Stem cells from cord blood could become the standard
Posted on Tue, Sep. 11, 2007Digg del.icio.us AIM reprint print email
BY FRED TASKER
ftasker@MiamiHerald
HUGH GRANNUM / MCT
A single umbilical cord has enough cells to treat a 120-pound
patient, so a single patient often requires a transplant from two
cords.
A South Miami Hospital doctor crusades for a leukemia lifeline
Today, stem cells from bone marrow are considered the ''gold
standard'' for treating leukemia, many immunologists say. But that
may be changing.
''I think it's likely that cord blood will become the standard in the
future,'' says Deborah Banker, vice president of the Leukemia &
Lymphoma Society.
In 2006, 17.5 percent of the transplants coordinated by the National
Marrow Donor Program were from cord blood, said spokeswoman Shauna
Sheffer. ''That is up 4.2 percent from last year and that number
continues growing,'' she said.
Because demand is expanding so rapidly, with a need for 150,000 units
in storage to serve all who need it, Congress in 2005 allocated $79
million to increase the supply.
''It's not enough to achieve 150,000 units, but it's a good start,''
says Dr. Edward Guindi, president of CORD:USE, an Orlando company
that takes part in the collection process.
The National Marrow Donor Program has up to 5 million registered bone
marrow donor volunteers. But blood marrow has several drawbacks. The
biggest is that only about 30 percent of patients who need stem cell
transplants can find a properly matched donor with bone marrow --
while a match from umbilical cord blood is much easier.
Also, it takes about three months to obtain bone marrow for a
transplant, because the donor must be located and brought to the
recipient. Cord blood stem cells are stored in a national bank, ready
for quick matching and immediate delivery.
Evidence of the value of umbilical cord blood stem cells for fighting
leukemia came in a June article in the medical journal The Lancet, by
Dr. John Wagner of the University of Minnesota. In the study, the
five-year probability of leukemia-free survival for patients was:
• 38 percent after transplantation of perfectly matched bone marrow
stem cells.
• 36 percent after slightly mismatched cord-blood stem cells.
• 60 percent after perfectly matched cord-blood stem cells.
A current limitation with cord blood stem cell transplants is that a
single umbilical cord has enough cells for only about a 120-pound
recipient. So Wagner has been changing tactics to transplant the
blood from two umbilical cords into a single patient.
''Two cords have enough cells for 93 percent of adults,'' says
Wagner. ``Our largest patient was 270 pounds.''
Another drawback of using umbilical cord blood stem cells is that
once they're used, they're gone, says Dr. Morton Cowan, director of
pediatric bone marrow transplantation at University of California in
San Francisco. A doctor can't go back to transplant more if needed --
as with bone marrow.
In the meantime, cord blood supporters continue trying to increase
donations.
''The major limitation is the number of units available,'' says
Banker, of the Leukemia Society. ``In a perfect world, if we could
recover a cord from every live birth, there would be a unit available
for every human.''
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StemCells subscribers may also be interested in these sites:
Children's Neurobiological Solutions
http://www.CNSfoundation.org/
Cord Blood Registry
http://www.CordBlood.com/at.cgi?a=150123
The CNS Healing Group
http://groups.yahoo.com/group/CNS_Healing
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