Bone Marrow and Peripheral Blood Stem Cell Transplants

Some children who have leukemia or other types of cancer may need a bone marrow transplant (BMT) or a peripheral blood stem cell transplant (PBSCT). In these treatments, the blood cells in the diseased or damaged bone marrow - the spongy material that fills the inside of bones and makes blood cells - are replaced with healthy cells (Stem Cell Transplants), which will grow new healthy cells.
Stem cells are immature cells that produce the three types of blood cells:

1. 1. White blood cells, which fight infection.

1. 2. Red blood cells, which carry oxygen to and remove waste products from organs and tissues.

1. 3. Platelets, which enable the blood to clot.

Most stem cells are found in the bone marrow, but some - called peripheral blood stem cells (PBSCs) - are collected from the bloodstream. Umbilical cord blood also contains stem cells. If your doctor proposes a stem cell transplant for your child, the stem cells may come from a donor's bone marrow, bloodstream, or umbilical cord blood or from your child's own bone marrow or bloodstream.

Healthy stem cells grow in two ways:

•     . They divide to form more stem cells.

•       .They mature into white cells, red cells, and platelets.

When transplanted into a cancer patient, stem cells can rescue the damaged blood-forming system.

Two circumstances create the need for a transplant. The first is when the cancer itself has injured the bone marrow. BMT and PBSCT are commonly used in the treatment of leukemia and lymphoma. The second circumstance is when a treatment requires such large doses of chemotherapy or radiation therapy that the child's bone marrow is damaged during treatment. Chemotherapy and radiation therapy target all cells that divide rapidly. Cancer cells divide more rapidly than most healthy cells and so are destroyed by the therapies. Bone marrow cells, however, also divide more rapidly than other healthy cells, so high-dosage treatment can have a damaging effect on them as well.

A BMT or PBSCT can be done in three ways: as an autologous transplant, an allogeneic transplant, or a syngeneic transplant.

• Autologous transplant - The child's own stem cells or PBSCs cells are used. They can be obtained from the bone marrow or from blood, using the apheresis procedure. Stem cells are collected while the child is in remission. To make sure that any cancer cells that remain are destroyed, the marrow may be treated with anticancer drugs. After the marrow or PBSCs are collected, the child receives high-dose chemotherapy, usually over 2 to 6 days, and, frequently, total body irradiation, during which the whole body is radiated, in one dose or in many doses over several days, to get rid of the cancer. The collected marrow or PBSCs are then returned to the child through a vein, as in a blood transfusion.

• Allogeneic transplant - The marrow or PBSCs from a sibling, parent, or someone not related to the child are used for the transplant. The transplanted material must be as closely matched to the patient's blood cells as possible. Cord blood transplant is allogeneic.

• Syngeneic transplant - The perfectly matched marrow or PBSCs from an identical twin are used for the transplant.

Before the transplant, a catheter is usually inserted into a large vein in the chest for transplanting the marrow or PBSCs, as well as for giving blood, antibiotics, and other drugs and for drawing blood. The child is given high doses of anticancer drugs and/or radiation. When the cancer cells - along with some healthy bone marrow cells - are destroyed, the new, healthy marrow or PBSCs can be given. The healthy marrow or PBSCs are given through the catheter and travel through the bloodstream to the bone marrow where they start to make red and white blood cells and platelets.

It usually takes 14 to 30 days after the transplant for the transplanted stem cells to make enough white blood cells to fight infection and to make other blood cells. During this time, your child will be at higher risk for infections, anemia, and bleeding. Complete recovery of your child's immune system can take 1 to 2 years after an autologous, allogeneic, or syngeneic transplant. Your child may need to remain in a hospital room that is kept as free as possible from anything that may cause an infection. Supportive care, which includes receiving blood transfusions and antibiotics, will be given.

• Supportive Care

Children having a BMT or PBSCT usually stay in the hospital for 1 to 2 months (sometimes longer), although outpatient BMT can be done for children who have brain tumors. Children receiving BMT or PBSCT may need supportive care.

For more information on side effects from chemotherapy and radiation therapy, see the charts in those sections.

