In less than two decades, cord blood transplants from unrelated donors have nearly tripled the number of adults who survive Leukemia. In the final piece of our 3-part series on Cord Blood, ideastream health reporter Gretchen Cuda shares one woman’s success story and examines the future of cord blood medicine.
Susan Fister nearly died four years ago – but a cord blood transplant saved her life. It all started when the Medina woman fell at work and developed a bruise that wouldn’t heal – so she went to have it checked out – and discovered she had leukemia. She had one bone marrow transplant, then two – both failures – when her doctor suggested trying something different - a stem cell transplant from umbilical cord blood
FISTER: This was my last chance. If this cord blood had not taken, I was not going to survive at all.
Her family prepared for the worst, but Fister held on. As the weeks after the cord blood transplant went by, she gradually got stronger, and unlike the last two procedures, her body didn’t reject these new cells. She hasn’t been back in the hospital since November of 2004 – unless of course you count what might be thought of as “well-baby” visits
FISTER: I am now going to be four years old in August. So I got my baby shots at a year, year and a half and two.
In other words, Fister, who is actually 56, has the blood and immune system of a toddler. And she’s noticed that her new immune system has had other benefits as well. When she fell off a table and tore a ligament in her knee – her doctor was shocked by how quickly she recovered for her age. And she says her skin heals faster too. Mary Laughlin, her transplant physician at University Hospitals Ireland Cancer Center, says it’s not surprising the stem cells have affected more than her Leukemia.
LAUGHLIN: These cells not only cure the leukemia or life-threatening blood disorder, we now appreciate that that they participate in repair of all the organs in the body
In fact, she says, in some children, cord blood stem cells have been found to comprise as much as a third of the heart -proof that these stem cells are capable of much more than previously thought possible. As a result, a number of promising clinical trials are being conducted to explore the regenerative potential of cord blood in treating cerebral palsy, diabetes and brain injury.
LAUGHLIN: If you just go to PubMed and search for cord blood and regenerative medicine you will find more than 3000 articles, all written in the last 36 months.
Of the 8 thousand or so cord blood transplants that have been conducted to date, most have been to treat some form of Leukemia - primarily because it offers some advantages over bone marrow. Finding a bone marrow donor can take months-time that some patients don’t have. By contrast an available unit of cord blood can be used right away. Furthermore, of the six possible markers required to match a donor to a recipient, a successful bone marrow transplant needs all six – compared to four when using cord blood. Finally, even when compared against a perfect bone marrow match, cord blood stem cells are less often rejected by the recipient. In Susan Fister’s case, both her bone marrow transplants were a perfect 6 out of 6 match – and yet they failed where cord blood succeeded. Laughlin explains that the problem is that our immune systems get smarter with age.
LAUGHLIN: Those immune cells, in you and I, are very well-educated. They’ve been well-educated for decades. They know who’s who. And even if we match very, very well – what we’d call a perfect match, we still see adverse immune reactivity.
But cells from new born babies haven’t had the benefit of all that education – and therefore are much more willing to be adopted into a new person’s body. And because cord blood can better tolerate a foreign immune system, it is often the only hope for racial minorities who don’t stand a chance at finding that perfect bone marrow match among primarily Caucasian donors.
LAUGHLIN: If you are Caucasian you have a 60% chance of finding a graft. Now if you are African American or Hispanic or oriental, your likelihood drops to 15%
Even finding good cord blood matches can be a challenge for minorities – but Laughlin hopes the unique population of African American genetics here in Cleveland will help change that. Ultimately what everyone wants are more stories like Fister’s – who says somewhere out there is a family she would like to hug.
FISTER: I’ll never know who, I’ll never know the couple, but I am here because of the birth of a child.
Cord blood advocates say a future where physicians use cells to heal people rather than drugs is real and within reach. And to find it we need look no further than our own bellybuttons. Gretchen Cuda 90.3