Umbilical cord blood could supplant bone marrow transplants

Several medical companies are developing different methods of using umbilical cord blood as a more effective and safer replacement for the traditional bone marrow transplant, according to The Wall Street Journal. Currently, the stem cell-rich bone marrow transplants are used to treat leukemia, lymphoma, and other blood disorders, but they can be incredibly dangerous for the host as it requires the body’s immune system to be wiped out to succeed.

Around 25 percent of patients die from the procedure itself while 30 percent die from a relapse in the disease, making it an option of last resort. Approximately 60 percent of the operations use marrow from the host themselves while the others find donors through siblings and unrelated matches called an allogeneic transplant. With allogeneic transplants, there is an additional risk that the host will develop a potentially lethal graft vs. host disease.

Cord blood is an attractive alternative because the stem cells contained within are immature and can lead to a successful transplant even if they are not an exact match with the host. This trait will, in turn, allow more patients the ability to qualify for an operation with potentially less risk of graft vs. host disease. However, because cord blood has only about 10 percent of the stem cells as bone marrow, it will take longer to engraft itself to the host who will then be vulnerable to dangerous infections for a more extended period.

Various options are currently in the development phase, each of which tackles the problem a little differently. Gamida Cell, for instance, cultures the cord-blood cells in nicotinamide which can produce a 100-fold increase in the stem count. Another, Nohla, instead uses a drug that compliments natural cord blood by creating a temporary immune system for the body while the stem cells engraft. Both methods have shown promising results in clinical trials.