• Graft-Versus-Host Disease

The graft-versus-host disease (GVHD) may occur in patients who receive bone marrow or peripheral stem cells from a donor. In GVHD, donated stem cells realize they are in a different body, so they may attack the patient's tissues, such as the liver, skin, or digestive tract. GVHD can be mild or very severe and can occur any time after the transplant - even years later. The doctor may give drugs to reduce the risk of GVHD and to treat the problem if it occurs.

Supportive Care for BMT and PBSCT:

Problem:	Supportive Care Provided:
Low counts of all types of blood cells	Isolation from people with infectious diseases. Transfusion with blood products, including platelets and red blood cells. Treatment with proteins that increase the number of white blood cells.
Infections	Intravenous antibiotics. Isolation from other people.
Gastrointestinal Infections	Low-bacteria diet. Mouth care. Liquid antibiotics.
Difficulty eating enough food	Intravenous nutrition-giving nutrients through a vein.

Cord blood donation

Cord blood donation – Many countries have a national cord blood banking system.  Unfortunately, the US is not one of them.  There are banks in the US which do take donations from the general public in certain areas.  Some of them are for-profit brokers who sell the cord blood to patients and research facilities, and others are set up as non-profit collection centers.  Most of them all connect their databases to the National Marrow Donor Program, which conducts searches for patients needing cord blood for transplant or treatment.  It is important to understand that once you give your cord blood away, it will most probably never be available to you or your family.  If you have decided not to bank privately for your family, please consider donating it to one of these collection facilities as opposed to throwing away this valuable resource.

Cord blood donation, blood collected and stored from the umbilical cord of a baby at birth, is one of three sources for blood transfusions in illnesses like leukemia and lymphoma. The other two sources are bone marrow and peripheral or circulating blood. This type of transplant does not have to match the recipient as closely as the other two. At birth, a mother can have the infant cord blood stored for her own family. Some people also will donate cord blood to blood banks or specific people who are seriously ill.Cord blood is rich in blood-forming cells and that is why it can be used for transplants.

Cord blood donation, Some examples of where banked cord blood might be used include people who are in need of a transplant quickly, or people who are having a hard time finding a matching bone marrow donor. Because cord blood does not need to match a tissue type as closely as other tissue transplants, people from racially or ethnically diverse communities can be helped more readily by a cord blood transplant. Cord blood is often stored on site at a hospital or trauma center and can be used more quickly when needed in an emergency. It is a viable choice to have a cord blood donation used in these situations. Many hospitals now have banked umbilical cord blood.

Donating cord blood to a public cord blood bank is free. When you donate umbilical cord blood, it is available to any patient in need of a blood stem cell transplant--it is not reserved for your family's own use. For more on donating cord blood, call the National Marrow Donor Program at 1-800-627-7692.

I've been involved with blood donation since the 1980s because there is a critical need.
Donna Reed 

Get here how to donate a blood

What is cord blood?

What is cord blood?

Before a baby is born he is connected to his mother by the umbilical cord and placenta. They allow nutrients to flow from the mother into the baby. After a baby is born his umbilical cord is cut and he is detached from the mother. The remaining umbilical cord and placenta, called the afterbirth, is expelled from the mother’s body minutes after the baby is born. Usually, the doctors and nurses throw it away. However, there is blood left in the umbilical cord and placenta, and this blood can be collected and used to help someone. It is called ‘cord blood’.

• What is cord blood used for? 

Cord blood has been used in the treatment of more than 70 different diseases so far. The most common disease category has been leukemia. The next largest group are inherited diseases (of red blood cells, the immune system, and certain metabolic abnormalities.) Patients with "lymphoma", "myelodysplasia" and severe "aplastic" anemia have also been successfully transplanted with cord blood. 
"Cord blood" is the blood that remains in the umbilical cord and placenta following birth. Umbilical cord blood contains unique cells called "stem cells" what is Cord blood is collected after the baby is born and immediately after the umbilical cord has been clamped and cut. It is a painless, safe procedure. When cord blood is collected and stored, the stem cells are immediately available for transplantation.

• What's special about cord blood?

Cord blood stem cells can be used in the treatment of many life-threatening diseases including certain cancers and immune and genetic disorders. what is Cord blood stem cells have the ability to treat the same diseases as bone marrow with significantly less rejection? Stem cell research may also help provide new treatments for stroke, heart disease, diabetes, and muscular dystrophy, to name a few.

