Sabrina Couillard recently celebrated her 15th birthday, a milestone age in Hispanic culture, and is cancer free. A year ago, Sabrina was diagnosed with Acute Lymphoblastic Leukemia (ALL). Although this disease has a high cure rate, Sabrina had the type of ALL that has a high risk of recurrence and requires treatment through bone marrow transplant.
Sabrina’s doctors immediately began the search for a match, testing her family and investigating national registries. When the search turned unsuccessful, they decided to try a relatively new form of bone marrow transplantation through the use of two donated umbilical cord units. Although the practice of using donated umbilical cord blood has been in use for years, an umbilical cord unit is small in size and is limited to patients weighing less than eighty pounds.
Dr. Kamar Godder, Director of the Bone Marrow Transplant Program at Miami Children’s Hospital, says the procedure is giving hope to patients who have not been able to find a close enough match in the registries. “In Sabrina’s case we were able to take the blood of two umbilical cords for a successful transplant,” said Dr. Godder. “The nice thing about cord blood is you don’t need to have the same degree of matching as in an unrelated donor graft,” she said.
Bone marrow transplantation involves replacing a patient’s immune system with a completely new one. Bone marrow transplant patients typically undergo full body radiation and chemotherapy to destroy the existing immune system and then the donated bone marrow is infused. Stem cells from banked cord blood are an increasingly important medical resource. No blood is taken from the healthy newborn baby, only from the cord and placenta with permission of the family.
The cord blood is frozen in a sterile bag, screened and banked with specific genetic information (tissue typing) so that it can be retrieved for use by patients with similar profiles. When the two units of cord blood are fused one after the other during transplant, the patient takes on the DNA of only one of those units.
Sabrina says she is feeling great and is looking forward to returning to high school this fall.