Heather Brown is a representative of the Cord Blood Registry, an organization where young parents can preserve the vital and often lifesaving stem cells found in their childrens' umbilical cords. We asked her to join us, and give us some background on stem cells, the research behind regenerative medicine, and how she helps to match families who have banked with CBR, to doctors who are conducting research.
I'd like to start with the basics. Heather, can you help us understand exactly what a stem cell is?
Sure. A stem cell is a master cell that can become all the different cells and tissue types in our body. They’re capable of self-renewal, and they’re capable of specialization. So I like to think of stem cells like undergrads in college. They start out undeclared, but then they become anything they wanna be. Later on in their college careers as they progress and declare a major, maybe they’d even further specialize in graduate school, but once you go far down a path, it’s hard to go back.
We understand that after a baby’s born, generally the umbilical cord is just cut and discarded. What is the benefit of preserving cord blood?
Right. Unfortunately, cord blood is generally just discarded as medical waste, but the blood left over in the umbilical cord and the placenta is a rich source of stem cells, which could be saved for future potential use by the newborn, a family member, or perhaps even an unrelated person in need.
What are the unique properties of cord blood stem cells that make them so beneficial?
Well, first and foremost, it’s their young age. Only moments ago, they were fetal stem cells without any of the ethical controversy surrounding embryonic stem cells. They’re still very young and very vital, and really as vigorous as the day we were born. They’re an immature, unspecialized cell that had limited exposure to any of the environmental toxins or infectious diseases or any of the ravaging of the aging process that we experience over our lifetime. They are very easy to obtain. Easy to store for the long term without any loss of function. One of the very unique benefits is they’re more tolerant of tissue mismatches.
Cord blood stem cells need to be matched just like if you were looking for an organ donor for fear of rejection. But cord blood stem cells are a little bit more forgiving than other stem cell types in terms of their matching capability.
What is the process? How are cord blood stem cells collected and preserved?
It’s really fairly simple. Typically, an OB physician would collect the cord blood within five or ten minutes after birth using a specialized collection kit that either comes from a family bank like CBR where families made specific, prior arrangements to collect their newborn’s cord blood, or perhaps there’s a donor opportunity in a hospital, and the hospital has a collection kit available. But basically, this kit has an anticoagulant that helps preserve the blood so it can be safely transported to the laboratory for processing. On average, about 60 or 70 milliliters or about a half a cup of blood is collected at birth.
How are the stem cells preserved?
Well, the cord blood stem cells are processed, so we’re storing just the white cell fraction of the collection at birth, and then they’re stored cryogenically in liquid nitrogen.
What illnesses are currently being treated using cord blood stem cells?
When most people think of cord blood, they think of blood disorders, cancers like leukemia or genetic diseases. In that instance, cord blood stem cells are being used to replace diseased or damaged blood in immune forming cells in the bone marrow. This is what we call sort of transplant medicine. But in recent years, cord blood has moved outside of the blood immune system to a field called Regenerative Medicine.
Cord blood stem cells are now under investigation to regenerate and repair damaged cells outside of the blood and immune system. Examples of that would include a cellular therapy where stem cells are infused just into the blood, and they migrate to a damaged area to facilitate repair like potentially a brain injury. Or an example of regenerative medicine might be tissue engineering where stem cells are used to create a graft or potentially a whole new organ in the laboratory and then transplanted to a sick individual.
Or it may mean gene therapy where the cells are genetically modified to deliver a therapeutic agent or replace diseased cells with the healthy cells. An example of that might be a genetic condition like Sickle Cell Anemia.
What are some of the technological advancements in recent years that make your service possible or easier?
Cord blood processing used to largely be a manual process. If you think back to high school chemistry wearing a lab coat using a pipette, working under a hood, it’s now a lot more automated. A computer controlled processing method has largely replaced the manual technology. That allows for faster and more consistent quality processing. It’s pretty remarkable.
Getting back to the service itself, parents will bank their child’s cord blood for future use?
That’s right. At a private or family bank, a family reserves their own newborn cord blood stem cells just by paying a small fee to keep it for potential use in their family.
How long can one keep cord blood?