• Why store your baby’s umbilical cord blood?

Your baby's birth provides the once-in-a-lifetime chance to collect and freeze your baby's unique cord blood stem cells for their current uses, and future potential medical uses.
Cord blood stem cells are a perfect match for your baby, have a 25% probability of being an exact match for a sibling (even greater chances of being a viable match), and can be potentially used for parents and grandparents.

• What Are Cord Blood Registries?

A Cord Blood Registry, or what is Cord Blood Bank, refers to a private service that has been set up to allow you to store (or bank) the umbilical cord blood of your newborn son or daughter.
Cord blood registries are new services that are designed to allow you to save the stem cells found in cord blood from your child at the time of the birth. There currently is some debate on whether cord blood banking is yet a practical solution for parents concerned about the health of their children, but many consider it a simple life insurance against unforeseen illness.

• Is Cord Blood Storage Expensive?

At this time, cord blood bank storage services are not inexpensive. Many services will charge an upfront fee for the collection of cord blood (at the time of delivery), as well as yearly fees to store the blood. The current costs of cord blood storage are probably the biggest argument against it.

Did you understand What is cord blood? if you don't understand make a comment.

What is cord blood? And why is cord blood banking important?

There's nothing more important than the health of our babies.
 Thalia

If you are an expectant parent thinking about storing your baby’s cord blood, here’s some information about what cord blood is and why cord blood banking is important.

A baby’s umbilical cord is cut right after childbirth. Once the umbilical cord is cut, some blood is left over in the placenta and in the attached umbilical cord. This placental blood is called umbilical ‘cord blood’.

Like the whole blood, cord blood important also contains plasma, platelets, red blood cells and white blood cells. But, most importantly, it is also a rich source of hematopoietic stem cells.

Medical research has proven that these stem cells found in cord blood has a huge potential in treating hematopoietic and genetic disorders. It is estimated that the stem cells in cord blood can cure about eighty diseases in blood, cardiovascular diseases, various forms of cancer and genetic disorders.

Cord blood banking and research has enabled the use of cord blood banking important as a substitute to bone marrow, which is the commonly used source of stem cells. Cord blood stem cells are much more primitive than bone marrow stem cells and this makes it more effective and adaptable in treating diseases.

The risk of graft versus host disease (GVHD) which occurs due to mismatching tissues between the donor and recipient is less while using cord blood. Moreover, the other advantages of cord blood stem cells over bone marrow stem cells are Collecting stem cells from umbilical cord is easier than having to do a surgery to collect them Bone marrow collection can be painful and a involves a small percentage of risk to the donor As what is cord blood is easily available, and can be stored using cord blood banking methods, more people can readily benefit from it.

• Cord blood stem cells can be transplanted to anyone while finding an exact matching bone marrow will be difficult.
• Cord blood stem cells are purer and reduce the risk of getting infected by certain viruses that may be present in bone marrow stem cells.

However, it is cord blood important to understand that even though many private cord blood banks advertise cord blood as a ‘wonder therapy’, this is a science which is still under research and treatment of many of the diseases are still under animal trial and no clinical trial in humans are carried out.

If there is no family history of specific genetic diseases, it is more advisable to donate your baby’s cord blood to a public cord blood bank for use of public (which might include any of your relative’s also) in future, rather than spending on preserving it in a private cord blood bank.

Get also ( 4 Ways to Cut the Umbilical Cord of a Baby )

Umbilical Cord Blood – Store or Donate?

Over the last decades, stem cell banking has become a significant medical practice for the treatment of a variety of diseases. Bone marrow has been considered as the primary source of stem cells for many years. But with the recent advancements in stem cell research, scientists have found the presence of master cells in the new-born’s umbilical cord blood. In the past, the umbilical cord that act as a lifeline to the baby is cut off and disposed right after the child birth. However, the discovery of perinatal stem cell presence in cord blood and umbilical cord tissue has given it a life-saving status. Since harvesting of umbilical cord tissue and blood is safe, quick and pain-less procedure, cord blood stem cell banking has been gaining immense popularity. Currently, cord blood stem cells are used to treat more than 80 life-threatening diseases which include leukemia, lymphoma and sickle cell disease to name a few. 

