Dr. Barker on Cord Blood Transplantation

Juliet N. Barker, MBSS, director, Cord Blood Transplantation Program, Memorial Sloan-Kettering Cancer Center, discusses using double-unit cord blood transplantation with a haplo-identical donor in patients with hematologic malignancies.

Barker says the cord blood transplant program at Memorial Sloan-Kettering is striving to improve access to cord blood transplant as well as improving the outcomes of cord blood transplants. When cord blood is transplanted, physicians are able to achieve high rates of sustained donor engraftment.

The problem with cord blood, Barker says, is that the count recovery is very delayed compared to transplanting adult donor stem cells. This makes the transplant more complicated during the first couple of weeks to months after the transplant. There is also a potential that the upfront transplant can be more dangerous, Barker says.

Physicians and researchers are now investigating methods to speed up the recovery of cord blood transplants in the early stages. Barker and her team have investigated the addition of peripheral blood stem cells from a half-matched family member, known as a haplo-identical donor, to a cord blood graft. Now the patient is receiving a double unit cord blood graft, which is combined with a half-matched family member, Barker says.

This technique has been studied in 20 patients. The results show that the patients are both grafting and recovering their counts more quickly, Barker says. This approach is feasible and safe and leaves patients feeling better more quickly.