Over 1/3 of transplant patients die now, but mortality rate under 10% in ongoing trial

A new treatment technique for cord blood transplants could offer patients with diseases such as blood cancers a lower risk of infection and higher likelihood of surviving the transplant, if a trial being conducted proves successful.

It involves culturing and growing cells from a single unit of cord blood in the laboratory over three weeks to produce more stem cells.

More than one-third of patients worldwide die from cord blood transplants that contain a low number of stem cells.

The new Nicord cord blood expansion technique has shown promise with a mortality rate of less than 10 per cent, said Associate Professor William Hwang, a senior consultant at the Singapore General Hospital's (SGH) Department of Haematology.

But Prof Hwang said long-term survival using the new technique has not been definitively proven. The trial is being conducted by biotechnology company Gamida Cell and Duke University Medical Centre in the United States.

Besides increasing the number of cells, the second phase of the trial showed a reduction in the average number of infections during the first 100 days after transplant.

Hospitalisation days were also halved to 11 from 24 .

These figures are based on 36 patients from Singapore, Europe and the US who took part in the trial’s second phase from 2013 to 2017.

The third phase started in November 2016 and is expected to be completed in December next year, with 120 patients being recruited globally.

Prof Hwang said a patient’s suitability to receive the treatment depends on his ability to wait for the cells to be grown.

“If the patient has a disease that cannot wait, for example, a previous transplant failed and the patient has a low blood count for a long time, I might say, just use the (conventional) cord blood transplant,” he added.

More than 80 stem cell transplants are performed at SGH every year on average, out of which four are cord blood transplants.

Ms Judith Chew, 53, is the first patient in Asia to receive a cord blood transplant with the new technique.

The business consultant was diagnosed with acute myeloid leukaemia, a cancer of the blood and bone marrow, in October 2016.

She needed chemotherapy to lower her white blood cell count before the operation in May last year.

She is still on immunosuppressants but is hopeful of a long-term recovery. “The entire process was really very manageable for me, and I’m most happy with the recovery process,” said Ms Chew.