Bone marrow transplants are often the best therapy for blood cancers like leukemia, but finding a matching donor can be tough.
Only 30 percent of family members match, and only two percent of the country is on the National Bone Marrow Donor Registry.
That’s why the potential of umbilical cord blood and its stem cells are the source of much hope.
Alexes Harris was diagnosed with leukemia two years ago.
“They told me that, initially, I’d have 18-24 months to live if I didn’t have treatment and then ultimately a transplant,” Alexes recalls.
No one in her family was a bone marrow match, and the two matches on the national registry declined to be donors.
Doctor Filippo Milano told her about cord blood and his clinical trial.
The odds of finding a donor for minorities like Alexes are lower than they are for Caucasians.
“The main advantage of cord blood is cells come from the baby and the cells are naive. There is no necessity of matching 100 percent between the host and the donor,” Milano explains.
He says cord blood will work for 95 percent of cases. The downside is that cord blood doesn’t have many stem cells.
It takes twice as long for patients’ immune systems to rebuild as it would with a bone marrow transplant. Also, patients need two units, which costs $80,000.
Milano’s trial increased the number of stem cells in the lab, hoping to cut recovery time by a week.
“Cord blood really proved to be a very good source of stem cells, and we need to make sure that many centers keep doing it,” Milano says.
Now, Alexes is raising awareness for minorities to get on the bone marrow registry, and for cord blood as an option.
“The parents who donated that umbilical cord saved my life, and I just feel like I need to make my cancer matter,” Alexes explains.
Milano says leukemia patients who get cord blood seem to have fewer relapses. He sees great potential for cord blood for blood cancers, and maybe regenerative medicine.
CORD BLOOD CAN SAVE LIVES!
BACKGROUND: Umbilical cord blood is the blood that remains in the placenta and the umbilical cord following birth. Today, stem cells are mainly used in the treatment of disease and in tissue regeneration. They typically come from three sources, one being cord blood. Cord blood stem cells are found in the blood of the umbilical cord, and can only be harvested and stored at birth. With their instant availability and proven usefulness, cord blood is quickly becoming a well-known source of stem cells. After a child is born and the umbilical cord is cut, the blood left in the umbilical cord can be collected and saved. The stem cells are then removed and stored for future use in medical application. The collection of the cord blood will not change the birthing process in any way and it is completely safe. As of today, there are nearly 80 health conditions that can be treated with cord blood and experimental treatments using cord blood for cerebral palsy and Type 1 diabetes are ongoing. They can renew themselves and become specializing stem cells to help repair or a replace a patient's damaged or diseased cells.
CORD BLOOD: APPROVED USES: Cord blood is approved only for use in “hematopoietic stem cell transplantation” procedures, which are done in patients with disorders affecting the hematopoietic (blood-forming) system. Cord blood contains blood-forming stem cells that can be used in the treatment of patients with blood cancers such as leukemias and lymphomas, as well as certain disorders of the blood and immune systems, such as sickle cell disease and Wiskott-Aldrich syndrome. “Cord blood is useful because it is a source of stem cells that form into blood cells. Cord blood can be used for transplantation in people who need regeneration, or regrowth, of these blood-forming cells,” explains Keith Wonnacott, Ph.D., Chief of the Cellular Therapies Branch in FDA’s Office of Cellular, Tissue, and Gene Therapies. For instance, in many cancer patients, the disease is found in the blood cells. Chemotherapy treatment of these patients kills both cancer cells and the healthy blood-forming stem cells. Transplanted stem cells from cord blood can help regrow the healthy blood cells after the chemotherapy; however, cord blood is not a cure-all. “Because cord blood contains stem cells, there have been stem cell fraud cases related to cord blood,” warns Wonnacott.
NEW STUDIES FOR CORD BLOOD: Dr. Joanne Kurtzberg, who heads the Robertson Clinical and Translational Cell Therapy Program at Duke University Medical Center, has teamed up with Dr. Geraldine Dawson, director of the Duke Center for Autism and Brain Development, to see whether a transfusion of a patient’s own umbilical cord blood containing rare stem cells could help treat their autism. The results were impressive. More than two-thirds of the children showed reported improvements. A larger second trial is underway, one its researchers hope will lead to long-term treatment for children with autism. "I was very interested in collaborating with people here at Duke who could offer medical approaches that could enhance neuroplasticity, or the brain's ability to respond to treatment," Dawson says. That's where Kurtzberg comes in. Over the past two decades, she had seen children with inherited metabolic disorders be treated with cord blood after receiving high doses of chemotherapy. Kurtzberg says, "We've been able to show that with some of these diseases, a cord transplant rescues them from death and also improves their neurologic outcome.” She began wondering, could cord blood help other children? What if we tested cord blood specifically for autism? "Some children, who were not speaking very much, had a big increase in their vocabulary and their functional speech," Kurtzberg says.