Stanford Medicine Newsletter Updates For the Local Community

 

Banking for transplants

Cord blood program expands stem cell registry

Amalia Kessler and her family were a driving force behind Packard Children's new cord blood collection program..

   

A new public cord blood collection program at Lucile Packard Children’s Hospital is now enabling new parents to donate their baby’s cord blood to an international stem cell transplant registry. Stem cell transplants cure leukemia, lymphoma and inherited blood diseases by replacing a patient’s blood-forming cells with those from a healthy donor.

“This is a public service project to expand the donor pool,” said Rajni Agarwal, MD, the clinical director for pediatric stem cell transplantation at Packard Children’s and medical director of the new collection program. “It will help physicians do more stem cell transplants and save more lives.”

The new program makes Packard Children’s the first Northern California hospital to both collect cord blood donations and use them in stem cell transplants. Blood left in the umbilical cord and placenta after delivery is a rich source of stem cells, which can differentiate into a variety of blood cells. Right now, nearly all cord blood is discarded as medical waste, while patients who need transplants sometimes die for lack of a donor.

Resource for others

Cord blood can be collected at no risk to a new mother and baby, and given to unrelated patients who need the stem cells. This public system is distinct from private cord blood banks, which charge families fees to collect cord blood and store it for the possibility of their own personal use.

“The chance of needing banked cord blood for your own child is very remote,” said Maurice Druzin, MD, division chief of Maternal-Fetal Medicine at Packard Children’s. Because blood cancers are so rare, very few families who privately bank cord blood use the cells, he explained. “But these cells are potentially lifesaving for someone else.”

Cord blood has important advantages over bone marrow—the most commonly used source of stem cells for transplant. It can be collected noninvasively at birth and matched to more potential recipients than bone marrow. Additionally, while bone marrow registries have relatively few donors from ethnic minority groups, Packard Children’s obstetric patients reflect the great diversity of the Bay Area’s population, which means the hospital’s donations could greatly diversify the cells available for transplant, helping more minorities to find a match.

A mother’s initiative

The program began because an expectant mother, Stanford law professor Amalia Kessler, JD, PhD, was surprised that she could not find any Bay Area hospitals collecting cord blood donations. During her first pregnancy in 2009, Kessler and her husband, Adam Talcott, decided they would rather donate their baby’s cord blood than bank it privately.

“We were bombarded with mailings and calls from private cord blood companies,” Kessler said, “but we wanted to do something that would be more valuable.”

Kessler asked a colleague, Hank Greely, JD, who is a professor of law with an expertise in genetics, to propose the idea of a cord blood donation program. Greely worked with bone marrow transplant expert Karl Blume, MD, an emeritus professor at the School of Medicine, to get the idea off the ground. Although the program wasn’t ready in time for Stella Talcott’s 2009 birth, that changed by the time little brother Ari arrived in the fall of 2011. His cord blood became the first to be donated at Packard Children’s.

The public cord blood program is a joint effort with MD Anderson Cancer Center in Houston, which already has an established cord blood bank. Packard Children’s is currently the only hospital in Northern California with an in-house collection system that can enroll any eligible donor mother when she comes to the hospital in active labor.

How does it work?

A technologist obtains consent from mothers in labor and collects the cord blood. It is then stored and shipped to Texas, where MD Anderson staff members screen the samples for infectious diseases and carry out genetic characterization. The samples collected at Packard Children’s are then entered into the international cord blood registry, becoming available to caregivers with patients in need anywhere in the world.

“We really want to encourage all our expectant mothers to consider making this altruistic donation,” Agarwal said, adding that her long-term goal is to collect donated cord blood from half of the 5,000 women delivering at Packard Children’s each year. Some patients, including those with infectious diseases such as HIV or hepatitis C, are not eligible to give cord blood, but most can donate.

Meanwhile, Agarwal is seeing first-hand the benefits of using cord blood for Packard Children’s hematology-oncology patients who need stem cell transplants. “In the past year, we’ve done 10 cord blood transplants,” she said. “And this is just the beginning.”

 

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