Survival and Matching

Transplant outcomes are better with related cord blood donor cells compared with unrelated cord blood or bone marrow donor cells.45 Related cord blood donor cells have been shown to further improve survival compared with unrelated donor cells, and to reduce immunogenicity and GVHD compared with related donor cells from adult sources.

Related Transplant Study

In a study by Gluckman et al, the transplant outcomes for patients who received cord blood stem cells from related sources (n = 78) were significantly better than those among patients who received cord blood stem cells from unrelated sources (n = 65). The study, which included 143 transplants performed during the course of 8 years in 45 European transplant centers, demonstrated a 2-fold increase in 1-year survival rates. This study also confirmed the GVHD advantage for related stem cells, as there was a 2-fold decrease in the risk of GVHD with the use of related versus unrelated cells.50

Family First

Before cord blood stem cells were available, transplant centers relied on the use of bone marrow stem cells. Although still widely used in standard transplant medicine, there are some challenges with respect to the availability of bone marrow stem cells for those in need. Because of the increased chance of survival, a transplant center's first choice is to look for a compatible match from a family member. Less than 1/3 of patients in need will find a suitable bone marrow match from a family member. Of those that look to the National Marrow Donor Program for a bone marrow match, roughly 30% of them will be successful. This means that roughly 50% of all patients in need of a donor will not find a bone marrow match from a family member or the national registry. 51,52

Family Banking Increases Chance of Match

Family banking increases the chances that a match will be available when it’s needed. There is up to a 75% chance that siblings will be a 3:6 HLA match for one another.16 Although it’s possible to perform transplants with a 3:6 HLA match, overwhelmingly cord blood transplants are performed with units consisting of a 4:6 HLA match or higher of which there is a 39% chance of sibling matching. Of course for any autologous procedure, there is a 100% chance that a child will be a match for his/her own stem cells.

20_Matching for transplants_pyramid

Mixed Ethnicity

According to the National Marrow Donor Program, the following minority populations are under-served in the current public registries:46 

  • Black or African American
  • American Indian or Alaska Native
  • Asian, including South Asian
  • Native Hawaiian or other Pacific Islander
  • Hispanic or Latino
  • Multiple race

Since minorities and individuals of mixed ethnicity may find it more difficult to find an acceptable donor, these individuals should strongly consider the family banking option.