A Local Bank Delivers Global Cures

By Jennifer Brinker, St. Louis Review, October 13, 2006

As a transplant physician at SSM Cardinal Glennon Children’s Hospital, Dr. Donna was becoming discouraged with her job.

Donna was attempting to treat her African-American patients with illnesses such as immune system disorders, sickle cell anemia, and leukemia, about ten years ago.

Her aggravation began when she had difficulty finding good matches for transplanting healthy stem cells to her patients. She ultimately turned towards umbilical cord blood, and achieved success.

The St. Louis Cord Blood Bank at Cardinal Glennon has rapidly grown to become the second-largest independent public cord blood bank in the world since its inception in 1995 says manager Regan McDermott. The purpose of the bank is to take blood donated from an infant’s umbilical cord, and handle the collection, processing, and storage of that blood.

Eventually, in order to build up a person’s immune system and make human blood, the stem cells from the cord blood are used in the transplantation of hematopoietic cells.

The fact that they are treating illnesses and at the same time doing so in a manner considered morally acceptable by the Catholic Church makes things even better for Regan and the staff at the St. Louis Cord Blood Bank.

The stem cells at the bank derived from an infant’s umbilical cord blood are referred to as adult stem cells, unlike embryonic stem cells, which are derived by creating and destroying human embryonic life.

Adult stem cells come from any human being who is born.

The Church has repeatedly taught that these stem cells are morally acceptable for research and treatments and do not bring harm to a person.

While the adult stem cells are capable of becoming any of the 220 tissues in the body (multipotent), scientists lack the ability to regulate their growth outside of the body says Reagan.

Cord blood and other adult stem cells are more fitting for use in human therapies because they are more mature and their growth can be directed in a predictable manner added Reagan.

Acute leukemias, Hodgkin’s Disease, immunodeficiency syndromes, congenital disorders, and more have been treated since 1997, with more than 1,000 units of blood exported around the world.

"That’s a huge number considering there have only been around 8,000 (umbilical cord blood) transplants worldwide," said Regan.

North America accounts for almost 84 percent of the cord blood unit export, but Europe, South America, Australia, and Asia, account for the other 16 percent.

"Because of the philanthropy of the women and doctors and nurses who work in this area, we have been able to serve people all over the world," she said.

A perfect match is not needed to be able to use the cells for treatment, which is the reason that stem cells from cord blood are so successful says Kathy, a nurse coordinator for the bank.

Cord blood stem cells have a better chance of adapting to another person’s system because they are more immature she said. However, a grown adult’s blood stem cells, in bone marrow for example, already are accustomed to the body in which they had been residing, and have a harder time adapting to another person’s system. Using human leukocyte antigen typing, a testing that determines whether a patient has a suitable donor for stem-cell transplant, a perfect match of six factors is needed for a bone marrow transplant.

But a match count as low as four out of six is acceptable for a cord blood transplant.

Thus, when trying to find a match, ethnic boundaries can be crossed.

"Maybe a Caucasian person is the best match for an African-American person. Or an African American is good for a Hispanic" person, said Kathy.

The survival rate of children who receive adult stem-cell transplants from umbilical cord blood is currently more than 55 percent and is improving for adults, said Regan. The practice of infusing two cords at once and the success of other newer applications is credited for the rate.

Traditional bone marrow transplants have a survival rate of about 35 percent, so cord blood transplants compare favorably said Reagan.

And those patients who cannot wait for a bone marrow search can benefit since cord blood products can be accessed more quickly.

Regan and the bank rely on the doctors and nurses and of course, the generosity of the parents who support the non-profit organization. More than 55,000 cord blood units have been collected since the bank started taking donations in 1996. To bring in donations, the bank works with 28 hospitals and 250 physicians in St. Louis and the metro East area.

The units were first only used in treating children because cord blood donations are so small, ranging from a teaspoon to eight ounces.

"It was thought that the numbers of cells that were in a cord blood unit that’s all you’ve got," said Regan. "You can’t go back to the baby and draw more cells."

But there are different ways in which adults could be treated using cord blood stem cells because of their adaptability, as researchers quickly found out. Now cord-blood products are used equally between children and adults confirmed Regan.

The transplant inventory holds between 25 and 30 percent of all the donated units, which translates to more than 14,000 units available for transplant. The remaining units are used for research purposes, she said.

Like other donor registries, such as bone marrow, it is more difficult to find minority donors stated Regan. She noted that the majority of cord blood donors are Caucasian.

In an effort to increase African American cord blood donations, the bank participates in the Charles Drew Community Cord Blood Donor Campaign, an effort of the American Red Cross, St. Louis University, Cardinal Glennon Hospital, St. Louis Children’s Hospital and the Washington University School of Medicine.

Thanks to affiliations with registries such as the National Marrow Donor Program and the Caitlin Raymond International Registry, both stem-cell donor registries, the bank continues to gain exposure.

Spinal cord injury, HIV/AIDS, multiple sclerosis, diabetes, Alzheimer’s and Parkinson’s diseases are all conditions that will be successfully treated with cord blood stem cells. And treatments are already bringing hope to those with life-threatening illnesses said Kathy.

However, "we’re very sensitive about making those claims," said Regan, because of the bank’s affiliation with the Food and Drug Administration as an investigational new drug application. \

"The FDA tells us you can’t make false claims about your products," she said.

"But there’s no reason we shouldn’t pursue all of those same applications from cord blood or adult stem cells that are being described from embryonic stem cells," said Regan.

"We like to say with the technology available today, this is what we know will work," she said. "We get those calls every day, “My daughter has diabetes,” or “So and so has this. Will it help?” We just say honestly we don’t know, but this is what we know it does today."