Well, our contracts are written for 18 years, and that’s the age when the newborn who the cord blood was collected from is sort of the legal custodian of their biologic material. But theoretically, cord blood stem cells stored under proper conditions should last the lifetime of an individual. There’s really no need to assign an expiration date although we have plenty of parents who say, “Wait a minute, at 18 hopefully my child is gonna be worried about pizza and beer money and college, and I don’t want them to have to make a decision about keeping their stem cells or not,” so they ask to extend the contract to maybe 25 years.
So your family has banked your cord blood. Now you're 56 and you need some kind of repair requiring stem cells. As an adult can use the stored cord blood stem cells?
It depends on the disease being treated and the amount of stem cells needed. Yes, it should provide a variety of treatment options over the lifespan of an individual.
We understand that there’s a considerable benefit to the child and family because of the low risk of rejection. Is that right?
Well, it’s an exact match for the newborn that the cells were collected from, and there is a greater probability that the stem cells will be a genetic match to family members. Certainly, the chance that you’re matching with a family member versus a random individual in the population is much greater.
Can a family donate a portion of the cord blood to an individual outside the family?
That’s a good question. It wouldn’t be easy to do, so there’s two sort of models or systems. There’s the family banking system that we’ve been talking about where a family reserves their own stem cells for their own use, and then there’s the public system where a family would donate, anonymously donate their own baby’s umbilical cord blood stem cells for any potential person in need.
In the donor bank system, those cord blood stem cells are immediately tissue typed. We talked about that a little bit earlier about needing a tissue match. They look at factors called our HLA type to see if a cord blood unit from one person could be used in another person. So those tissue types are all cataloged and search-able for a donor in need. Since family bank samples are reserved just for the family, and we know that’s an exact match from the newborn, and we know the potential match is probable for a family member, the cord blood stem cells aren’t typed up front, only when the unit is in need. So it would be difficult to know if your cord blood sample sitting in a bank would be a good match for an anonymous individual.
As a representative of the Cord Blood Registry, what is your main objective?
Well, CBR’s mission is to give families hope for longer, healthier lives. I head up the scientific and medical affairs group, so I work with researchers who are looking at cord blood stem cells to treat conditions that have no real good treatment options today. My goal is to fulfill that mission to help improve the quality of life for our clients and their families.
This would be a part of regenerative medicine, is that right?
That’s correct.
Can you tell us a little bit about the advantages of regenerative medicine?
Regenerative medicine aims to repair, replace, restore tissues that have been injured or damaged in some way. Traditional transplant medicine typically is used as a last resort or an end-stage therapy. But regenerative medicine we see as a first line treatment or potentially being able to provide treatment for a condition where only supportive care is available today and there is no real good treatment option.
I imagine it's a friendlier treatment and less invasive.
That’s true. In transplant medicine, if you were treating a blood disorder or cancer, or genetic disease, the recipient typically undergoes rounds of chemotherapy and radiation, which are very destructive. They’re destructive to the body’s tissues, but they’re purposely destructive because you’re trying to destroy that diseased blood and immune system. The stem cells actually rescue that patient. They’re transfused to provide and rebuild that damaged blood and immune system.
With regenerative medicine, typically there aren’t any preparative regiments. You don’t undergo chemotherapy and radiation, you’re just given an infusion of your own umbilical cord blood stem cells. So it is a safer, gentler, easier treatment for the body to tolerate.
What advancements do you foresee for the use of cord blood stem cells in the next few years?
Well, cord blood stem cells really are such a versatile that anything is possible. I think what’s unique is that stem cell science really intersects every specialty of medicine. Stem cells could be used for growing new organs, helping burn victims with skin graphs, restoring hearing in a deaf child. My training background is in genetics, and I really thought I was in a fast-moving science, but since joining Cord Blood Registry and learning more about stem cells science and the potential for regenerative medicine, it’s really an incredibly fast moving science.
What do you feel researchers are working on today that will be that next big step in regenerative medicine?
Well, the most promising research is really in the area of heart disease, so helping victims of heart attacks or congestive heart failure, cord blood stem cells are – and actually, bone marrow stem cells and other types of stem cells have really helped reduce the scar formation and aid in the healing process following heart disease.
Another big area is really any form of neurologic disability. So somebody who sustains a traumatic brain injury in a motor vehicle accident or spinal cord injury, strokes, epilepsy, anything that involves our nervous system does seem to be a key area of clinical treatment for stem cells.
