Umbilical cord blood can help leukemia patients

Discuss stem cells, adult and embryonic, and their therapeutic potential for MS here.

Umbilical cord blood can help leukemia patients

Postby adjanimals » Wed Nov 24, 2004 9:36 pm

Found this on CTV.ca about umbilical cord blood used to help a leukemia patient.
I know the U of W, Madison is doing stem cell reaserch.
http://www.news.wisc.edu/packages/stemcells/
It would be nice if some trials would be started for use in MS.

http://www.ctv.ca/servlet/ArticleNews/s ... TopStories

Umbilical cord blood can help leukemia patients
CTV.ca News Staff

For decades, adult leukemia patients have had to rely on finding a bone marrow donor to give them a new supply of blood cells. Now, two studies show that adults can safely use umbilical cord to help them rebuild their health.

Elizabeth Rhodes is alive today because of umbilical cord. She was diagnosed with leukemia and was told she needed a bone marrow transplant to survive.

Leukemia patients often undergo radiation or chemotherapy to kill their cancerous white blood cells. But the treatment also wipes out their immune systems. Bone marrow is often recommended because it's rich in

Now, two new studies in the New England Journal of Medicine show that while bone marrow from a related donor is the best chance for an adult surviving leukemia, umbilical cord blood is almost as good..

But for Rhodes, there were no suitable donors in her family or in any public bone marrow bank -- leaving her in a not uncommon predicament for leukemia patients.

As she continued to search for a suitable donor, time was running out. So doctors at a Cleveland hospital turned to a new experimental source -- stem cells from umbilical cords.

"I am alive and well and working full time. I have my normal life restored to me," Rhodes says -- all because of a medical product that is usually disposed as medical waste.

"The baby and the mother don't need this umbilical cord anymore and by preserving it, it offers the opportunity for others like myself a chance to go on living," she says.

The wonders of umbilical cord blood are well-known. But until now, cord blood was considered suitable only for children, because each donation has only about one-tenth the number of stem cells in a marrow donation.

Now, two new studies in the New England Journal of Medicine show that while bone marrow from a related donor is the best chance for an adult surviving leukemia, umbilical cord blood is almost as good.

"Umbilical cord blood as a medical therapy is a valuable asset," believes Dr. Mary Laughlin, an Associate Professor of Medicine at Case Western Reserve University School of Medicine.

What's more, retrieving umbilical cord is easier that extracting bone marrow, which is highly painful for the donor. Harvesting umbilical cord blood after birth is simple and can be made available in a matter of weeks.

"It offers a treatment modality for patients who wouldn't otherwise undergo this procedure," says Laughlin.

Dr. Laughlin led a team of researchers in collaboration with the International Bone Marrow Transplant Registry, headquartered at the University of Wisconsin in Milwaukee, and the New York Blood Center National Cord Blood Program. They compared treatment results in more than 500 adult leukemia patients.

Researchers directly compared patients who had cord blood stem cell transplants with two groups: patients who had fully-matched unrelated bone marrow transplants and patients who had one antigen-mismatched unrelated bone marrow transplants. The study included patient's ages 16 to 60 years who underwent transplants in the United States during a six-year period ending in 2001.

Survival rates were highest -- about 33 per cent -- for bone marrow transplants with matched unrelated donors. Survival rates were the same -- about 22 per cent -- for cord blood and antigen-mismatched unrelated bone marrow transplant patients.

A European study involving 682 patients produced similar results. It found that those who got cord blood were just as likely to be free of leukemia two years later as those who got marrow.

For Laughlin, the results clearly indicate the efficacy of cord blood stem cells when bone marrow donors are unavailable.

Dr. Pierre Launeville of Royal Victoria Hospital in Montreal says this means thousands more leukemia patients in North America will be offered a lifesaving transplant each year.

"It's wonderful in that it's fully accessible and is used in a manner that doesn't inconvenience or harm anyone. It's a wonderful opportunity," he says.

But the discovery means that more people will need to donate to public umbilical cord storage banks. There are already some 60 around the world, and two in Canada.

