Can UCB be used for autologous use, (own child’s cells), even for leukemia?
Yes. Autologous transplantation today is the first choice, if there is available an autologous graft.
Until today in Europe there have been performed 25000 transplantations by using hematopoietic stem cells. 70% of these transplantations were autologous, the stem cells were derived from the patient himself, and 30% were allogeneic, they were derived from a donor. In the 70% of these cases the donor was within the family, Watt et al 2007, Methods Mol Biol 368: 237-259.
It is explained by the fact that the possibility one autologus graft to transfer the disease, because it is collected after the appearance of the disease, is balanced by the danger of host versus graft disease that is the main complication after allogeneic transplantation.
There are few available data about the treatment of leukemia by using autologous UCB stem cell in patients who they had cryopreserved their own stem cells. These grafts even they are valuable, today are very spare. With simple words few children that developed leukemia had cryopreserved their own stem cells from UCB.
In 2007 a case of a 3 year old child, suffering from acute lymphoblastic leukemia, was cured with its own stem cells and published in medical journal. At 2003 when the disease was appeared, chemotherapy failed twice in the child and finally the physicians decided to use the child’s stem cells that the family had cryopreserved, only for percussion, in a private bank, Hayani et al 2007, Pediatrics 119, 296-300. Today 4 years post transplantation the child is free of symptoms. In leukemia the total survival among patients that received their own stem cells or allogeneic compatible grafts don’t differ significantly, Loy Ys et al 2007 Leuk Lymphoma, 48 (1), 72-9. This application change the therapeutic methods for leukemia and DNA tests for leukemic clones detection that circulates between stem cells, leads the decision of using its own or allogeneic stem cells.
The treatment of childhood tumors (sarcomas, neuroblastomas, lymphomas) is accomplished with autologous stem cell transplantation.
The annual frequency of occurrence of cancer in children is 130 per million, so the probability of a child to present leukemia or cancer until the age of 16 is 1/500 and for 1 in four children a hematopoietic transplantation is required, Smith et al 2002, Principles and Practice of Pediatric Oncology, 4th edition Philadelphia PA Lippincott. The probability to use one graft is doubled, if one considers the blood relatives that may make use of the graft.