by my predecessors, the co-infusion of 2 UCB units had not previously been performed,” said Dr. Verneris. “We now know that without this double transplantation procedure, the majority of the patients treated would have had no other reasonable treatment option for their leukaemia. The fact that they had less leukaemia relapse was a wonderful surprise.” This study was funded with grants from the National Cancer Institute and the Children’s Cancer Research Fund. SOURCE: University of Minnesota E-mail this page to a friend or colleague! To print, use this version