Bone marrow or cord blood transplant

Bone Marrow or Cord Blood Transplant?

Should you opt for a bone marrow transplant or put your faith in cord blood? We shed light on the debate.

The world over, doctors are seeing a rise in the cases of bone marrow cancer[1] (also known as multiple myeloma). Bone marrow cancers occur when the white blood cells in the marrow become cancerous (known as myeloma cells) and begin to accumulate. Soon, they overpower the normal cells and attack bone tissue, which damages the bones.

Typical symptoms of bone marrow cancer include localised pain in the bone developing into a consistent pain that comes in waves, fatigue, fever and weight loss.[2]

What is bone marrow transplantation?

The world over, doctors perform bone marrow transplants from healthy, matching marrow to treat this disease; this is done so that new stem cells may be cultivated. Marrow is extracted from the breast bone, or the hip, skull, spine or rib – these are found to contain stem cells that produce leukocytes, erythrocytes and platelets.

However, the operation is often expensive and highly invasive. A bone marrow biopsy can reveal the extent of the issue, and if a transplant is deemed necessary, a search for the right donor marrow begins.

What’s different about cord blood transplantation?

As opposed to this, the use of cord blood in transplantation to treat bone marrow cancer is rapidly gaining ground[3], especially due to its advantages over bone marrow aspiration and transplantation. Let us briefly see some of these advantages:

– While collected bone marrow must be used within a few hours, cord blood can be stored and used even up to 12 years after collection.

– A bone marrow donor must be prepped and conditioned for the transplant under doctor’s supervision. No such condition exists for cord blood transplantation, with required units of blood being procured as per need.

– The recipient and bone marrow donor must be perfect matches, while in the case of cord blood transplants, HLA-mismatched transplants are possible.

– Stem cells found in cord blood are considered to have higher regenerative proportion than those in bone marrow – this has major implications in the cure of this particular cancer.

– Bone marrow may be transplanted about two or more months after the donor is found – this is done to prepare the marrow for operation, as well as complete legal formalities. Meanwhile, cord blood transplants can happen in a matter of days, once matching units are procured and the paperwork is completed.

However, there are certain factors to take into consideration in the case of cord blood transplantation to treat bone marrow cancer. There are no chances for repeat transplantation from the same donor and there is a risk of a genetic disease being transplanted into the patient during surgery. Doctors say that the chances of cord blood rejection are higher as compared to those for bone marrow transplants. It is advisable to speak with your doctor about both options of transplantation before making a decision.

 

[1] John Hopkins Medicine, The Sidney Kimmel Comprehensive Cancer Centre, ‘Multiple Myeloma’.

[2] Arogya Cancer Support Group, ‘Bone Marrow Cancer Signs and Symptoms’

[3] Women’s Health, http://www.womens-health.co.uk/bone_marrow.html

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