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Can a child with cancer be treated with his or her own cord blood?
Childhood cancers are rare, and make up less than 1% of all cancers diagnosed each year1. It is even rarer for a child to require a stem cell transplant for cancer. In the US, the probability of a child having a stem cell transplant over the years from birth to age 20 is only 3 in 5000 or 0.06%2. This probability includes all 80+ of the diseases treated with cord blood.
Children that have a solid tumor have been treated with their own cord blood. This includes diagnoses such as neuroblastoma, medulloblastoma, and retinoblastoma. The very first case in the world where a child was given a transplant of her own cord blood happened in 1998 for a girl in Brazil who had neuroblastoma3.
Blood cancers such as the various forms of leukemia are the most common cancers in children. In the US, acute leukemia is one of the leading causes of death in children under 15 years of age4. Pediatric leukemia has been backtracked to birth5,6. Researchers have discovered that in most cases of pediatric leukemia the genetic mutation which triggered the leukemia started in utero, before the child was even born, and is present in the cord blood. In fact, researchers are now studying cord blood to learn which children are at risk for pediatric leukemia and how it can be prevented7,8.
Children should not be transplanted with their own cord blood if they have a pediatric blood cancer like leukemia, or a hereditary blood disorder like Thalassemia Major or Sickle Cell Anemia. All of these diseases have a genetic basis and they will be present in the child’s cord blood, so it is not safe to use that cord blood for transplant. Children with hematologic (blood) disease in need of transplant should receive stem cells from a donor. The ideal donor is a matched sibling donor.
References:
- American Cancer Society - Key statistics for childhood cancers
- Nietfeld JJ, Pasquini MC, Logan, BR, Verter, F, Horowitz MM. Lifetime Probabilities of Hematopoietic Stem Cell Transplantation in the U.S. BBMT 2008; 14(3)316–322.
- Ferreira E et al. 1999; Autologous cord blood transplantation. Bone Marrow Transplantation 24(9):1041.
- NIH Reporter. Backtracking Leukemia-Typical Somatic Alterations in Cord Blood at Single-cell Resolution. Project Number 1R01CA262012-01
- Ford AM, Bennett CA, Price CM, Bruin MCA, Van Wering ER, Greaves M. Fetal origins of the TEL-AML1 fusion gene in identical twins with leukemia. PNAS 1998; 95(8):4584-4588.
- The Institute of Cancer Research (ICR). Pioneering scientist Mel Greaves is knighted after research to unveil cause of childhood leukaemia. News archive Published 2018-12-28
- Marcotte EL, Spector LG, Mendes-de-Almeida DP, Nelson HH. The Prenatal Origin of Childhood Leukemia: Potential Applications for Epidemiology and Newborn Screening. Frontiers Pediatrics 2021; 9:639479.
- Spector L. Studying Cord Blood to Prevent Childhood Leukemia. Parent's Guide to Cord Blood Foundation News Published 2022-07