"We would like to store as many samples as we possibly can and our aim in the interim is to get about 1,000 samples a year. No one knows how many samples will be adequate in the future."
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Postby adjanimals » Wed Nov 24, 2004 9:49 pm

Article from cbc.ca basically the same with more info.

http://www.cbc.ca/story/science/nationa ... 41124.html

Umbilical cord blood can help treat adults with leukemia: studies
Last Updated Wed, 24 Nov 2004 21:51:34 EST
EDMONTON - Blood from umbilical cords of newborns can be used in place of bone marrow for some adults with leukemia, doctors say.

Bone marrow transplants are used to restore the immune systems of leukemia patients after radiation and chemotherapy.


Umbilical cord blood can save adults with leukemia.
Matching marrow from a brother or sister works best, although this option is only available to about 30 per cent of potential recipients.

Now, two studies in this week's issue of the New England Journal of Medicine have concluded cord blood works nearly as well as unrelated bone marrow for leukemia patients.

Researchers from Europe and the U.S. studied hundreds of adult patients who were successfully treated with cord blood containing stem cells, which are less likely to attack the recipient's body than marrow.

"It's exciting because, if you think of it, what do we do with cord blood, we throw it in the garbage," said Dr. John Akabutu, director of the Edmonton Cord Blood Bank. "Now all of a sudden we've discovered there are some very important cells in that garbage that can save people's lives."



FROM OCT. 23, 2002:Life-saving cord blood bonds mother, daughter

So far, one Canadian adult has received the treatment. The Montreal woman fully recovered from leukemia after receiving cord blood collected from her own child's umbilical cord.

About 80 children in Canada have also received cord blood transplants.

Doctors caution nearly two-thirds of the adults who received cord blood transplants died, which is a higher proportion than among those who received matched bone marrow from someone other than a relative.

Bone marrow remains the first choice, but for 25 per cent of the 4,000 new cases diagnosed in Canada each year, a bone marrow match can't be found. They almost always die.

"What's important about cord blood is it provides us even another way of getting a transplant," said Dr. Clayton Smith, who was part of the original research team at Duke University in North Carolina.

Smith recently joined the B.C. Cancer Agency, which will begin offering cord blood transplants within a few months.

Given the results of the studies, doctors should consider searching for an unrelated donor in both bone marrow and cord blood registries, said hematology researcher Miguel Sanz of Hospital Universitario La Fe in Spain. Sanz wrote a editorial accompanying the research.

Written by CBC News Online staff
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Postby adjanimals » Fri Nov 26, 2004 12:34 pm

Another interesting article from the Associated Press in the New York Times

http://www.nytimes.com/2004/11/26/healt ... f840b1b0cd

In Studies, Umbilical Cord Blood Shows Promise for Adults
By THE ASSOCIATED PRESS

Published: November 26, 2004

Umbilical cord blood, now used mostly to treat children with leukemia, could save thousands of adults with the disease each year who cannot find bone marrow donors, two large studies indicate.

A European study found that those who got cord blood were just as likely to be free of leukemia two years later as those who got marrow. A United States study looking at three-year survival yielded results almost as promising.

Leukemia patients often undergo radiation or chemotherapy to kill their cancerous white blood cells, a treatment that wipes out their immune systems, too. To restore their immune systems, doctors give these patients an infusion of bone marrow or umbilical cord blood, both of which contain stem cells capable of developing into every kind of blood cell.

Cord blood offers an important advantage over marrow that makes it particularly valuable for use in transplants: its stem cells are less likely to attack the recipient's body. That allows a wider margin of error in matching up donors and recipients.

Up until now, though, cord blood has been considered suitable only for children because each donation has only about one-tenth the number of stem cells in a marrow donation.

The two new studies, published yesterday in The New England Journal of Medicine, suggest that is not a serious impediment.

In the European study, involving 682 patients, about a third of both those who got matched marrow and those who got cord blood that did not quite match their own tissues were alive after two years. In the American study of 601 patients, about a third of those who got matched marrow were leukemia-free after two years, compared with about one-fifth of those who got cord blood or unmatched marrow.

Both studies were based on records from transplants in the late 1990's and early 2000's.

