A recent, phase 1/2 study showed that donated umbilical cord blood cells, can be more effective if first expanded on a bed of cells that mimics the bone marrow enviroment, prior to transplantation. The study, released by researchers of The University of Texas, focuses on the transplantation of umbilical cord blood stem cells instead of hematopoietic stem cells (bone marrow transplant) to patients who have had their bone marrow destroyed by chemotherapy or radiation to treat some form of cancer or blood-related condition.
Elizabeth Shpall , one of the key-researchers, said that umbilical cord blood cell transplantation is currently inferior to standard bone marrow transplants.
“You get fewer cells – blood stem cells, immune cells – from two umbilical cords than you do by collecting from a donor’s bone marrow or peripheral blood,” and added “It’s a high-risk time, patients don’t have white blood cells to fight infection, they don’t have platelets to keep them from bleeding,”
Shpall explained that their study showed that if the cells are first grown in a lab, on a bed with mesenchymal precursor cells, the final outcome of the transplantation is improved. The total number of transplanted cells is bigger, recovery is faster and the proportion of patients who accept the new blood cells increases.
Video of Elizabeth Shpall, explaining how they grew umbilical cord blood cells in the lab
“This led to faster engraftment of white blood cells and platelets, which we believe enhances patient safety.”
According to Shpall, if their method is proven to be safe, it had the potential to replace standard bone marrow transplantation techniques. All that is needed is a confirmed randomized clinical trial on humans.
"Pre-transplant cord blood expansion on mesenchymal stromal cells could become the new standard of care if our findings are confirmed in a randomized clinical trial,”
During the study, two groups were compared. The first one contained 31 patients who received expanded umbilical cells from one of the two transplanted cords. The other group (control) contained 80 patients who had a standard double cord transplant
The results showed that 63 % of the patients in the first group achieved neutrophil engraftment within 26 days, platelet engraftment within 60 days and survival at 100 days. On the other hand, the ratio for the control group was only 23 %
A randomized phase 3 trial ,led by Shpall, in 15 centres is too be expected soon. The study will have 240 participants, 120 for control and 120 who will receive umbilical cells as described before.
Elizabeth Shpall is a professor in MD Anderson’s Department of Stem Cell Transplantation and Cellular Therapy.
University of Texas M. D. Anderson Cancer Center (2012, December 12). Pre-transplant umbilical cord blood expansion in lab speeds