Umbilical Cord Stem Cells and Cancer


The umbilical cord blood stem cells have been used to treat cancer patients whose bone marrow tissues have been wiped out by radiation or chemotherapeutic treatments. Several clinical trials have addresses the capacity of umbilical cord blood to reconstitute the bone marrow of cancer patients.

The first set of clinical trials have examined the use of umbilical cord blood in children. Gluckman and her colleagues reported the use of umbilical cord blood to treat children who had suffered from a variety of blood maladies. 74 patients were treated with umbilical cord blood. 63% of the patients survived one year after the procedure, and the rate of graft-versus-host disease (GVHD) was only 9%. Now this study showed that umbilical cord blood could be used to reconstitute the bone marrow, but how well does it work compared to bone marrow transplants?

To answer this question, Rocha and his colleagues compared kids who had received umbilical cord blood transplants with those who had received bone marrow transplants. 113 cord blood transplant patients were compared to 2052 bone marrow transplant recipients. In this study, the umbilical cord blood recipients took longer to have their bone marrow reconstituted, but the rate of graft-versus-host disease was lower. The survival rate of the two groups three years after the procedure was also about the same (64% for the umbilical cord blood recipients and 66% for the bone marrow recipients). Thus, umbilical cord blood seemed to work as well as bone marrow when it came to reconstituting the bone marrow.

Since the rates of GVH disease were so low, could umbilical cord blood that was not properly tissue matched to the recipient also work? The answer was yes. Once again Gluckman and her colleagues showed that the rate of GVH disease was rather low, and the rate of recovery in a group of 65 patients was quite high (87%). Such a treatment with unmatched bone marrow would be a disaster, since GVH disease would almost certainly result from such a treatment. The results of Gluckman’s small study were confirmed by a much larger study by Rubinstein and others in 1998.

Can cord blood be used to treat adults with similar maladies? Clinical studies have confirmed that the answer is yes. Survival rates from a host of clinical trials have ranged from 15%-70%, but clearly adults can benefit from umbilical cord blood transplantations. Once again, the rates of GVH disease were lower in umbilical cord blood recipients when compared to bone marrow recipients, but once again, the time required for bone marrow recovery was greater.

In Minnesota, Wagner and his colleagues pioneered the use of “double umbilical cord blood grafts” in which umbilical cord blood is taken from two different babies to treat an adult patient. This overcomes the limited volume and cell numbers in an umbilical collection from a single donor. These are only used for patients who are very ill, but studies have shown that patients who have received double umbilical cord blood grafts have a ten-fold lower decrease in the risk of relapse of blood cancers.

Thus over the past two decades, umbilical cord blood transplants have become rather attractive sources of material to reconstitute bone marrow. Although low cell numbers are still a chronic problem with them, the ability to culture and expand these cells in culture may give a new life to this useful treatment.

British Hospital Refuses to Hydrate a Dehydrated Patient: Hospital Administrators Hide and the Patient Died


I lived in Great Britain for three years (1994-1997) and have first-hand experience with the National Health Service. Needless to say, I was not impressed. They do fine with child-birth and then abandon older people to their own fate. Nationalized health care is rationed health and do not let anyone tell you differently. When you become old enough, the health service you spent your whole life paying into abandons you in your time of greatest need. Now we have a stark example of this.

Wesley Smith has a blog entry on this. It will make you sick. According to the British newspaper, The Daily Mail, a desperate hospital patient died after he was denied hydration by the hospital. To get hydration, he called the police and begged them to bring him a drink. The patient, Kane Gorny, 22, needed drugs to regulate his hormone levels after successfully beating brain cancer months earlier. However, during a further hospital stay nurses forgot to give him his medication and he became so delirious he was forced to call 999 (the UK equivalent of 911) to ask for help. The police officers went to St George’s Hospital in Tooting, south London, but were turned away by staff who insisted that Mr Gorny was fine. Gorny had been admitted in May 2009 to undergo hip replacement surgery after his bones became brittle. This was a side-effect of his prescribed steroids. Kane’s mother, Rita Cronin, said she spent hours trying to convince hospital staff that Kane needed urgent attention but was repeatedly “told he was alright.” See http://www.dailymail.co.uk/news/article-2167643/Patient-dying-thirst-rang-999-Inquest-hears-mothers-fury-nurses-neglected-son.html for the article.

An inquiry into the matter has been initiated by the Crown Prosecution Service at the behest of Gorny’s parents.  Kane Gorny had surgery on his pituitary gland, and he had problems regulating his levels of salt and water in his system.  Pituitary surgery commonly damages that back part of the pituitary gland and this prevents the release of antidiuretic hormone (ADH, also known as vasopressin).  Without ADH, patients have a condition called diabetes insipidus, and they need to take exogenous ADH.  Without exogenous ADH, the patient will urinated themselves to death.  The nurses failed to give him his medicine, and dismissed his concerns and the concerns of his mother.  Because he was so dehydrated, Kane called the police to get some fluid, but the nurses at the hospital dismissed them.  He died from dehydration and abnormally sodium levels.  His death was almost certainly a painful one.

The inquiry will probably result in some nurses being sacked (British for fired), but the status quo will probably be maintained.  This kind of abuse is more routine in the British Health System than they would probably admit.  Doctors have even started to prescribe water to elderly patients to prevent them from dying from dehydration.  Is this what we want for the US?