An alternative to embryonic stem cells, umbilical cord blood (the blood that remains in the umbilical cord and placenta following birth) contains adult stem cells and offers excellent opportunities for research.
Loyola University Health System researchers will explore the benefit of double cord blood transplant in a federally funded study through the Center for International Blood and Marrow Transplant Research. A double cord blood transplant is blood from two different umbilical cords. Loyola also is planning a clinical trial later this year that will look at a way to grow cord blood outside of the body to reduce complications following cord blood transplants.
Already, umbilical cord blood transplants at Loyola are curing or slowing the progression of many cancers originating in the bone marrow (e.g., leukemia, myeloma) or lymphatic system (lymphoma).
"Umbilical cord blood is a rich source of stem cells from which new, healthy blood and immune cells can be produced," said Dr. Patrick J. Stiff, professor of medicine and pathology, Loyola University Chicago Stritch School of Medicine, Maywood, Ill. "Patients unable to find a matching bone marrow donor may have an alternative with umbilical cord blood transplantation." More than 106,000 people in the United States each year are diagnosed with these life-threatening diseases. In addition, 10,000 to 15,000 people are unable to find a suitable bone marrow donor among relatives or from the national bone marrow donor registry. "Because cord blood cells are more easily matched to recipients, cord blood transplantation may offer greater treatment options to patients," said Stiff.
"Umbilical cord blood matching is less restrictive than that of bone marrow, which must be perfectly matched between donor and recipient for best results."
Stem cells produce white blood cells, which fight infections; red blood cells, which carry oxygen to the tissues and organs; and platelets, which help clot the blood, preventing excessive bleeding. Bone marrow, which is comprised of red and white blood cells, platelets and stem cells, is found in the center cavities of all bones as well as within the ends of the long bones of the arms and legs.
A transplant provides the patient with healthy, new stem cells to develop a new immune system.
"The goal of the umbilical cord blood stem cell transplant is to replace diseased or nonfunctional stem cells with healthy stem cells," said Stiff. "The transplant can also be used to replace cancer patient's bone marrow cells that are damaged from high-dose chemotherapy or radiation therapy. These new cells may cause the bone marrow to again function normally."
Loyola has the largest bone marrow transplantation program in Illinois, performing 160 transplants each year. It is a participating center in the National Marrow Donor Program network. Loyola physicians have performed more than 40 adult umbilical cord blood transplants and Loyola was the first center to report the successful use of cells grown outside of the body for transplantation purposes.
Stiff has developed a unique method of preparing umbilical cord blood that enables more stem cells to survive and provide a leukemia or lymphoma cancer patient with a new immune system. He is working on further increasing the number of stem cells that can survive.
Loyola has been awarded a $1.4 million research grant by the state of Illinois. With funding from the Illinois Regenerative Medicine Institute (IRMI), Loyola researchers are investigating ways to grow both blood stem cells and immune cells from cord blood stem cells outside the body. "The ultimate goal," Dr. Stiff said, "will be to use these cells as a stem cell transplant source for those adults without related or unrelated living donors, making it possible for the first time to find a donor for everyone needing a transplant to fight cancer.
Of the 3,000 cord blood transplant procedures that have been performed worldwide, only a small portion have been on adults, due to the limited number of stem cells in these small cord blood samples.
Loyola is focusing its research on cord blood transplantation to increase the number of adults who have access to this potential curative therapy.
"It can be painlessly and safely collected after the umbilical cord has been clamped and cut," said Stiff. "Since a cord blood donation yields far fewer stem cells than a bone marrow donation, the procedure has been used primarily in children and teens. Therefore, we need to find ways to grow these cells outside the body for broader use in adult patients.
"The critical time for patients is after transplant but before engraftment when the transplanted cells start making blood cells," said Stiff. "During this in-between time, the blood counts are low, so it is a delicate balancing act of treating the disease and protecting the patient from rejection and infection. In addition, we are learning that late infections are also a problem as more patients are going home after this critical first part of the transplant. This new research will develop a method to boost immunity after the transplant is completed."
Much of the research is taking place in the new McCormick Tribune Foundation Center for Cellular Therapy, located in Loyola's Cardinal Bernardin Cancer Center. Here, scientists can produce pure cell populations that are contaminant-free for infusion into cancer patients. For information on Loyola's umbilical cord blood program, cancer treatment or physician referral, visit www.LoyolaMedicine.org or call (888) LUHS-888.