x Abu Dhabi, UAEWednesday 24 January 2018

Blood storage offers new kind of cure

As stem-cell therapy advances, a decision to store your newborn's umbilical cord blood now could turn out to be a solid investment in his future.

Umbilical cord blood, which is a rich source of stem cells, is easy to collect and store, and may safeguard children against a host of diseases in the future.
Umbilical cord blood, which is a rich source of stem cells, is easy to collect and store, and may safeguard children against a host of diseases in the future.

Storing the blood from the umbilical cord of your newborn baby with a private blood bank will set you back around £1,500 (Dh8,340). It's not cheap exactly, but if stem-cell technology delivers on its rich promise, it could prove to be a sound investment in your child's future. Cord blood offers huge potential to clinicians for a number of reasons. First, it's a rich source of stem cells, which are found throughout the body but especially in bone marrow (the body's main blood cell "factory"), circulating blood and the umbilical cord. These cells offer tremendous potential for treating a host of diseases because they are the only cells in the body that renew and repair damaged tissue.

Second, the collection and storage of cord stem cells is compliant with Sharia law and approved by the Vatican, so does not raise the same moral or ethical issues as embryonic stem cells, which have provoked a storm of controversy, especially in the US. And third, unlike the notoriously difficult area of organ donation, which has led to a severe shortage of organs for transplant in countries such as the UK, US and Australia, collecting cord blood is simple, especially as the umbilical cord is normally disposed of after childbirth.

Richard Branson, an advocate of stem-cell technology, set up the Virgin Health Bank (VHB) in the UK in February 2007. Last March, he moved the headquarters to Doha and began working closely with the maternity hospitals in Qatar. Andrew Glen, VHB's commercial director, outlines its plans for the Middle East: "Throughout 2009 we focused on training Qatar's nurses, midwives and doctors. In 2010, we will build a cord blood bank storage and processing facility in Doha, and our plan is to offer cord blood banking services to parents in all the Gulf countries."

Before setting up the Qatar operation, VHB received a fatwa that shows cord blood banking is compliant with Sharia law. Glen explains why the need for a Gulf-based bank is so great: "Unfortunately, there are only a limited number of stem-cell units currently available for people with an Arabic genetic background. And there are a number of genetic disorders that are prevalent in the Gulf region, such as beta thalassaemia major and sickle cell anaemia, both of which can be treated with stem cells."

Although VHB is a private operation, all stem cells collected are divided into two parts. One will be kept for at least 20 years for use by the donor's family, and the other is placed on an international registry that will be available to all. Of course, for most parents, hi-tech medical advances for humanity are far less important than the health and well-being of their children. The good news is that cord blood is easy to collect and store, and may later help safeguard children against a host of diseases.

In the UK, a groundbreaking scheme launched last year by a cancer charity is storing blood taken from the umbilical cords of newborn babies and, it is hoped, will use that blood to save lives in the future. The Anthony Nolan Trust Cord Blood Bank hopes for 50,000 donations over the next five years, which, the charity predicts, will prevent thousands of deaths from leukaemia and other blood disorders. The National Health Service already has a cord blood bank, which takes donations from women at four UK hospitals, collecting around 5,000 samples a year. There are also a number of private facilities in the UK. But the new centre, based in Nottingham, is the first NHS facility to combine storage of potential cord blood transplants with a research facility developing new techniques to use them.

Terie Duffy is the midwife cord blood co-ordinator at King's College Hospital, London, and is in charge of donations for The Anthony Nolan Trust's new bank. "The trust holds the register for adult bone marrow donors," explains Duffy. "About 20 years ago, they discovered that what they needed from bone marrow they could get from the umbilical cord. So that was a potential source of stem cells for people with leukaemia or other blood disorders."

Leukaemia patients require transplants because the intensive chemotherapy and radiotherapy used to treat the disease severely weakens their immune system. The transplant provides the patient's body with healthy cells capable of regenerating this system. For patients requiring a bone-marrow transplant, an exact match is essential to ensure the body doesn't reject the new tissue. With allogeneic transplants (from another person, rather than from another part of the patient's body), the donor tissue must be of the same genetic type as the person needing the transplant, usually from a brother or sister. But with the stem cells found in cord blood, a close match is good enough.

"My job is to get consent from the mothers-to-be, then collect the blood after birth, freeze it and send it to our bank, where it is added to the register," Duffy says. "As soon as we have enough samples, this register will be available to patients throughout the world." And why exactly is cord blood so special? "The blood found in the placenta and umbilical cord is halfway between mother and baby," Duffy says. "Within that blood are stem cells that can be extracted and transfused into someone that will do the same job as bone marrow: create new, fresh, healthy blood that will eventually help cure the recipient."

And it's not just leukaemia: this treatment will potentially cure so many diseases that listing them would take a full page of this newspaper. Dr Mitchell Cairo, a professor of paediatrics, medicine and pathology at Columbia University Medical Center, explains the most significant: "Cord blood is used to treat leukaemia, lymphoma, aplastic anaemia, sickle cell anaemia, immunodeficiencies and metabolic disease, among many others."

In the US, he says, cord blood donation is "very uncommon, unfortunately, because it's an excellent alternative allogeneic donor source. There are approximately four million deliveries per year in the US but only 25,000 to 50,000 donations". This figure will increase as blood banks proliferate. In addition to public banks such as the new Nottingham centre, private banks are springing up across the globe for parents looking to harvest precious stem cells. As Cairo explains, these cells are presently used to treat blood disorders. But stem-cell technology is one of the fastest-growing and most promising fields of medicine. Within our children's lifetimes, it will be instrumental in treating a wide range of conditions.

Dr Robin Lovell-Badge, the head of stem-cell biology at the UK's National Institute for Medical Research, says: "Stem-cell therapy has been around for over 20 years. But in the next decade or so we will see a wide range of applications of stem-cell-based therapies, such as using adult stem cells to repair the eye, damaged joints and bones, the heart and even the spinal cords of paralysed patients."

Stem-cell therapy hit the headlines last year when three Australians had their sight restored with a combination of their own stem cells and contact lenses. The innovative technique was used to reverse blinding corneal disease, but it promises to be a quick, painless and cheap treatment for other disorders. The stem cells were extracted from the sides of the patients' corneas, then cultured in extended-wear contact lenses. The lenses were fitted into the patients' eyes, and when the stem cells began attaching to the cornea, the lenses were removed, leaving the recipients with "new eyes".

And last January, the US Food and Drug Administration announced that it had cleared the way for the world's first clinical trial of a therapy derived from human embryonic stem cells. Trials are ongoing, with patients who have suffered severe spinal cord injuries receiving injections of specialised nerve cells that enable electrical signals to travel between the brain and the body. Researchers hope this will allow patients who have been paralysed by spinal cord injuries to make a full recovery.

Restoring sight to the blind and allowing quadriplegic patients to walk again may sound like the stuff of science fiction, but these treatments are either available now, or will be in the near future.