More Promise Found in Umbilical Blood

Blood from umbilical cords can build new immune systems for adults with leukemia, offering a potentially lifesaving treatment for the many patients who cannot find suitable bone marrow donors.

An estimated 4,000 to 6,000 Americans die each year while awaiting a bone marrow match.

Until now, stem cells drawn from umbilical cord blood have been reserved mostly for treating children. Because an umbilical cord contains only a tenth as many stem cells as a marrow donation, experts believed there was too little tissue to reconstitute the immune defenses of an adult.

However, new research shows that because the umbilical cord cells proliferate so rapidly they can indeed be used to treat adults.

In the first U.S. study of cord blood transplants in adults, researchers at University Hospitals of Cleveland and other sites gave 68 adults cord blood transplants from unrelated donors.

While infections, bleeding and other complications killed many of the patients within months, nearly one-third survived long term, about the same as with bone marrow transplants.

“This field will explode” and may even replace bone marrow and other sources of stem cells, said Dr. Andrew L. Pecora, director of the blood and marrow stem cell center at Hackensack University Medical Center in New Jersey. “Cord blood transplantation holds the promise of making it so everyone has a donor.”

The research is reported in today’s New England Journal of Medicine.

Dr. Mary J. Laughlin, director of the transplant program at University Hospitals of Cleveland, said that within five years stem cells from cord blood will be used for repairing damaged blood vessels in heart and stroke patients, repairing brain tissue in Parkinson’s disease patients and, in diabetics, replacing pancreas cells that are not producing enough insulin.