Properties of Cord Blood

The growing interest in cord blood storage is underpinned by the value of two types of stem cells derived from cord blood – the blood forming hematopoietic stem cells (HSC) and the multipotent mesenchymal stem cells (MSC).

Hematopoietic stem cells (HSC)  In the human body, new blood cells are constantly produced to replenish mature cells which are routinely lost and destroyed. This process of blood cell generation is called hematopoiesis and it takes place largely in bone marrow.

Historically, transplant of HSC is the most common treatment for blood cancer patients. There are three sources for collecting HSC for transplantation: bone marrow, peripheral blood, and cord blood. Before Broxmeyer discovered the hematopoietic property of cord blood, bone marrow transplants were most commonly used for the replenishment of blood cells.

To date, one half of all transplants from unrelated donors in children now use cord blood in the United States [1]. In Japan, this is true for adults as well [2]. Cord blood transplant not only provides an alternate option to bone marrow transplant, but more important, it has offered new hope for patients who had not been able to find a bone marrow match.

In recent years, MSC were reported to have been isolated from cord blood and expanded under specific conditions [3].

Footnotes:
[1] “Cord blood can save lives” www.nationalcordbloodprogram.org (accessed 13 June 2007).
[2] Ibid. 
[3] Bieback K et al.(2004), Stem Cells. 22(4):625-34

Cord blood transplant is a treatment option to bone marrow transplant.

Since the clinical application of cord blood is a relatively recent phenomenon, there is no conclusive agreement yet on the comparative benefits of cord blood over bone marrow in HSC transplants.  However, a number of observations, outlined in the table below, are generally accepted by the medical community.

Bone Marrow/Peripheral Blood Cord Blood
Donation requires surgery. Matched donors are hard to find, and even if they are found, only 1/3 can avail themselves to the hospital for the donation [1]. Collection of cord blood is painless and risk free, independent of the transplant operation. Once processed and HLA typing completed, the cord blood unit is ready for matching
Requires a perfect match of HLA for successful grafting. Partial donor-recipient matching is possible in cord blood transplant although patients generally benefit from a higher matched cord blood unit.  Because partial matching is viable, transplants to adults using multiple cord blood units were reported.
A higher chance of inducing graft-versus-host diseases (GvHD) [2] since stem cells harvested from bone marrow are more matured. Less likely to induce a GvHD complication because the cord blood stem cells appear to be immunologically primitive[3].
More prone to virus infection, particularly those viruses which were dormant in the donor's body might become active and attack the patient when his/her immunity system is most vulnerable. Cord blood stem cell is less likely to be exposed to virus infection.
Provides a large dose of stem cells and thus enables rapid engraftment. Limited dose of stem cells and thus slower engraftment.

In Hong Kong, in a retrospective study aimed at reviewing the outcome of unrelated umbilical cord blood transplantation in children using cord blood from the Hong Kong Red Cross, doctors had confirmed that “the outcome of which (umbilical cord blood transplantation) was comparable to that of bone marrow transplantation.”[4]   Depending on the disease and the patient's condition, cord blood transplant and bone marrow transplant may each have its own merits specific to the situation.

Footnotes:
[1] "Cord Blood: A Solution for Bone Marrow Transplantation", http://www.nationalcordbloodprogram.org, (accessed 10 May 2007).
[2] GvHD stands for graft vs host disease which is a condition whereby the white blood cells from a donor attack the tissues of the recipient after a transplant.
[3] Laughlin, M.J. (2001). "Umbilical cord blood for allogeneic transplantation in children and adults", Bone Marrow Transplant. 27, 1–6.

Stem cell compatibility in HSC transplants

One of the major discoveries found during the initial bone marrow transplants was the human leukocyte antigen (HLA). The HLA is a type of antigen protein found on the cell surface. HLA mainly contains of six major antigens that are highly variable in the human population, therefore they are almost unique to each individual.

They are markers present on the outer surface of body cells, recognized by the immune system, to distinguish between self cell, pathogen-infected cell and foreign cell. A child inherits HLA antigens from both parents to form his/her own unique HLA typing. For a bone marrow transplant to be operable it requires a perfect match of HLA types between the donor and the recipient.

However, a partial match of only 4 pairs of antigen is sufficient for cord blood transplant.

