Umbilical cord blood in the treatment of blood cancer

magter13Blood has a number of vital functions in human body. No wonder, human life is only possible as long as the heart pumps blood through the vessels.

The red blood cells (erythrocytes) carry oxygen throughout the human body, white blood cells (leukocytes) provide immune defense, and platelets (thrombocytes) are involved in blood clotting under conditions of vascular injury.

All blood cells are produced in the bone marrow. This is the most important hematopoietic organ that is localized within the pelvic bones, as well as in the epiphysis of long bones and, to a lesser extent, within the vertebral bodies.

The science that deals with blood diseases is called hematology. Blood pathology, mainly includes conditions, in which hematopoiesis is insufficient (anemia) or abnormal (blood malignancies (leukemias). In the latter case, instead of the normal full-functional blood cells malignant bone marrow produces abnormal cells that will eventually displace normal hematopoiesis. It is important that the pathological foci of hematopoiesis may occur in other organs, impairing their function .

Currently, malignant blood diseases are widespread worldwide and in Ukraine, and are leading in the structure of cancer in children. The only way to cure some forms of leukemias and lymphomas is the destruction of pathological hematopoiesis by high-dose chemotherapy and transplantation of bone marrow of a healthy patient.

thomas_postcardThe first transplantation of hematopoietic (blood-forming) stem cells of the bone marrow was held in 1959, by Donnal Thomas, the future Nobel laureate. And in 1973, in London the world’s first Bone Marrow Donor Registry was created, including volunteers, willing to donate part of their bone marrow to immunologically compatible patient. Currently, the global registry has about 22 million potential donors of hematopoietic stem cells. However, the complications of the search for immunologically compatible transplants (sometimes the probability of finding a compatible bone marrow is 1 : 1 000 000) led scientists to look for alternative sources of hematopoietic stem cells. Due to considerable polymorphism of human immune passport or speaking the language of science – HLA system (human leukocyte antigen), even in modern conditions it is sometimes impossible to find unrelated matching donor for each patient. It is especially difficult to find an immunologically compatible bone marrow to children of mixed marriages and ethnic minorities.

gluckmanIn 1974, it was proved that cord blood contains a sufficient amount of the same hematopoietic stem cells as bone marrow. The first transplantation of umbilical cord blood instead of bone marrow was conducted in 1988 by Professor Eliane Gluckman in Paris to a child with Fanconi’s anemia. The patient for more than 25 years is healthy and leads a full life.

In 2006, the European Group For Bone Marrow Transplantation (EBMT) announced that cord blood is equivalent to the bone marrow, confirming it again in 2010. Uptodate cryotechnologies allow to store cord blood in liquid nitrogen (-196 C) indefinitely. So many conscious parents worldwide, and in Ukraine, preserve cord blood, collected at birth of their children as a biological insurance against the disease, which is treated by bone marrow transplantation. At the same time, in the developed world the public cord blood banks, funded by the stare are actively operating.

EBMT_logoAs of 2013, the number of umbilical cord blood hematopoietic stem cell transplantations exceeded 30,000. The number of cord blood transplants performed in children is about 1250 transplants per year. At the same time, according to the World Marrow Donor Association (WMDA), the number of cord blood transplants in adult patients in the world has grown to 2,750 transplants per year. Also it was estimated that over the period from 2006 to 2010, 45% of unrelated hematopoietic stem cell transplantations in ethnic minorities were performed with the use of umbilical cord blood. To date, the public cord blood banks store about 600,000 samples, and at least as many samples the parents stored in autologous banks of a family type.

WMDAAccording to modern research, umbilical cord blood is the preferred source of stem cells in a number of congenital diseases of metabolism. Also it was proved that even in the case of incomplete immunological compatibility the risk of posttransplant complications is lower when umbilical cord blood is used compared to the adult bone marrow donor. This is because the umbilical cord blood contains young cells, which are less immunogenic.

The scientists in recent years made significant progress in the expansion (increase of the number) of cord blood stem cells, as well as production of immunobiological preparations to support the immune system of patients in the post-transplant period and treatment of rejection reactions. At the same time prenatal stem cell transplantation (before birth) is being actively developed in the treatment of genetic diseases of metabolism and hematopoiesis. We can already talk about the successes in the treatment of severe immunodeficiencies by prenatal stem cell transplantation.

And that’s not all the benefits of umbilical cord blood, which is a precious elixir, presented a child by the nature.

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