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What have the over 25 years of umbilical blood transplants learned from us?

What have the over 25 years of umbilical blood transplants learned from us?



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What have the over 25 years of umbilical blood transplants learned from us?

The most synthetic and at the same time comprehensive answer to this question would be the humor:

The 25 years of umbilical blood stem cell transplantation have taught us that continuous progress and expansion of therapeutic uses are the hallmarks of this field.

But let's see how it all started ...

Year 1988 marked the beginning of this new and dynamic chapter in the field of stem cell transplantation. At 32 years after Dr. E Donnall Thomas's first bone marrow transplant, the joint effort of a team of Franco-American physicians was fully rewarded by the success of the first transplant with a placental fraternal blood transplant.

Matthew Farrow he was a boy of 5 years old, diagnosed with a severe form of Anemie Fanconi, a genetic disease of the blood, which causes an insufficient formation of new cells in the bone marrow, having as a consequence the anemia (reduced number of red blood cells), leukopenia (low blood leukocyte count) and thrombocytopenia (low blood platelet count). The available treatments could only improve some manifestations of the disease, but they could not cure or extend the patient's life. The only way to achieve this was by performing an innovative treatment at that time, respectively by performing umbilical blood transplantation, as a source of hematoform-forming stem cells.

The transplant was performed in France, at Saint-Louis Hospital in Paris by Dr. Eliane Gluckman, after the team led by researcher Dr. Hal E. Broxmeyer prepared the transplant graft for placental blood harvested at the birth of Mathew's sister.

At 27 years old from the transplant Mathhew Farow is a healthy young man, with a normal functional bone marrow and completely restored immune system. The cells in his blood continue to form on the basis of transplanted stem cells.

At the moment Mathew is 32 years old, he is married and the father of a 12 year old boy named Elijah. His life experience has led him to become an active promoter of informing future parents about the importance and value of umbilical blood banking.

In 2015, in an interview he stated: “My goal is to share my story to help increase the degree of information and understanding of the value of blood in the umbilical cord. There are so many people who don't really know its importance. ”

But why is umbilical blood important? And especially what I learned over the 25 years?

During the 25 years there were outlined 5 characteristic aspects and that reveal the therapeutic importance of the umbilical blood. These are:

1. The safety of umbilical blood collection for both the mother and the newborn. From this perspective, umbilical blood is the easiest way to obtain a zero-risk stem cell source. Harvesting is done at birth, after previously the last pulsations of the umbilical cord have ceased, the cord was cut, and the newborn was taken by the midwife to be given the first medical care.

The procedure for collecting umbilical blood is simple, painless and lasts between 30 seconds and 2-3 minutes, depending on the amount of blood remaining available in the umbilical cord and placenta. It can be performed regardless of the type of birth: by natural or by cesarean section.

The decision regarding the appropriateness of performing this medical procedure can only be determined by the obstetrician doctor, depending on the way the birth occurs.

2. Confirmation of the therapeutic value of umbilical blood grafts, through the more than 35,000 transplants performed worldwide to date. Umbilical blood is part of the 3 clinically validated hematoform stem cell sources, along with bone marrow and peripheral blood. In contrast to these two, umbilical blood has some unique features, which translate clinically into the benefits of transplantation. More details here.

3. Extending the use of umbilical blood grafts in adults and reducing the period of transplantation. The achievement of these 2 objectives were challenges of real interest among the researchers. Obtaining an increase in the cellularity of the grafts was the main way of achieving these objectives. In this sense, in the last years various methods have been proposed and evaluated, the first positive results not delaying to appear. An example is the publication in 2003 of the encouraging results obtained in a first study to evaluate the therapeutic efficacy of the use in tandem of 2 umbilical blood grafts in adult patients diagnosed with severe forms of leukemia.

4. Confirming the maintenance of the viability and repopulation capacity of the bone marrow by umbilical blood grafts after long-term storage.

The harvesting of umbilical blood being possible only at the unique moment of birth, it was necessary to identify a way by which the stem cells could maintain their viability for long periods of time, respectively until the moment of indication of their therapeutic use.

Following the research, it was found that these cells could remain alive (viable) during freezing, cryogenic storage at -196 ° C and thawing prior to administration, only if the umbilical blood collected was subjected to the processing procedure. This procedure consists of a prior preparation and treatment of the blood with a cryopreservation agent (most commonly used being DMSO), with obtaining a transplantable usable transplant.

In order to be able to perform all the intermediate steps until obtaining a stem cell transplant from the umbilical blood, it was necessary to create and implement an organized framework, regulating all the procedures, starting from the collection of the umbilical blood and ending with the release of the transplant graft. .

To this end, in 1992, the first public umbilical blood bank was set up, within the New York Blood Center (public banking), and in 1995 the first family bank was established in the US (family banking), so that both systems will know one later. significant development and expansion worldwide.

An essential aspect associated with the banking activity, was to obtain the answer to the question: what is the duration of maintaining the viability of the stored grafts? Thus, in order to be able to provide a response based on concrete results, Dr. Hal.E Broxmeyer, one of the most titled researchers in this field has conducted laboratory studies at various intervals.

Cryogenic umbilical blood samples for 5 years, 10 years, 15 years and 23.5 years respectively were evaluated after thawing by applying the same parameters that were used before freezing. The obtained results were comparable, confirming the preservation of stem cell viability and the ability to form cell colonies at 5, 10, 15 and 23.5 years of cryopreservation respectively.

Indeed, in an interview in 2014 he optimistically states "Based on laboratory studies, it is possible that umbilical blood grafts may be kept frozen for decades and continue to be a potent source of stem cells usable for transplantation."

5. The importance and role of umbilical blood grafts in the field of regenerative medicine

Laboratory researches and especially clinical studies carried out over the last 10 years have contributed to the increasingly clear contouring of the value of umbilical blood grafts for the new, avant-garde field of regenerative medicine. Patients with diseases with high incidence in the population and limited current therapeutic possibilities could benefit from the encouraging results of the increasingly numerous studies that are ongoing in this field.

Thus neurological disorders (childhood cerebral palsy, stroke, spinal cord trauma, Alzheimer's disease, autism spectrum disorders), cardiovascular diseases (myocardial infarction, congenital valvulopathies, arteriopathies) autoimmune diseases (multiple sclerosis, severe diabetes mellitus). type I at the beginning).

During the following articles I invite you to go through a journey in knowing the relevance and potential benefits of family umbilical blood banking.

Dr. Speranta Arciudean

Tags Benefits Stem Cells Placental Blood Stem cells in placental blood