Example of search for compatible cord blood unit
HLA type A1 A2 B1 B2 DRB11 DRB12 Matching result
Patient *02CRFN *11BDFZ *15DJVP *51DREH *0803 *0406 /
Sample 1 *02ANJ *3303 *3802 *4601 *0901 *1502 Incompatible
Sample 2 *02CRFN *11BDFZ *15DJVP *51DREH *0803 *0406 Perfect match
Sample 3 *02ANDC *11BDFZ *1511 *3905 *0901 *14SXE 1/6 HLA match only
Sample 4 802ANJ *11BDFZ *40DGWB *51DREH *0803 *0406 4/6 HLA

Bone marrow transplant:only sample 2 is suitable for transplant
Cord blood transplant:sample 2 and 4 are suitable for transplant.

The Functions of Cord Stem Cells

Cord blood stem cells vs. Cord tissue cells:

Cord tissue cell Cord blood stem cell
Source Cord Cord blood
Type of stem cell Mesenchymal stem cell
(create structural and connective tissue)
Mesenchymal stem cell
(create structural and connective tissue)
Usage Repair damage organ such as: stroke, spinal cord injury Blood Disorders such as: Aplastic Anemia, Fanconi’s Anemia, Sickle Cell Anemia Thalassemia

Umbilical cord contains rich sources of Mesenchymal Stem Cells (MSCs).

Mesenchymal Stem Cells (MSCs)

MSC is a multipotent stem cell that can differentiate into a variety of cell types in the laboratory, including fat cells, cartilage, bone, tendon and ligaments, muscles cells, skin cells and even nerve cells [4].

Unlike other adult stem cells, MSC can be obtained in appropriate quantities for clinical applications, thus making it the perfect candidate for tissue repair [5].

Footnote:
[4] S Kadereit, “Adult Stem Cells” http://www.isscr.org/public/adultstemcells.htm, (accessed 20 June 2007).
[5] Ibid.

Mesenchymal Stem Cells (MSCs)

Research & Clinical Uses

According to the National Cord Blood Program in the US, up till October 2011, their cord blood inventory alone has benefited a total of 83 different diseases. New clinical results are coming out literally every day.

Diseases commonly treated with cord blood transplant

Malignancies Acute Lymphoblastic Leukemia (ALL)
Acute Myelogenous Leukemia (AML)
Chronic Lymphocytic Leukemia (CLL)
Chronic Myelocytic Leukemia (CML)
Hodgkin’s Disease
Non-Hodgkin’s Lymphoma
Hemaglobinopathies/
blood disorders
Aplastic Anemia
Fanconi’s Anemia
Sickle Cell Anemia
Thalassemia
Inherited disorders Osteopetrosis
Immunodeficiency Adenosine Deaminase Deficiency

Complete list of diseases treated with cord blood stem cells

For More up to date information, please visit the websites of:
National Cord Blood Program at www.nationalcordbloodprogram.org
National Marrow Donor Program at www.marrow.org
Beike Biotechnology at www.beikebiotech.com

Footnotes:
* Patient Statistics - 2,199 cord blood transplants worldwide using NCBP units (as of 9/30/06), http://www.nationalcordbloodprogram.org, (accessed 13 June 2009).

Diseases treated with cord transplant (Clinical trial status)

Stroke
Cardiovascular Disease
Dilated Cardiomyopathy
Heart Failure
Ischemic Heart Disease
Myocardial Infarction
Limb Ischemia
Kidney Acute Kidney Injury
Lupus Nephritis
Bone/Cartilage Arthritis-foot Fusion
Bone Fracture
Bone Neoplasms
Cartilage Defects
Spinal Fusion
Liver Cirrhosis

Regenerative therapy

In recent years, research in regenerative medicine is advancing and producing encouraging results.  In a report published in Cytotherapy in August 2005, it was suggested that "human cord blood (UCB)-derived multipotent stem cells improved sensory perception and movement in the SPI (spinal cord injury) patient's hips and thighs within 41 days of cell transplantation." [1]  The case examined a 37-year-old female patient suffering from SPI who had received a transplant of HLA-matched cord blood-derived multipotent stem cells direct into the injured spinal cord site and the finding was most encouraging: "it is suggested that UCB multipotent stem cell transplantation could be a good treatment method for SPI patients." [2]

In Feb 2006, the University of Minnesota Medical School announced they have discovered a new population of cells in human cord blood that have the properties of primitive stem cells.  In other words, these cells have the potential to produce a greater variety of cell types.  Laboratory research found that transplantation of these stem cells to rodents with experimental strokes resulted in "significant reduction in the size of the brain lesion." [3]  The report also claimed "some of the transplanted stem cells developed into "neuron-like" cells that are typically found in the brain."

