Unrelated cord blood transplants cure X-linked immunodeficiencies.

Transplantation of banked, unrelated umbilical cord blood generated normal immune systems in 3 boys with X-linked immunodeficiencies, according to a report in the April issue of the Journal of Pediatrics.

E. Richard Stiehm, MD and colleagues from the University of California at Los Angeles transplanted 2 brothers with X-linked lymphoproliferative syndrome and 1 boy with X-linked hyper-IgM immunodeficiency using unrelated, banked umbilical cord blood cells that were partially HLA-matched (5/6 loci). Although the boys developed mild graft-versus-host disease, 6 to 12 months after their transplants, they were off all medications and had normal immune function. Now 3 years' posttransplantation, the children are doing well and require no medications. Stiehm said that unmatched umbilical cord blood transplants are as good as bone marrow transplants from a parent or a matched unrelated donor "but not as good as a matched sibling transplant."

In a related editorial, Alexandra Filipovich of Children's Hospital Medical Center In Cincinnati, OH discussed the future prospects of cord blood transplants. "If the ongoing study of feasibility of cord blood transplantation supported by the National Heart, Lung, and Blood Institute shows benefit to recipients of 4/6 or even 3/6 matched grafts, this could establish use of cord blood as a valuable addition to the armamentarium of hematopoietic stem cell sources for patients lacking other options and provide the rationale for funding future cord blood banking."

If that day arrives, Stiehm warned that it will increase the demand for umbilical blood cord. He urged parents to donate their baby's cord blood now, if asked. "It may help him or her or save another life."