What is a cord blood transplant?

What is it?

A bone marrow or stem cell transplant means that doctors or nurses will put new, healthy stem cells into your bloodstream. These cells make their way to your bone marrow where they begin to grow and make healthy new blood cells.

If you need a transplant and you’re having your stem cells donated from someone else,  one option is to use stem cells from umbilical cord blood. A cord blood transplant can be an alternative option if a brother, sister or matched unrelated donor (found on the stem cell register) is not available. Stem cells found in cord blood are ‘immature’, which means they can develop to suit the patient and don’t need to be an exact match.

Where does cord blood come from?

Cord blood is found in an umbilical cord. An umbilical cord connects a baby in the womb to the placenta. The placenta and umbilical cord are a rich source of stem cells. If a mother agrees to donate her baby’s cord blood, the procedure is safe and simple. Once a baby has been safely delivered, the mother delivers the placenta, the cord is cut and the stem cells can be collected by an Anthony Nolan cord collector.

The blood is taken to our cord bank, where it can be frozen for a number of years. If you need a stem cell transplant and cord blood could be your best option, we will test your tissue to see if it matches any of the cords in our bank. We’ll also search a worldwide cord blood bank registry. For more information about this process see our webpage Finding a donor for your stem cell transplant.

When a suitable cord match is found it is usually available quickly because it has already been collected and stored.

If you’re an adult then you may need two cord blood ‘units’ – that means, from two different umbilical cords.

Who can have this kind of transplant?

A cord blood transplant could be a suitable treatment option for:

• a condition that means that you’re not able to make your own healthy blood cells, for example aplastic anaemia or a genetic condition affecting your blood, bone marrow or immune system
• blood cancer that is unlikely to be cured by chemotherapy alone
• anyone needing a stem cell transplant who does not have another suitable stem cell donor.

What will happen before the transplant?

You will have conditioning therapy to prepare your body for the new cells. This is done with chemotherapy, sometimes in combination with a type of radiotherapy called total body irradiation (TBI). This also gets rid of any remaining abnormal cells if you have them.

What will happen during the transplant?

Your transplant normally takes place the day after your conditioning therapy has finished.

The transplant itself involves thawing out the cord blood cells in a water bath. They will then be passed as a fluid through a thin tube into your bloodstream, a bit like having a blood transfusion.

After your transplant, the stem cells make their way to your bone marrow. They will then start to grow into normal blood cells – this is called engraftment.

The cord blood stem cells you receive form a new immune system that recognises any remaining cancer cells in your body and attacks them. You might hear this called 'graft versus tumour' or 'graft versus leukaemia' (GvL) effect.

Recovering from a cord blood transplant

It can take longer for engraftment to happen after a cord blood transplant because there are fewer stem cells in an umbilical cord, compared to stem cells from an adult donor. This might mean you have a slightly longer stay in hospital after your transplant than someone who has had an unrelated or sibling transplant (sometimes about one to two weeks longer).

You’ll probably be in hospital for about four to six weeks, in protective isolation with precautions taken to protect you from infection. For more information about how to cope during this time, see our webpage Your Stay in Protective Isolation.

It usually takes at least six months to a year before your level of activity starts to get back to normal.

What side effects can I expect?

Having a transplant is a very intensive treatment that has a big physical and emotional impact on your life. Your transplant team will talk to you about the risk of complications and side effects so you can make the best decisions for your care.

Side effects of a cord blood transplant vary from person to person and can be short term or long term. They are often caused by the conditioning therapy you have before the transplant, as well as the effect of the transplant itself.

Short-term side effects include

• need for blood and platelet transfusions
• increased risk of infections
• sore mouth (mucositis)
• liver and kidney problems
• tiredness
• diarrhoea and feeling or being sick
• loss of appetite.

It’s also common to feel a bit down or anxious during the early stages of recovery. We have further information on this in our Recovery section.

Your transplant team will be monitoring you closely and there will be treatment and support available.

Long-term side effects include

• increased risk of infection
• feeling extremely tired (fatigue)
• graft versus host disease (GvHD).

When you’ve had a stem cell transplant, there are still small differences between your new developing immune system and other cells in your body. As a result, your growing immune system may harm some of the cells in your own body because it sees them as ‘different’. This is called graft versus host disease (GvHD).

It can affect different parts of your body but commonly affects your skin, gut and liver. It can be short or long term, and mild or severe. Your transplant team will be monitoring you closely for signs of GvHD and will offer you treatment that can help. Find out more by reading our webpage on GvHD.

For more information on the long-term effects of a stem cell transplant, visit the Recovery Body, Mind and Life section of our website or read our booklet The Seven Steps: The Next Steps.