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Cord Blood Bone marrow contains stem cells (or seed cells) which divide constantly and produce new blood cells within 4-6 weeks. Stem cells are also present in umbilical cord blood which can be used instead of bone marrow in a transplant. Stem cells can replace damaged bone marrow in patients with malignant diseases which require treatment with very high doses of chemotherapy and/or radiation therapy. They can also correct diseases in which the marrow malfunctions (e.g. immune deficiency, aplastic anemia, red cell aplasia, white cell disorders). Stem cells produce other types of cells (glial cells and macrophages) that slowly, over about one year, travel to the brain, liver, and other organs. These cells can produce enzymes that are missing or defective in children with some inherited metabolic diseases (inborn errors of metabolism). If transplantation is carried out before significant damage has occurred the damage can be arrested and sometimes prevented. In the past, stem cell transplants could only be performed in children who had matched donors in their families. Over the past decade, cord blood banks have been established and patients in need of a transplant can use donor units from these banks when they don't have a matched donor in their family. Cord blood does not have to match as closely as bone marrow, so most (>90%) patients will be able to find a donor within 1-2 weeks from this source. Children undergoing transplantation are prepared with several days of high dose chemotherapy with or without radiation therapy. They are usually hospitalized for 2 months and need to live near the transplant center after they are discharged for approximately two additional months. It is a big undertaking that carries a 10-20% risk of dying from the procedure. |
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