Umbilical cord-blood transplants for immunodeficiency

Abstract

Two brothers with X-linked lymphoproliferative syndrome (XLP) and one boy with X-linked hyper-IgM syndrome (XHIM) appear to have been cured two years after receiving unrelated umbilical-cord blood that was MHC-matched at five of six sites. Lead author Richard Stiehm, Professor of Pediatrics at Mattel Children's Hospital at UCLA, CA, USA explained in a press release, ‘most children born with these immune deficiencies die at an early age and nearly all succumb in young adulthood’. Advantages of using cord blood over bone marrow include: the fact that it is never infected with Epstein–Barr virus, which can cause problems in XLP; fewer problems with graft-versus-host disease; the ready availability of cryopreserved cord blood (within two weeks of donor identification); and the fact that histo-incompatibility is better tolerated with cord blood than bone marrow. The UCLA umbilical cord-blood bank was set up with $10 million from the NIH as part of a program to investigate the efficacy and viability of cord-blood transplants. J. Pediatr. (2001) 138, 570–573. HM