Posted on 11/24/2004 4:24:09 PM PST by tvn
For decades, 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 adult patients 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 rich in stem cells that are capable of developing into every kind of blood cell.
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."
Two new studies in the New England Journal of Medicine showed that while bone marrow from a related donor is the best chance of surviving leukemia, umbilical cord blood was just as good as using bone marrow from a bone marrow bank.
"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."
Umbilical cord stem cell research could stand much more attention by liberals, in the public eye, and in the lab.
Here's where I think an "opt-out" plan on umbilical cord donation is in order. Unless someone says something specifically about the umbilical, it goes to help further science and medical treatments. Since the umbilical has served its purpose and is no longer needed by the baby, there should be no real ethical concerns at that point.
Considering that umbilical cords and placentas are now collected for their collagen, it seems reasonable that their blood stem cells would be harvested as well.
ping
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