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Cord blood: An option for leukemia patients

Stem cell transplantation using umbilical cord blood is a standard treatment option for blood disorders in children, but not for adults, due to the difficulty of obtaining a sufficiently large dose of cells. To solve this problem, researchers from the University of Minnesota examined a new technique that combines two cord blood units from different donors for transplantation into adult or adolescent leukemia patients. Their study is to be published in the February 1, 2005, issue of Blood, the official journal of the American Society of Hematology.

Twenty-three patients with high-risk acute and chronic leukemias were studied for up to two and a half years. As is often the case, a suitably matched volunteer donor could not be found for these patients, and without an exact match, a transplant would likely be unsuccessful.

Cord blood is more tolerant of differences between patient and donor, making it possible to perform cord blood transplants without an exact match. Though a single cord blood unit with a satisfactory dose could not be found for these patients, senior study author John Wagner, M.D., Scientific Director of Clinical Research of the University of Minnesota's Blood and Marrow Transplantation Program and Stem Cell Institute, theorized that they could still have successful transplants if two partially-matched units were used for each patient.

"Currently, many adult leukemia patients are not eligible for an umbilical cord blood transplant due to the inability to find a single unit of blood with enough cells for transplantation. With this new technique of increasing the dose by combining two units, this procedure could be made available to thousands more patients and has the potential to save many lives," said Juliet N. Barker, M.B., B.S., Assistant Professor of Medicine at the University of Minnesota and co-author of the study.

While two patients with acute leukemia in relapse died from infection shortly after the transplant, in the remaining 21 patients, the transplanted stem cells completely incorporated themselves in the patient's body and began to produce normal, healthy cells. Disease-free survival was 57 percent at one year and, for those who received the transplant while their cancer was in remission, the success rate was even higher at 72 percent.

"The results of this study are heartening, but further investigation of this approach in larger clinical trials is needed to determine the full impact of this transplant procedure for adults and larger adolescents," said George Q. Daley, M.D., Ph.D., Associate Director of the Stem Cell/Developmental Biology research program at Children's Hospital Boston.

http://pregnancyandbaby.com/read/articles/1333.htm

Teen an inspiration to the end

Christine Mulvihill
1988-2005

By Susan Sherring -- For the Ottawa Sun

In her far too short life, Baby C -- as she was known to her friends -- helped teach those around her about hope. Hope and humour. Those were her two trademarks. Christine Mulvihill was, as CHEO staff describe it, an old soul. Small wonder.

Diagnosed with high-risk leukemia at the age of three, she lost her first best friend at the unthinkable age of just four years old. Those sorts of things make you grow up a lot quicker than those around you. Little Christine beat the cancer that had invaded her body.

While she was always a little more mature than those around her, maybe understood a bit more than the rest of us about enjoying each and every moment, she knew that life -- and the people in it -- were there to be enjoyed.

One of the constants in Christine's life was the love and affection she felt for her brother Stephen. "She adored everything about her big brother. He did martial arts, so she did martial arts," mom Mary Pat told the Sun.

'Fearless'

And when her treatment for leukemia was over, she was finally able to get involved in hockey -- just like her brother -- something her mother Mary Pat had promised she could do as soon as the treatment was over. "She would try out for everything. I always knew she wouldn't make the team, but that never stopped her. She was fearless," Mary Pat said.

With house league hockey, everyone makes the team and it didn't matter one whit to Christine that she perhaps didn't skate as well as the other kids or wasn't quite as fast on the ice as the rest of the players.

She wanted to try everything.

At the age of 15, she was diagnosed with an inoperable brain tumour. Medical experts were left trying to explain to a 15-year-old girl who had everything ahead of her, and knew enough to appreciate all of it, that her life was being cut short. Treatment began again, this time on her very aggressive tumour.

Everyone knew the treatment wasn't going to get rid of the tumour but would hopefully give her a little bit more time. It was very important for Christine to stay at home. She didn't want to spend her final days and months in the hospital. So that's what she did, having friends and family drop by, to chat, to play games, to laugh.

"She had goals in her life. She was very spiritual. She believed in God, and at one point, she tried bargaining with God," her mom said.

'Like magic'

With her birthday approaching in March, and getting increasingly weaker, Christine decided to hold her birthday party earlier, inviting 75 of her closest family, friends, even some CHEO staffers, to help her celebrate her 16th birthday. "It really was like magic," her mom said.

Throughout her illness, while girls her age were spending much time worrying about what to wear or how they looked, somehow Christine managed to worry about others around her.

A planned Grade 11 trip to a Third World country with her St. Paul's classmates -- something she'd looked forward to for some time -- simply wasn't possible. Without Christine there, some of her friends didn't want to go either. One friend in particular was having difficulty leaving her dying friend behind.

"Christine talked to her, told her, 'You're going to be doing my work.' She was very ill, but she was totally selfless, right to the end. One of the things she told me she was worried about was that she hadn't done enough for people."

Christine managed to inspire those around her, doing what she could to help make those around her feel comfortable. "At the worst periods of her life, she could always make people laugh," her mother said. "She embraced life. She was an ambassador of hope."

Along with very large extended family, Christine leaves behind her parents Mary Pat and Mike, and 19-year-old brother Stephen.

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