World Cord Blood Day (WCBD) is a day organized and hosted by Save the Cord Foundation to promote awareness and education on the topic of cord blood. It is a community celebration to recognize and commend those involved in the process and message of cord blood banking. This year’s event featured many keynote speakers who spoke about the value of stem cells found within cord blood, and the importance of donating or banking these cells for future use. Another topic at the forefront was the unique challenges and opportunities this year has revealed in terms of COVID-19 and cord blood transportation and transplant logistics. Speakers included obstetrician–gynecologists, transplant specialists, patients of cord blood treatment, and various leaders and partners in the cord blood industry. Let’s take a look back at some of the messages highlighted throughout the WCBD 2020 presentations.
An Overview of Cord Blood Clinical Trials for Autism, Cerebral Palsy, & Stroke
Dr. Joanne Kurtzberg, Director of the Marcus Center for Cellular Cures at Duke University and Cryo-Cell’s Medical Director, gave an overview of the progress made in several clinical trials in which she is involved. In addition, she reviewed her work with the manufacturing of three types of therapeutic cells: cord blood, cord tissue mesenchymal stem cells (MSCs), and DUOC (cells manufactured from cord blood). These manufactured cells from the listed sources above are being explored in the treatment of conditions such as chronic brain injury, cerebral palsy, stroke, graft vs. host disease, autism spectrum disorder, COVID-acute respiratory disease (ARDS), hypoxic-ischemic encephalopathy, osteoarthritis, leukodystrophies, and multiple sclerosis.
A published study
of children with cerebral palsy (CP) showed that an autologous cord blood dose of 25 million nucleated cells/kg provided treated children with a significant improvement in motor function one year after infusion and was accompanied by new motor track development. A similar study
was done to test the safety and efficacy of treating children with CP using umbilical cord blood from a sibling for infusion. Clinical results demonstrated the same clinical improvement as the children treated with autologous cord blood.
Dr. Kurtzberg and her colleagues have also conducted research in babies with hypoxic-ischemic encephalopathy (HIE), a brain injury that can be fatal. These studies involved cord blood infusion coupled with the standard of care, which is cooling. A Phase I study
indicated that twice as many babies survived with normal function at one year with cord blood infusion and cooling compared to babies with cooling alone. A Phase II clinical trial, known as BabyBac 2
, was performed among 37 babies. Half were treated with a placebo (a dilution of red blood cells in the cord blood), and half were treated with cord blood. This study also showed a clear improvement in function and survival at one year among babies infused with cord blood.
Over the last five years, Dr. Kurtzberg and her team have dedicated a significant amount of research concerning autism
and the use of cord blood for treatment. The Phase I and Phase II published studies also revealed cognitive improvement in children treated with autologous (the use of one’s own stem cells) and allogenic (the use of someone else’s stem cells) cord blood infusion. In addition to cord blood, she and her team are also studying the effects of umbilical cord tissue MSCs in treating autism. A Phase I study was completed in treating 12 children with a dose of 2 million cells/kg. 58% of patients showed improvement in at least 2 out of 3 tested measures of improvement. These results led to a Phase II study (IMPACT)
among 164-300 children ages 4-11 years. The study was started, but placed on hold due to COVID-19. The study is projected to resume soon and will take roughly two years to complete.
Additionally, another clinical trial is set to begin during the first quarter of 2021 in adult patients with multiple sclerosis who are to be treated with DUOC, a manufactured cord blood product. Under the 2017 Expanded Access Protocol at Duke University, over 400 patients have been treated to date. There are 600+ additional screening patients and a reported 1,600 patients waiting for follow-up contact. In addition to the upcoming progression and completion of some of the above-mentioned clinical trials, there are also plans to begin a Phase I clinical trial using umbilical cord tissue MSCs to treat adult patients with COVID-acute respiratory distress syndrome and children with COVID-multisymptom inflammatory syndrome.
The Impact and Future of Cord Blood Amid COVID-19
Various speakers discussed the changes that have occurred due to COVID-19 restrictions. During a Q&A session with WCBD partners, Dr. Joanne Kurtzberg revealed adjustments to collection operations, processing laboratories, and how communication was exchanged with donating mothers at Carolinas Cord Blood Bank. She also expressed concern at the onset of the pandemic about bone marrow availability as it became unclear whether donor facilities would close. As far as cord blood use during this time, cord blood has gone up in the unrelated transplant setting. New recommendations were established by the National Marrow Donor Program (NMDP) to require every adult donor transplant also to have an alternative cord blood unit in place. The use of cord blood has reportedly increased within the last six months, partly because of new restrictions but also due to its “off-the-shelf” or readily available nature.
Donna Regan, Director of Customer Ready Products with the NMDP-Be The Match, also reiterated similar challenges regarding hospitals restricting collectors allowed on-site. Currently, Be The Match also reports a higher percentage of cord blood grafts in unrelated transplants because of cord blood’s availability. She also noted the expanding diversification of the world’s population. In turn, younger patients are having a more difficult time finding a match than older patients. Manufactured cord blood stem cells are becoming more widely recognized as a platform for research and are being used in the clinical setting for COVID-19 related conditions like acute respiratory distress syndrome
(ARDS) and cytokine release syndrome. Regan voiced, “I’m especially excited for the potential role of cord blood in treating immune therapies, such as moderating auto-immune diseases.” Her enthusiasm for the possibilities of cord blood segued into expressing a need for education among the next generation of clinicians. We share her belief that cord blood should become a more apparent option for diseases in which it is a standard indication
Patients of cord blood transplants were also present to recall their transplant experiences and express the importance of cord blood. One such patient was cancer survivor Dr. Vanessa Yenson, the first adult in Australia to receive a cord blood transplant in 1999. After being diagnosed with acute lymphocytic leukemia (ALL) and testing 50 members of her family with no bone marrow match, cord blood proved to be her only option. However, at the time, it had only been used in children. Where there were no matches within her family, physicians were able to find 3 to 4 acceptable cord blood matches. She now serves as
Cure Brain Cancer Foundation's Research Operations Manager.
Dr. David Hall, a retired OBGYN, shared a similar story of his battle with acute myeloid leukemia (AML) in 2012. After undergoing two rounds of chemotherapy, he was told he would need a bone marrow transplant. However, a matching donor could not be found among the 23 million registered adult donors. After a successful cord blood match and transplant, he lives today to share the significance of cord blood with expectant parents.
Cord Blood Banking Is a Message Worth Sharing
With umbilical cord blood and cord tissue cells being explored in regenerative medicine, damaged organ and tissue reconstitution, neurological disorders, and for the use of reducing inflammation in certain acute conditions and COVID-related conditions, there is a growing need to have these cells available for use. The stem cells within cord blood
and cord tissue have proven to be a desirable source because of their ability to differentiate into other cell types, ease of collection, and reduced risk of transplant-related complications. Given this pandemic's current circumstances and an ever-growing list of diseases treatable with cord blood, cord blood stem cells remain a reliable source of stem cells for treatment.
Expectant parents should be aware of the many benefits of banking
cord blood and cord tissue stem cells for their families’ personal use. Cryo-Cell remains dedicated to educating parents about the standard and innovative cord blood and cord tissue applications and the many advantages of banking these cells privately. To learn more, we invite you to register for an upcoming virtual seminar to speak with one of our cord blood educators.