Medical Device Daily

ATLANTA — About 20 some odd years ago, the idea of using umbilical cord blood or “cord blood” to cure some aliments in children was laughable to some segments of the medical community. Cord blood was thought of as a discarded material not fit for any further applications.

That was until Hal Broxmeyer PhD, of the IndianaUniversity School of Medicine (Indianapolis) and his colleagues became pioneers in using cord blood as a means of cell replacement. Broxmeyer, a pioneer of cord blood research, spoke to a standing room only audience at the Georgia World Congress Center, during the 49th Annual Meeting of the American Society of Hematology (Washington), which will end today.

Umbilical cord blood is human blood from the placenta and um bilical cord, collected after the cord has been detached from a newborn baby. Cord blood is utilized as a source of stem cells for transplantation and is usually cryogenically frozen and stored.

“Over 6,000 probably closer to 10,000 cord blood transplants have been done for a variety of malignant and non malignant tumors,” Broxmeyer said. “The road to and the future of cord blood transplantation has been an exciting, satisfying and rewarding trip. But I think it’s clear to everyone that it’s not finished yet.”

Broxmeyer helped establish the world’s first Cord Blood bank and in 1988, his research led to cord blood stem-cell treatment of a five-year-old boy with Faconi anemia. The disease is usually characterized by short stature, skeletal anomalies, increased incidence of solid tumors and leukemias, bone marrow failure (aplastic anemia), and cellular sensitivity to DNA damaging agents such as mitomycin C.

Before Broxmeyer’s findings hematopoietic stem cells (HSC) were derived from bone marrow – but often proved ineffective because of its low cell count.

Cord blood was successful as long as it was frozen when it was stored and retained more HSC, those cells with the uncanny ability to form multiple cell types multipotency and their ability to self-renew.

“Why do we find that cord blood worked,” he asked the audience rhetorically. “It was because of the quality and not the quantity of the cells.”

The procedure has been pushed along dramatically because of scientific findings and legislative support.

Nearly two years ago, Rep. Chris Smith (R-NJ) passed legislation to increase usage and research into cord blood stem cells. Smith’s Stem Cell Therapeutic and Research Act of 2005 authorized $265 million for stem cell therapy, umbilical cord blood and bone marrow treatments.

The bill, which was signed into law by President George Bush, in December 2005, authorizes $79 million for the collection of cord blood stem cells with the goal of building the nation’s public umbilical cord blood supply by adding 150,000 new units to the current inventory. The intention of the law is to collect a genetically diverse cross-section of cord blood units in an effort to make matches available to 90% of patients in need.

It also created a national registry to match cord blood for those in need. All the cord blood banks participating in the inventory program would be linked into a search system that would allow transplant physicians to search for cord blood and bone marrow matches through a single access point.

The bill helped give cord blood a stronger footing and allowed for greater insight to be gleaned from its usefulness. With such a significant push researchers are now faced with questions as to what is the future of cord blood and its possible applications.

The answer is looking at each individual harvest and getting as many HSCs as possible.

“Gordon Douglas went into the placenta to get more cells out,” he said. “He was able to double the output of cells that are normally found from a simple cord blood harvesting procedure. In the future you’re going to see researchers go for a greater expansion of these cells.”

There are still some issues that are stumbling blocks for the procedure. Some are ethical. Often the question of private banking for cord blood has raised objections from many governments and nonprofit organizations. The controversy centers on varying assessments of the current and future likelihood of successful uses of the stored blood.

Despite those issues, Broxmeyer said that the field will continue to grow.

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