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Washington Post story on cord blood transplants for cancer: Too many anecdotes and not enough evidence

Rating

2 Star

Categories

There’s new hope for blood cancers, and it comes from umbilical cords

Our Review Summary

Microscopic view of embryonic cell and needleThis is a story about the use of cord blood stem cells to combat certain blood cancers like leukemia.

Stem cell research is a well-established field at this point, and there are thousands of scientific articles on various uses of cord blood, a source of stem cells. And yet none of that evidence is brought to bear in this article. We’re even a little confused as to whether the article is squarely about cord blood transplantation or also about transplants from relatives because of a foray into the latter midway through the piece.

That said, we did appreciate how it addresses the risks of the treatment throughout the piece. We also like that the article clearly states that one person’s experience is not going to be the experience for everyone — either in the difficulty of finding a donor or in responding well to cord blood transplantation.

Overall, though, there were too many missing pieces in this story to give readers a full picture of this area of cancer treatment.

 

Why This Matters

The so-called “liquid” tumors (leukemias and lymphomas) have proven to be difficult to treat, especially in adults.  The gold-standard treatment, bone marrow transplant, is an arduous, expensive and risky treatment modality that has traditionally required matching donors.  The use of umbilical cord stem cells may provide patients with greater access to treatments that do not require matching donors. The results to date are encouraging, but definitive clinical trials need to be done.  While the patient stories presented here are both encouraging and heartwarming, they do not represent the whole story. Words to describe cord blood stem cells as a “huge home run,” and an “amazing and beautiful resource” must be balanced out with a discussion of the state of the science.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

There is no mention of costs in the piece or whether the treatments are covered by insurance.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

There is one quick mention–at the very end of the story–about a small number of patients who were involved in one clinical trial. Out of 13, two of them died and 11 are in remission. How long have they been in remission? The story says an average of 4.7 years. So it could be that some are only in remission for a few months and others many years. In general, we wish there was much more discussion of the researched benefits.

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The story nicely raises the risk of cord blood transplantation and the risk of standard cancer therapies throughout the piece. For example, it says, “Because each umbilical cord produces only a tiny number of stem cells, umbilical-cord transplants take longer to work than standard transplants, which makes patients more likely to get fatal infections. And if cells from several umbilical cords are used, the chances of immunity problems increase.”

We do wish that the story made it clear earlier on that the new approach is preceded by intensive chemotherapy and the inherent side effects it entails.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

It’s not clear in this piece how much evidence there really is for the technique described, whether the evidence has been peer reviewed, how often these studies have been repeated, etc. What makes it even trickier is that the story seems to be talking about two very different types of treatments. It begins with a long anecdote about a woman receiving a cord blood transplant — meaning she was injected with stem cells from the umbilical cord of someone she did not know and was not related to. But then the story says, “This therapy and another —haploidentical transplantation, which uses bone-marrow cells that are only half-matched to a patient — have revolutionized the treatment of blood cancers in the past few years. Every biological child is a half-match for a parent, and vice versa.” From that point forward, it is very difficult to know whether the purported benefits being discussed and claims about always finding a match for a patient, etc. are about one treatment, the other treatment, or both combined. We also don’t have strong evidence presented for either.

Does the story commit disease-mongering?

Satisfactory

There is no disease mongering in this piece. In fact, its description of the different cancers that are addressed and its details about the patient experiences are a very nice model for how to be descriptive without trying to exploit readers’ emotions.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

Every source in the piece is either directly involved in the types of treatments being discussed or is a patient who has undergone treatment.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story mentions chemotherapy and radiation but no true comparison to standard cancer therapies or even emerging cancer therapies — like immunotherapy — is done in the piece.

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

The story does not make it clear how frequently these treatments are performed or how widespread they are. Does one have to travel to Seattle to have this treatment? It’s unclear.

Does the story establish the true novelty of the approach?

Not Satisfactory

There is a very bold statement of novelty in the piece that is not backed up by evidence or independent sources.

“This expanded cord-blood technique has been a ‘huge home run’ for patients,” said Colleen Delaney of the Fred Hutchinson Cancer Research Center in Seattle, who helped create it.”

“‘No one had successfully taken stem cells and gotten them to grow and put back in a person,’ she said. The advance should be particularly valuable for minorities and people of mixed-race background, whose chances of finding a matched donor were slim to none.”

Does the story appear to rely solely or largely on a news release?

Satisfactory

The story does not rely on a news release.

Total Score: 3 of 10 Satisfactory

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