28 Aug 2007
BY DAPHNE CHUAH
WHEN 19-year-old Candy Yeow was diagnosed with an aggressive form of acute leukaemia early in 2005, she was so weak she could hardly climb a small flight of stairs without having to stop for a breather.
Now, a year after a successful double cord blood transplant at the Singapore General Hospital (SGH), the second-year Business Management student from Nanyang Polytechnic is off all immuno-suppressants — medication that reduces or retards the body's immune response — and in the thick of her studies, after deferring them for a year.
Although it has long been known that cord blood is a potential source of stem cells and can be used to treat a host of diseases, such as blood disorders and cancers, the small number of these healing cells in each unit collected reduces its efficacy.
Adults generally need larger doses and officials say about 10 grown-ups have gone through cord blood transplants — Ms Yeow being one of them. Most of the over 40 patients who have undergone the procedure in Singapore are children.
"One cord blood unit may not contain enough stem cells for an adult patient," said Dr Mickey Koh, a consultant haematologist at the SGH. "The rationale for combining two units is a novel concept of applying cord blood in adults."
In Ms Yeow's case, the double cord blood units provided sufficient stem cells for engraftment to occur — the process in which the newly transplanted stem cells begin to function and start producing new blood cells — thereby preventing rejection and helping her achieve remission faster, he added.
Cord blood contains only one-tenth the number of stem cells as bone marrow, and as a result of this low number, engraftment takes an average of 25 days, compared to 15 days for a bone marrow transplant.
One of the main advantages of cord blood transplants is that cord blood units do not need to be as stringently matched with the recipient's tissue type, unlike traditional bone marrow transplants — which requires a 100-per-cent match.
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