Tapping into a promising new therapeutic technique for a host of pediatric disease, doctors and researchers at the Medical Center are collecting umbilical cord blood from recently-born babies.
"Cord blood is an exciting new avenue of therapy for many people who don't have other good alternatives to treat severe medical illnesses," said David Rizzieri, associate professor of oncology. The blood is rich in stem cells-undifferentiated cells that can later grow into anything from muscles to nerves.
When transplanted into patients, the cells can be induced to differentiate as needed. Stem cells are a key element in new therapies for cancer, metabolic problems and other congenital defects. Until recently, such conditions necessitated bone marrow transplants.
Future uses for cord blood may include treatment of genetic disease such as sickle cell anemia and thalassemia, said Joanne Kurtzberg, professor of pediatric hematology and oncology.
The Medical Center's cord blood program allows new parents to donate their child's cord blood for storage and eventual treatment of diseases.
Cord blood is a more attractive treatment option than bone marrow transplantation because cord blood donors do not have to be as closely matched to patients. In order for a bone marrow transplant to be successful, six of six antigens, or cell surface proteins, must match. Only four of six need to match for a cord blood treatment to function.
Prospective patients can choose between two methods of obtaining cord blood: public banks and private banks. Public banks, like the University's, accept donations of cord blood and then distribute it to patients as needed.
Private banks charge a fee for extraction and storage of a child's cord blood. Once stored, however, the cord blood is property of the parents and can be used at their discretion.
"Most of the cord blood transplants performed in the past five years have been in children. The effects of cord blood in adults are just beginning to be studied," said Kurtzberg. The massive St. Louis Cord Blood Bank, which stores more than 4,000 units, is the largest public bank in the United States. Operating in a similar fashion to the Duke facility, this bank takes donations from 40 Missouri hospitals and provides blood worldwide.
Each cord transplant costs $15,000, in accordance with Food and Drug Administration regulations. "That is considerably less expensive than bone marrow," said Kathy Mueckl, nurse coordinator of the St. Louis Cord Blood Bank, who added that bone marrow transplants could range in price from $30-100,000.
At the University, it costs between $1,500 and $2,500 to collect and test an individual's cord blood.
The largest private cord blood bank, with more than 11,000 units, is the Cordblood Registry, based near San Francisco, Ca. The company, for a fee of $1,200, stores cord blood in its University of Arizona-based lab.
In the three years of operation, the Cordblood Registry has used seven units. In only 18 months, the St. Louis Bank has distributed 50.
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