Treatment on Cerebral Palsy and Type 1 Diabetes  Recently, the world’s largest private cord blood bank Cord Blood Registry (CBR) collaborated with the Duke University in US to conduct research on stem cell therapy to treat Cerebral Palsy (CP). In the research, scientists observed significant improvement in CP patents; speech and motor abilities in a few weeks after an autologous cord blood transplant. [4]

In another research project in the US, Type 1 Diabetes patients were invited to undergo autologous cord blood transplant to treat their conditions. Results indicated that patients were able to maintain a normal blood glucose level without the intervention of insulin injection after the transplant. This outcome suggested possible migration of the infused stem cell to the pancreas and restore the β–cell function necessary to produce insulin for regulating patients’ blood glucose level. [5]

Footnotes:
[1] K-S Kang, SW Kim, YH Oh, JW Yu, K-Y Kim, HK Park, C-H Song and H Han (2005), "A 37-year-old spinal cord-injured female patient transplanted of multipotent stem cells from human UC blood, with improved sensory perception and mobility, both functionally and morphologically: a case study", Cytotherapy  Vol. 7, No. 4, 368-373
[2] Ibid.
[3] "Researchers Identify New Cord Blood Stem Cell: Discovery Suggests Potential Treatment For Regenerating Nerve Tissue After Stroke", press release issued by the University of Minnesota, 16 February 2006.
[4] David T. Harris, Stem Cell Rev (2008) 4:269-247
[5] Brusko T et al., Cell Biochem Biophys. 2007;48:165-175



