The new director of the bone marrow transplant program at the Georgia Regents University Cancer Center said he would like to start a program for children and begin using cord blood that could help more patients find suitable matches.
Dr. Claude Sportès joined the center after more than 20 years at the National Cancer Institute. One of his early priorities is beginning a pediatric bone marrow transplant program. Currently, the closest one is in Atlanta, and those patients’ families face long trips out of town.
Getting it started will require some changes to patient rooms and possibly construction, Sportès said. Doing the transplants in children is very different than in adults, he said.
“Children are not small adults,” Sportès said. Their immune systems are different, which can work in their favor in adapting to the newly installed immune systems from the transplant.
“You inherit that immune system,” Sportès said. “Children are better apt to educate that new immune system” to adapt to the new host.
The emerging field of cord blood transplantation is also on his agenda, having trained in Paris under the doctor who did the world’s first cord blood transplant in 1988.
With bone marrow transplant, traditionally the approach was to try for a sibling match, where most patients had about a one-in-four chance of finding a suitable donor in the family, Sportès said. That is becoming more difficult now, he said, because “first of all, the family size is decreasing.”
Patients can seek an unrelated match through the National Marrow Donor Program, but the odds vary. White patients will ultimately find a match about 70 percent of time, but blacks are only about 30 to 50 percent successful, Sportès said. Cord blood doesn’t require as precise a match, he said.
“We can get away with less matching with cord blood transplants because the immune system of the neonate is not as mature” and is less likely to provoke a reaction to it from the host, Sportès said.
In programs that have pioneered the use of cord blood in transplantation, such as the University of Minnesota, blacks are finding matches 80 to 90 percent of the time, he said. That obviously would be important to the GRU Cancer Center and Georgia, Sportès said.
“As a state university and providing care for the state of Georgia, it is clearly a population that needs to be better served in terms of transplants,” he said.