Using cord blood could improve the odds of getting a transplant for the 16,000 American adult leukemia patients each year who cannot find a compatible marrow donor, said the leader of the United States study, Dr. Mary J. Laughlin of Case Comprehensive Cancer Center in Cleveland.

Still, Dr. Nancy Kernan, assistant chief of marrow transplantation at Memorial Sloan-Kettering Cancer Center in New York, said cord blood transplants in adults should be done only as part of studies to look at and improve their effectiveness.

Public cord blood banks, where blood drawn from umbilical cords and placentas at birth is kept frozen, need to quadruple their supply to find a match for every leukemia patient who needs one. With four million births a year in this country, and most cord blood thrown away, that should not be a problem once more public money comes into play, doctors said.

A federal Institute of Medicine committee is already looking into the best way to set up a national cord blood supply and is scheduled to complete its report in March.

"I know our committee will consume this study avidly," said Kristine Gebbie, chairwoman of the group.

The first bone marrow transplants were done in the 1960's; cord blood transplants started in the 1990's. Stem cell transplants save only 20 percent to 30 percent of the patients who hope to grow new immune systems. But without the treatment, virtually all of them would die.
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Postby adjanimals » Sun Nov 28, 2004 3:12 pm

Another one on cord blood.

http://www.optusnet.com.au/news/story/a ... 253284.inp

Cord blood stem cells cure paralysis
3:23 PM November 28

A South Korean woman paralysed for 20 years is walking again after scientists repaired her damaged spine using stem cells derived from umbilical cord blood.

Hwang Mi-Soon, 37, had been bedridden since damaging her back in an accident two decades ago.

South Korean researchers last week went public for the first time with the results of their stem cell therapy.

Ms Hwang walked into their press conference with the help of a walking frame.

The researchers say that it is the world's first published case in which a patient with spinal cord injuries has been successfully treated with stem cells from umbilical cord blood.

The researchers caution that more research is needed and verification from international experts is required but the case could signal a leap forward in the treatment of spinal cord injuries.

The use of stem cells from cord blood could also point to a way to side-step the ethical dispute over the controversial use of embryos in embryonic stem cell research.

"We have glimpsed at a silver lining over the horizon," Song Chang-Hoon, a member of the research team, said.

"We were all surprised at the fast improvements in the patient."

Ms Hwang stood up from her wheelchair and shuffled forward and back a few paces with the help of the frame at the press conference.

"This is already a miracle for me," she said. "I never dreamed of getting to my feet again."

Multipotent cells

Medical research has shown stem cells can develop into replacement cells for damaged organs or body parts.

Unlocking that potential could see cures for diseases that are at present incurable, or even see the body generate new organs to replace damaged or failing ones.

"Multipotent" stem cells, such as those found in cord blood, are capable of forming a limited number of specialised cell types, unlike the more versatile "undifferentiated" cells that are derived from embryos.

However, these umbilical cord blood stem cells have emerged as an ethical and safe alternative to embryonic stem cells.

Clinical trials with embryonic stem cells are believed to be years away because of the risks and ethical problems involved in the production of embryos, which are regarded as living humans by some people, for scientific use.

In contrast, there is no ethical dimension when stem cells from umbilical cord blood are obtained.

Additionally, umbilical cord blood stem cells trigger little immune response in the recipient.

Embryonic stem cells have a tendency to form tumours when injected into animals or human beings.

Technical difficulties

For the therapy, multipotent stem cells were isolated from umbilical cord blood, which had been frozen immediately after the birth of a baby and cultured for a period of time.

These cells were then directly injected to the damaged part of the spinal cord.

"Technical difficulties exist in isolating stem cells from frozen umbilical cord blood, finding cells with genes matching those of the recipient and selecting the right place of the body to deliver the cells," Han Hoon, president of government-backed umbilical cord blood bank Histostem, said.

Dr Han teamed up with Dr Song and other experts for the experiment.

They say that more experiments are required to verify the outcome of the landmark therapy.

"It is just one case and we need more experiments, more data," Oh Il-Hoon, another researcher, said.

"I believe experts in other countries have been conducting similar experiments and accumulating data before making the results public."

- AFP

Source: AFP
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