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Umbilical cord blood shows promise as cancer treatment

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July 18, 1996
Web posted at: 1:45 a.m. EDT

From Correspondent Jeff Levine

PHILADELPHIA (CNN) -- Two new studies show umbilical cord blood can be used to treat cancer, even when the substance comes from an unrelated donor. The research raises hopes for cord blood therapy in many diseases.

Transplanting blood obtained from the umbilical cord is still a technique in its infancy. However the studies, reported in the New England Journal of Medicine, show its promise.

"It would provide us with the ability to transplant many more patients with cancer and immunodeficiency disorders," Dr. Leslie Silberstein with the University of Pennsylvania said.

In one study, the patients were mostly children with a variety of severe illnesses, including leukemia. In 25 patients, only two had a severe reaction to the transplant. And that, in spite of the fact the blood was not a perfect match to their immune systems.

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In another case, a 26-year old woman with leukemia received a cord blood transplant. Her treatment succeeded, even though the donor wasn't a family member. Her case could help answer the question of whether cord blood works in adults.

Cord blood is rich in stem cells, the building blocks of the immune system and whole blood. Until now, they've generally been extracted from bone marrow, but the process is painful and expensive, and many times mismatches don't work.

"In our experience with stem cells derived from bone marrow, very few mismatches are tolerable to the recipient," Silberstein added.

Ethical questions raised

Normally, cord blood is thrown away at birth. Now, doctors are starting to freeze it for later use, such as a bone marrow transplants. The experimental approach has been tried about 200 times.

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Research at the University of Pennsylvania and other centers is encouraging. It shows cord blood transplants have great potential, but there are ethical questions to be answered. A key issue is confidentiality related to information obtained from the blood sample.

"Cord blood leaves a footprint. If you have HIV, if you have a genetic disease, if you have ... biological material that tells you something about an infection or something that the person's been exposed to, or their heredity," Arthur Caplan of the University of Pennsylvania said. "Maybe they want that information revealed; maybe they don't."

Another issue is whether companies should be allowed to charge for collecting and storing cord blood to treat an illness that might develop in the future.

"I think if you put companies into this area and you start having them market, the danger is that they're going to prey upon the fears of people," Caplan said.

But cord blood bankers see it differently. One proponent says these studies show cord blood transplants have arrived as a mainline treatment.

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