Reference Link

Autism
1. Transplantation of UCB Increases Nerve Growth Factors for  Patients with Autism (2015)
2. Stem Cells as a Cure for Autism  (2015)
3. Progress of  MSC Therapy for Neural and Retinal Diseases (2014)
4. Efficacy of Fetal Cell Transplantation in Autism  (2014)
5. MSCs in Treating Autism (2014)
6.  Transplantation of UCB Mononuclear Cells and UC MSCs in Autism  (2013)
7. Therapeutic Role HSCs in Autism  (2013)
8. Perspective  of Use of Stem Cell for Autism Treatment (2013)
9. Current Findings and Research Prospective in Autism  (2013)
10. Autologous BM Mononuclear Cell Therapy for Autism  (2013)
11. An Improved Case of Autism after Autologous BM Mononuclear  Cells Transplantation (2013)
12. Stem Cell Trial for Autism Launches in US  (2012)
13. Stem Cell Therapy to Treat Autism?  (2012)
14. Stem Cell Research: An Opportunity for Autism  (2012)
15. Autism is MSC Personalized Therapy the Future  (2012)
16. Stem Cell Therapy for Autism (2007)
Adipose stem cells
1. ASCs with PRP for Chronic Skin Ulcer Therapy  (2016)
2. Cartilage Regeneration with ASCs Current Status  (2016)
3. ASCs for  Tissue Engineering and Regenerative Medicine (2016)
4. Regeneration of Cartilage in Knee with Autologous ASCs  (2016)
5. ASCs & PRP Transplantation Enhance Stemness  (2015)
6. ASCs in Cell Therapy Safety and Feasibility  (2015)
7. ASCs for Regeneration Medicine (2014) 
8. Clinical  Application of ASCs in Plastic Surgery (2014)
9. Safety of Intravenous Infusion of ASCs  (2011)
10. The  Potential of ASCs in Regenerative Medicine (2011)
11. Differential Gene Expression in ASCs Cultured in AHS versus  FBS (2010)
12. Current Challenges and Clinical Perspectives for ASCs  (2010)
Mesenchymal Stem Cells
1. MSC Therapy for Pediatric  Disease(2016)
2. Use of MSC for Therapy of Cardiac Disease  (2015)
3. Long-Term Expansion on MSCs (2015)
4. Cancer Gene Therapy Using MSCs (2014)
5. Treatment  of Knee Osteoarthritis with Autologous MSC (2013)
6. MSC Based Experimental and Clinical Trials: Current Status and  Open Questions (2011)
7. MSC Delivery of TRAIL can Eliminate Metastatic Cancer  (2009)
8. Therapeutic  Efficacy and Fate of Engineered Human MSC for Cancer Therapy  (2009)
9. Stem Cells in Regenerative Medicine  (2008)
10.  MSC: From Biology to Clinical Use (2007)
Immunotherapy
1.  Personalized Immunotherapy in Cancer Treatment: A Mini Review  (2016)
2. Immunotherapy, the Next Generation of Cancer Treatment  (2016)
3. T Cells in  Cancer Therapy: Opportunities and Challenges (2015)
4. Study on Adoptive T-cell therapy for Metastatic Cervical Cancer  (2015)
5. Cancer  Immunotherapy: Harnessing the Immune System to Battle Cancer  (2015)
6. Cancer Immunotherapy Review (2015)
7. Autologous T Cells - Personalized Drug for Immunotherapy of  Human Cancer (2015)
8. Efficacy of Autologous Chemo-Immunotherapy on Non-small Cell  Lung Cancer (2014)
9. Effectiveness of Chemo-Immunotherapy on Non-small Cell Lung  Cancer (2014)
10. Comparative Study on Chemo-Immunotherapy Vs Chemo in  Colorectal Cancer (2014)
11. Autologous Immune Enhancement Therapy in Gall Bladder Cancer  (2014)
12. Efficacy of Chemo-Immunotherapy on Colorectal Cancer  (2013)
13. Autologous immune enhancement therapy against an advanced  epithelioid sarcoma: A case report (2013)
14. Autologous immune enhancement therapy: A case report of a  stage IV colonic cancer (2013)
15. Autologous Immune Enhancement Therapy after Radiotherapy  Carcinoma Cervix (2013)
16. Autologous Immune Enhancement Therapy after Radiotherapy  Carcinoma Cervix (2013)
17. Efficacy of Chemo-Immunotherapy in Gastric Cancer  (2012)
18. Autologous Immune Enhancement Therapy in Ovarian Cancer  (2012)
19. Treatment  of Gastric Cancer by Autologous Chemo-Immunotherapy (2006)
Umbilical Cord Blood 
Dramatic Expansion of HSCs: New Possibilities for HSC Transplant?  (2016)
UCB Draws Focus From More Scientists Seeking Cures  (2014)
UCB  Transplantation Review (2014)
UCB Draws Focus From More Scientists Seeking Cures  (2014)
Autologous UCB in Cerebral Palsy (2012)
Autologous UCB Transplantation in a Child with Neuroblastoma  (2012)
Clinical Trials in Non-hematological Disorders using UCB  (2012)
Update on UCB  transplantation (2009)
Autologous UCB  Transplantation in Leukemia Treatment (2007)
Umbilical Cord Blood Banking
1. Prevalence of Medical Conditions for Cellular Therapy among  Families of Private UCB Banks (2016)
2. Long-term Frozen Storage of Stem Cells: Challenges and  Solutions (2016)
3. Umbilical Cord Blood Banking (2014)
4. UCB Transplantation: The First 25 Years and Beyond  (2013)
5. Effect of 21-year Cryopreserved UCB  (2011)
6. Self-renewal and Differentiation Capacity of Young and Aged  Stem Cells (2008)
7. Aging of  MSC in vitro (2006)
Umbilical Cord Mesenchymal Stem Cells
1. UC as  Prospective Source for MSC Therapy (2016)
2. UCMSCs: A New Era for Stem Cell Therapy  (2015)
3. UCMSC: The  New Gold Standard for MSC Based Therapies? (2014)
4. Advantages  and Potential Clinical Utility for UCMSCs (2014)
5. Transplantation of UCMSCs to protect central nervous system  (2012)
6. Cryoperservation of UC under GMP Conditions for Cell Banks  (2012)
7. Therapeutic  Potentials of UCMSCs (2011)
8. Therapeutic Potential of UCMSCs in Treatment of Rheumatoid  Arthritis (2010)

