Transplants using cord blood stem cells seem to be a fairly common occurrence in medicine today. The first successful cord blood transplant occurred 27 years ago, in 1988, when a young boy was successfully cured of Fanconi anaemia using the stem cells collected from umbilical cord of his younger sister.
Since then, more than 30,000 transplants using cord blood stem cells have taken place around the world (Ballen, Gluckman & Broxmeyer, 2013). The medical fraternity has quickly realised the potential of the stem cells collected from umbilical cord, with many public and private stem cell banks being established in the past two decades. Currently, there are more than 600,000 umbilical cord blood samples preserved.
This article will take a look at the history of using cord blood stem cells in transplants.
Researchers Discover the Value of Umbilical Cord Blood Stem Cells
While bone marrow stem cells have been used to treat a number of illnesses since the 1960s, the stem cells collected from umbilical cord blood weren’t discovered until 1974 (Altman & Baehner, 1974). Over the next decade, researchers continued to analyze the components of cord blood, discovering their incredible potential.
It wasn’t until 1982 that researchers talked about using the hematopoietic stem (HSC) and progenitor (HPC) cells in cord blood for transplantation (Ballen, Gluckman & Broxmeyer, 2013).
In 1988, studies led by Dr. Edward A. Boyse found that umbilical cord blood stem cells could restore blood cell production and immune system function in the same way that bone marrow transplants would.
In 1989, the ground-breaking paper Human umbilical cord blood as a potential source of transplantable hematopoietic stem/progenitor cells analyzed the capabilities of umbilical blood stem cells in detail (H E Broxmeyer, 1989). This paper helped the medical community understand that umbilical cord blood could be safely used instead of bone marrow for most procedures.
Transplants Using Cord Blood Stem Cells
The first transplants occurred before scientists fully understood how the stem cells collected from umbilical cord blood functioned. In 1963 a cancer patient was injected with the cord blood of 17 babies to treat her metastatic sarcoma. Her condition improved briefly, but she passed away.
In 1970 another attempt was made to use umbilical cord blood on a patient with cancer. This time scientists used the cord blood from eight different babies to treat a leukaemia patient. The treatment was ineffective, but the patient later recovered using conventional forms of treatment.
The first successful stem cell transplant occurred in 1988 when a young boy was successfully cured of Fanconi Anaemia. He received a stem cell transplant from his baby sister. He is still alive and well today, completely free of the disease. His sister was a 100% compatible donor (HLA-identical) and the surgery was performed without any complications.
Shortly afterwards, in 1992, the world’s first public umbilical cord blood bank was established in New York by Dr. Pablo Rubinstein. Previously umbilical cord blood was discarded as medical waste. This cord blood bank helped increase the awareness of the value of cord blood.
In the same year, the first privately owned cord blood sample was placed into storage. Dr David Harris, professor of microbiology and immunology at the University of Arizona, stored the umbilical cord blood of his son Alexandre.
The first cord blood transplant between unrelated donors occurred in 1993 in the United States. The cord blood sample used in the procedure came from the New York Blood Centre, the public cord blood bank which had been created one year earlier.
By 1998 the United States launched a cord blood registry, managed by the National Marrow Donor Program. Later that year, umbilical cord blood stem cells were used to cure a person with sickle cell disease, a world first.
A research paper in 2003 demonstrated that cord blood could be successfully frozen for long periods while retaining high levels of stem cell viability. It showed that cord blood samples frozen for 15 years were as good as fresh samples of umbilical cord blood.
Another important research breakthrough occurred in 2004 when scientists discovered that pluripotent stem cells in cord blood could be used to create many types of cells. This was an important breakthrough in the field of regenerative medicine.
Around this time, more hospitals actively began promoting the donation of umbilical cord blood to public banks. This greatly increased the number of samples being preserved. Regulatory bodies also began creating better guidelines for the transportation, storage and transplantation of cord blood.
Governments around the world began creating legislation to encourage the storage and use of umbilical cord blood. Over the next 6 years, the United States introduced the Stem Cell Therapeutic and Research Act of 2005 and the Cord Blood Education and Awareness Act of 2009. By 2011 most parts of the world have educational programs that encourage parents to publicly or privately bank their child’s umbilical cord blood.
Umbilical cord blood stem cells are now used to treat nearly 80 illnesses. Recent trials have indicated that cord blood may also play a role in treating autism, cerebral palsy, diabetes and blindness. It is a very exciting time for stem cell researchers and the next few decades are guaranteed to contain some exciting new breakthroughs.
Sources:
Ballen, K., Gluckman, E., & Broxmeyer, H. (2013). Umbilical cord blood transplantation: the first 25 years and beyond. Blood, 122(4), 491-498. doi:10.1182/blood-2013-02-453175
H E Broxmeyer, E. (1989). Human umbilical cord blood as a potential source of transplantable hematopoietic stem/progenitor cells. Proceedings Of The National Academy Of Sciences Of The United States Of America, 86(10), 3828. Retrieved from ncbi.nlm.nih.gov/pmc/articles/PMC287234/
Altman, A., & Baehner, R. (1974). PRODUCTION OF GRANULOCYTIC COLONIES IN-VITRO FROM THE PERIPHERAL BLOOD (PB) OF A CHILD WITH ADULT-TYPE CHRONIC GRANULOCYTIC LEUKEMIA (CGL). Pediatr Res, 8(4), 397-397. doi:10.1203/00006450-197404000-00340
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