Umbilical cords are used to gather cells for transplant in patients to launch a new blood supply after chemotherapy. Dr. Elizabeth Shpall is a professor in MD Anderson’s Department of Stem Cell Transplantation and Cellular Therapy.
“Cord blood has become a source — a very mainstream, now, source — of support for patients who need a bone marrow transplant but don’t have a donor. So the first transplant was done in 1988 and it’s just exploded on the scene since then, and now there’ve been more than 20,000 transplants.”
The big issue has been that cord blood hasn’t been yielding enough cells for transplant so it takes longer for the new blood supply to fully engage. That leaves the patient subject to infection and bleeding problems. Dr. Shpall says by taking blood from one of two donated umbilical cords and growing it in the lab on a bed of cells taken from bone marrow, researchers greatly increased the number of cells transplanted and reduced recovery time.
“The most recent strategy, where we would get part of the bone marrow that you can grow and put it into flasks, and it’s kind of like the nurturing surrounding region of the marrow. And when would do that and put the cord in there and culture it for two weeks, we got dramatically higher numbers of engrafting cells. And the report in the New England Journal showed a statistically significant improvement not only in the time to engraftment but the number of patients who actually engraft at all.”
That technique achieves a median 12-fold increase in total cells transplanted and a 40-fold increase in the cells that are crucial for engraftment. Dr. Shpall’s paper on the technique was published in the New England Journal of Medicine. What does that mean?
“Well, lots of phone calls! Hopefully we get more grants to continue to refine the institution, because this is considered a very good publication, in terms of the impact factor. It’s more verification that what we’re doing may actually help the patient.”
A randomized trial is up next.
“And so it has brought together lots of colleagues, not only in the United States but in Europe, to try and get this randomized study done and definitively prove it. And then it becomes a big deal Then it’s a standard of care and insurance companies will cover it, et cetera.”
If you are a parent-to-be, you may want to read the article “Cord Blood Decision Difficult for Parents-to-be.”