News

造血幹細胞移植 治愈惡疾 東方日報
罕見基因病 治療費500萬 有線新聞
兒子臍帶血救了患白血病爸爸 新浪新聞
Boy with terminal leukaemia now saved after baby sister is perfect donor match Daily Mail
首例異體臍帶血治女童罕病 蘋果日報
Paralysis reversed: Man walks again after revolutionary transplant fusing nose cells in spine SCMP
From Stem Cells to Billions of Human Insulin-producing Cells Technology Networks (UK)
糖尿病人福音 治療法有突破 Yahoo News HK
Beat tennis elbow with stem cell injections: Patients are receiving jabs to heal hard-to-treat tendon injuries DAILY MAIL
Cord blood gives 3-year-old with cerebral palsy hope The Straits Times 
Stiff Person Syndrome Treated With Stem Cell Transplantation Helps Two Women Achieve Remission Medical Daily
Stem cells show promise in stroke recovery BBC News
幹細胞可治中風癱瘓 蘋果日報
Stem cell research could lead to new muscle repair treatments CTV News
幹細胞治療膝蓋受傷Stem Cell Operation treat knee injuries The Guardian
免疫治療癌症Patient's Immune System Harnessed to Attack Cancer The Wall Street Journal
心臟損壞可修復嗎Can heart attack damage be reversed? CNN
迪馬利亞幹細胞療傷 趕決賽復出 信報財經新聞
愛女罹2癌 葉爸病房外住146天 中時電子報(台灣)
$15 Million Award to Go Toward Exploring New Treatments for Autism, Other Brain Disorders Duke Medicine
臍帶血移植治療挽救生命 Umbilical cord transplants saving lives ABC7 Los Angeles
血癌女換骨髓八年 盼搵工自食其力 蘋果日報
嬰兒用自身血液醫治大腦麻痺 Could babies fight cerebral palsy with their own blood? Herald Sun
免疫治療證實對癌病有幫助 Immunotherapy shows promise for cancer patients NYDailyNews.com
Recent scientific advances are giving hope to spinal cord injury patients SCMP
New therapy wipes out cervical cancer in two women Medical Xpress
New Immunotherapy Drug Data Show Promise in Treating Cancer WSJ
Burrillville’s Tyler Seddon, 7, prepares for marrow transplant in his fight against leukemia The Providence Journal
Meet the Doctor Who 'Fixed' Bartolo WSJ
Amazing news on Immune Cells Therapy WSJ
Patient’s Cells Deployed to Attack Aggressive Cancer The New York Times
皮膚細胞培植出幹細胞 組織器官再生有望 蘋果日報
注射造血幹細胞改善中風症狀 蘋果日報
自體血幹移植治癌 九東輪候期減至1月 明報
HK doctors hope stem cell treatment will ease boy's pain SCMP on 13.8.2012
Umbilical Cord Draws Focus From More Scientists Seeking Cures Wall Street Journal
Emily's Story: A Young Girl Beats Cancer with Immunotherapy CancerResearchInst
Liposuction Fat Turned Into Stem Cells, Study Says National Geographic News

Video Share

  •   
 


Disclaimer:

The information contained in these pages is gathered from a number of sources and is provided for reference only. While the information is updated from time to time, it may not be up-to-date in every aspect. Neither CRYOLIFE nor the information providers give any guarantees, undertakings or warranties concerning the accuracy and completeness of the information provided or whether it is up-to-date or not. CRYOLIFE does not accept any liability or responsibility in connection with the information provided. In particular, CRYOLIFE does not accept any liability or responsibility for any loss arising from inaccurate or incomplete information, however, caused. Hypertext links on this website are inserted merely for visitors' convenience. Hypertext links may not be comprehensive, accurate or up-to-date in all cases. CRYOLIFE has no interest in, responsibility for, or control over any third party websites that can be accessed through this site. CRYOLIFE therefore gives no guarantees, undertakings or warranties in respect of the comprehensiveness or accuracy of contents of any such third party websites. In any event, CRYOLIFE does not accept any liability or responsibility in connection with any use of such hypertext linking.

About CRYOLIFE

CRYOLIFE is the first Private Cord Blood Bank in Asia, established in 1996. We believe in the potential of stem cell therapy in the field of reparative and regenerative medicine, and encouraged by the proliferation of successful cord blood transplants in the US, we decided to introduce the concept of saving cord blood to the local community.  Our mission is to serve the community's needs in cord blood storage by providing the best-in-class cord blood collection, processing and storage services, and continuous improvement in cryopreservation technologies.