Could hyperbaric oxygen therapy improve umbilical cord blood transplantation outcomes?

This study examined if hyperbaric oxygen therapy is safe and can improve outcomes in umbilical cord blood transplantation. This study concluded that the use of hyperbaric oxygen therapy before umbilical cord blood transplantation is safe and can improve outcomes in certain patients.
 

Stem cells allow the production of blood cells. They can be used in the treatment of some blood cancers. Umbilical cord blood (UCB) transplantation can be used when patients do not have a matched related stem cell donor. Stem cells from donated umbilical cord blood are introduced to the patient. Sometimes the transplant is not effective, or there can be side effects. Graft versus host disease (GVHD) is a serious complication of stem cell transplant. It means that the donated cells attack the body.  

Previous studies have shown that hyperbaric oxygen (HBO) therapy may be used to help with UCB transplantation. This involves breathing pure oxygen in a pressurized room or tube. This increases the level of oxygen in the blood. Erythropoietin (EPO) is a hormone that controls the production of red blood cells. EPO is reduced when there are high levels of oxygen in the blood. 

It is not known if HBO therapy is safe and can improve UCB transplantation outcomes.

55 patients were included in this study. 14 patients received HBO treatment before UCB transplantation. 50% of these patients received single UCB units. 41 patients acted as a control group. These patients had received a UCB transplant but were not treated with HBO.  90% of this group received double UCB units. 

All patients in the HBO group and 67% of the control group were alive 6 months after UCB treatment. One year after treatment, survival rates were similar in both groups (62.3% for the HBO group vs. 56.5% in the control group).

Lower death rates due to return of cancer and other causes were seen in HBO-treated patients. There was no significant difference in the number of patients with GVHD in both groups.  

In the HBO-treated group, there was an increase in early B cell (immune cell) recovery, compared to the control group. The researchers found a relationship between lowered EPO levels after HBO therapy and positive outcomes. These patients tended to live for longer without progression of the cancer. 

This study concluded that the use of HBO therapy before UCB transplantation is safe and can improve survival in certain patients.

This was the first study of this kind. It included a small number of patients. Larger studies are needed to assess the effectiveness of HBO therapy before UCB transplantation.