Multiply the umbilical cord cells to improve the success of transplantation
New research published in the journal Nature Medicine ‘has proved possible to multiply in the lab, before injecting, so that the transplant will work.
As in the traditional bone marrow transplant, stem cells from a compatible donor umbilical cord are used to regenerate the bone marrow of patients with leukemia and other haematological malignancies. First, chemotherapy ‘clean’ all malignant cells and, subsequently, the umbilical blood of the donor is responsible for ‘repopulate’ again.
The problem is that when stem cells are injected are not enough, take too long to generate new blood cells (clean of cancer). This leaves the patient several weeks with a bone marrow ‘medium gas’ (aplastic), and susceptible to infection, rejection or even death.
So far, this problem is solved by combining cells from two different strands (or by using this material especially for children, who do have sufficient size). However, the solution might be to expand, to complete a single unit a sufficient number of stem cells, as scientists have succeeded Fred Hutchinson Center in Seattle (USA).
As many as in the bone
As the team explains Colleen Delaney, his method of “cell engineering” (via a pathway called Notch signaling) has succeeded in multiplying by 164 the number of stem cells from a single cord and in a small clinical trial, injected with successful in 10 patients with leukemia. Delaney explained that if a string is slightly less than 200,000 stem cells per kilo of weight of the receptor, they managed to raise this figure to six million cells, which is more similar to other cell sources, such as bone marrow or called hematopoietic progenitors.
“The small proportion of cells is a problem we are trying to solve 10 years ago,” explains Joan ELMUNDO.es Garcia, one of the leaders of the Blood and Tissue Bank of Barcelona. Evidence of this interest is that there are numerous groups, one of which is itself trying to expand Garcia in various ways.
The advantage is that the cord is not necessary as accurate compatibility between donor and recipient and with cells from the bone, making it a good choice when there is a fully compatible marrow. It is estimated that 30% of patients who need non-identical donor available in public banks around the world, a problem which amounts to 95% for ethnic minorities.
Successfully tested
Manipulation is safer have shown in a first phase I study with 10 patients with leukemia (who were between three and 43 years), but still have to wait for more extensive research results in order to implement the ‘multiplication’ to large scale. Being an investigation as experimental, participants received two units of cord, one expanded and one without prior handling.
“There was a risk that when multiplied, the manipulated cells losing the effect of stem cells and disappear with the passage of time,” says Dr. Garcia, “so they made sure at least long-term success without manipulating the cord” .
If a transplant usually takes about three or four weeks to ‘catch’ (ie, replaced with clean bone marrow cells from the patient), the expanded cells did it in just 14 days. And the tests showed that white blood cells that were generated before (only a week after the transplant) are the result of expanded stem cells. Seven of the patients still alive at the moment and no sign of leukemia.
One of the issues to be monitored closely for researchers is the possibility that these engineered cells can generate tumors in the future, “a theoretical risk that exists and has not yet been resolved,” as noted by Garcia. At the moment, says this specialist, such studies are very promising, although there will be cautious: “It’s not the best, but it’s something.”
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