Families can either bank or donate their baby’s umbilical cord blood (CB) and tissue. Banking CB at a private cord blood bank may cost you a pretty penny, whereas donation to a public bank is absolutely free of cost. If you are an expectant parent, then it is important to educate yourself about the importance and medical benefits of stem cell banking. Do spend enough time in research so that you can get a better understanding about the current therapies and future treatments using CB stem cells. If you have decided to store your baby’s cord blood, then it is important to plan ahead of time. Expectant parents who can’t afford to bank the cord blood at a private facility can think about public donation, as it can save a life. Sick patients who are in need for a stem cell transplant may benefit from your CB donation. So, have a detailed discussion with your doctor and family members in order to take an informed decision.

What is Cord Blood & Cord Tissue?

If you are an expectant parent, then you might be probably busy with a lot of planning such as meeting the doctor, discussing different health issues, setting up the nursery, planning the baby shower and more. But have you ever thought about banking your new-born’s cord blood? Most of us will agree that it is one of the rarely discussed topics. But having a detailed understanding about the medical benefits of cord blood (CB) can help you in taking informed decisions regarding its banking. First of all, let’s find out what cord blood is. As we all know umbilical cord connects a baby in the womb to its mother and provides him with oxygen and nutrients. And that is why umbilical cord is considered as the lifeline of developing embryo or foetus. Soon after the child birth, this cord is cut and discarded away. But now research has shown that the blood present in the baby’s cord contains adult stem cells. Umbilical cord blood tissue, being a rich source of stem cells can be collected and stored for several therapeutical applications and research purposes. 

Not just the blood present in the cord, but even the tissue of the umbilical cord is used in the field of stem cell research and regenerative medicine therapy. Collection ofcord blood and tissue is a quick and pain-less procedure carried out right after the child birth. But what exactly is the difference between cord blood and cord tissue? CB is a rich source of blood-forming cells or Haematopoietic Stem Cells (HSCs), whereas umbilical cord tissue contains Mesenchymal stem cells (MSCs) that can differentiate into a variety of cell types. Another notable difference is that while cord blood has been used for treating more than 80 diseases, cord tissue is only available in clinical trials at this point of time. But according to the researchers, the future of cord tissue stem cell based therapy looks bright and promising. Expectant parents who wish to reap the therapeutical benefits of CB may consider banking it. Those who can’t afford the higher cord blood banking prices can also donate their new-born’s cord blood.

Benefits of Banking Cord Blood & Cord Tissue

The field of stem cell research have made significant stride in the recent years and the discovery of stem cell presence in umbilical cord blood was one of the remarkable achievements. Have you been thinking what exactly cord blood is? Blood left in the umbilical cord and placenta is termed as the cord blood (CB). Until recently, both the umbilical cord and placenta were discarded as medical waste right after the child birth. But during the 1970s, researchers discovered that the umbilical cord blood is a rich source of stem cells. Also known as the master cells, adult stem cells possess remarkable potential to develop into a complete array of tissue and organ cells of the body. Cord blood contains haematopoietic stem cells (HSCs) that are responsible for maintaining blood production in our body. On the other hand, cord tissue contains Mesenchymal Stem Cells (MSCs) that have the potential to differentiate into cartilage cells, bone cells and fat cells. Several clinical trials are underway exploring the therapeutical cord tissue benefits and applications. 

Currently, umbilical cord blood is used to treat more than 80 life-threatening diseases. Some of the major conditions include cancers, blood diseases and immune deficiency disorders. HSCs present in the umbilical cord blood develop into red cells, white cells and platelets further restoring the body’s ability to produce blood. Patients with cancerous blood disorders are treated with chemotherapy or radiation, which reduces the stem cells in the bone marrow. Cord blood stem cell transplant helps to replace the damaged blood forming cells with healthy HSCs. Since the collection of cord blood is easier and probability of complications is slighter, CB transplants have become a safe and effective alternative to bone marrow stem cell transplants. On the other hand, researchers continue to investigate the therapeutical cord tissue benefitsthereby offering promising hope for the treatment of several debilitating conditions such as Parkinson’s disease, stroke, spinal cord injury, diabetes and more.