People who need a stem cell transplant but do not have a matched donor now have another option -- a transplant using a new stem cell product called omidubicel. Mitchell Horwitz, MD, a stem cell transplant specialist at Duke Health, said that the cell therapy, which was approved by the FDA in 2023, will benefit many people ages 12 and older with blood cancers. People of African, Hispanic, Middle Eastern, southern European, Asian, or mixed ethnic backgrounds may benefit the most. “The chance of finding a match in the national donor registry is much lower for these groups than for white people of European descent,” he said.
Options for Stem Cell Transplantation
Stem-cell transplantation – also called bone marrow transplantation -- can be a life-saving procedure for people with a range of diseases, including blood cancers like leukemia and lymphoma as well as non-malignant blood disorders such as sickle cell disease. “When we evaluate a candidate for stem cell transplant, we determine if they should get their own stem cells or donor stem cells,” explained Dr. Horwitz. “If they need a donor, we look for a match in the family or in the national donor registry.”
If those efforts are not successful, doctors can use a donor that is not an exact match. That might be a family member, or it could be donated umbilical cord blood, he said. However, because cord blood does not contain many stem cells, there may not be enough to perform a successful transplant in an adult.
A Faster Recovery, Better Outcomes
Omidubicel increases the number of stem cells in cord blood so that one unit is more than sufficient for transplant. Studies show that it also shortens the time it takes for transplanted cells to grow and make healthy blood cells from an average of 22 days to 12 days. Patients who have a transplant with omidubicel recover faster, are at lower risk for infections, and spend less time in the hospital.
More Stem Cell Transplants for More People
“One of the most important advantages of cord blood is that it doesn’t need to be matched to the recipient,” said Dr. Horwitz. This is especially relevant for people who are not white. Because the national bone marrow donor registry lacks ethnic and racial diversity, it can be difficult for people of certain backgrounds to find a match. For example, a Black person has a 29% chance of finding a matched donor in the registry, while a white person has a 79% chance. In addition, donated cord blood is prescreened, tested, frozen, and ready to use immediately. The process of locating and confirming a donor can take months.
A Donor for Everyone
Dr. Horwitz said omidubicel is an example of progress in stem cell transplantation. “We have gone from only offering transplants to people who are younger and have a match to today. It’s rare these days that we turn somebody away because we do not have a suitable stem cell donor.” Duke was the first center to perform stem cell transplantation with omidubicel and has completed more than any center worldwide.