Dr Kurtzberg’s presentation was delivered electronically
to the AusACPDM conference in Christchurch on March 6th. Due to
flight cancellations, Dr Kurtzberg did not make her planned trip
to Christchurch in person. Instead she sent her presentation, recorded
the audio for it and sent that through. The two were sync’d
and played to the conference. When the recorded conference was over
she came on the phone to host a most interesting question and answer
period. So what did I learn from her presentation.
• Cord blood (stem cells) are used to treat a number of hereditary
illness’ in young children that would otherwise die. What
has to happen in these cases is that the child’s immune system
is destroyed using chemotherapy, a foreign source of stem cells
is introduced resulting in the body accepting these cells and reconfiguring
itself, and thus curing the condition. A radical treatment but justified
in the face of death.
• In the USA cord blood is often collected for the Public
Bank. This is where a public facility collects the cord blood and
stores it for anyone’s use. The donor gives up their rights
to it. Cord blood can also be collected by private clinics who store
it solely for the donor’s eventual use. The collection process
is quite simple, however the preparation and hygiene for storing
the sample is quite involved. Cryogenic storage can keep samples
viable for at least 20 years, probably more.
• Using cord blood to treat children with cerebral palsy is
really in its trial phase. The only children it could benefit are
those whose cerebral palsy has been caused by post-utero causes.
This would therefore, only account for 5-10% of cases of cerebral
palsy. Most cases of cerebral palsy are caused in-utero for unknown
reasons. As cord blood is the same as the baby’s blood, reintroduction
after birth is a waste of time for cerebral palsy in-utero caused.
Dr Kurtzberg is running a trial on the benefits of cord blood re-introduction
for those whose CP is caused post-utero, and whose parents were
fortunate enough to have their cord blood stored. To date she has
re-introduced a child’s own cord blood into 198 children with
CP. Results to date look encouraging. Her trial is continuing and
scientific results will be about 4 years away. There have been virtually
no adverse reactions to the reintroduction, only minor things like
the child developing a cold have been noted, so the down side is
virtually nil. People from all over the world may apply to be on
this trial if their child’s cause of CP is post-utero and
they have stored their child’s cord blood. Dr Kurtzberg is
in the final stages of seeking FDA approval to run this clinical
(Google Dr Kurtzberg and Duke Health)
Dr Mike Sullivan, a pedeatric oncologist from Christchurch
University also spoke on stem cells. He spoke of the dangers of
stem cell treatments in places like China, Russia and Mexico. Stem
cells from a foreign source would be attacked by the childs own
immune system and they would be destroyed within a week. (hence
the reason when treating hereditary/blood/Immune illness, for destroying
the child’s immune system first). Also as the stem cells are
from a foreign source, origins unkown, the risks of problems occurring
are significant and reports of tumors forming have been documented.
The scientific evidence for any improvement for this type of treatment
using someone else’s stem cells does not exist.
Dr Sullivan also went on to review techniques presently being developed
that will allow science to manufacture your own stem cells from
skin tissue and other sources. This may, over time, negate the need
for one to collect their own cord blood.
This field of stem cells is rapidly changing and holds great potential
over the next 10 years.
But wait, there’s more….
I attended a lecture at Brain Week held at Auckland University on
the 20th March on Stem Cells by Assoc Prof Bronwyn Connor. An interesting
presentation that added to my knowledge bank. This presentation
discussed the different stem cells available:
Embryonic stem cells: These are the ones that have
the moral issues around, as they come from human embryoes.. These
are basically unprogrammed and can be used to make any cell in the
body. They effectively are awaiting instructions. These stem cells
can reproduce 10x more rapidly than adult stem cells. Programming
them as to what parts of the human body they should make it the
tricky part. You can see the potential for good and bad that exists
Adult stem cells: In the adult human reside many
areas where stem cells exist. These stem cells are partially programmed
to produce cells related to that system in the body.In the brain
there is a fluid cavity whose lining is rich in brain stem cells.
These are normally used to replace olfactory cells in the nose,
however when damage occurs in the brain they race off to start repairing
this damage. Stem cells In cord blood exist that are partially programmed
to create new blood, it is these cells that are hoped to cross the
brain protection barrier and effect some repair to post-utero damage
in children with CP. Similarly in bone marrow there is a rich supply
of stem cells to help the immune system.
Be Wary: One of the issues with embryonic stem
cells is that if their programming has not be rigorous, and some
are unprogrammed then there is a significant risk of teratomas being
formed (tumours). In fact the one clinical trial being done has
been halted due to this.