Hematopoietic cells can be defined as primitive cells that have the ability to disintegrate and further develop into a wide range of particular forms of cells. Due to this capability of the same cells, these same stem cells have been used for standard treatment in the present for a variety of immune and auto immune diseases which is evident from the very first introduction of chemotherapy in 1959. The Bone marrow cells are the main source for these stem cells for a number of years now. Treatment in the use of BM, hematopoietic stem cell is made possible from a direct harvest from the bone marrow of a donor before transplanting to the patient or from cryopreserved birth.
In the mid-70s, Knudtzon detected relatively mature hematopoietic progenitor’s cells in the cord blood of human. At birth placenta and umbilical cord both are opulence with hematopoietic stem cells, although the potency of human cord blood (CB) in clinical setting, was not deep until 1989, the first cord blood transplantation (CBT). The first reports for the (CB) procedure revealed the collection of cord blood as a trans-section of doubly ligated umbilical cord during (pending) labor in third stage following the baby’s birth, then suiting and dropping blood from the sectioned umbilical vein into a graduated glass beaker or bottle which contains sodium citrate anticoagulant. However, this technique has been substituted with a more contemporary way where venipuncture and (CB) placed into an integral plastic blood collection bag. There have been two approaches in the (CB) timing of collection, the most considered and used frequently is in the third stage of labor via venipuncture while the placenta is still in the uterus (Sullivan, 2008). To avoid interference with the conduction of birth, the umbilical vein bleeds in the ligated cord attached to the delivered placenta by gravity into a transfusion blood bag as an alternative technique. Though, this technique does not possess the risk of blood clotting in the vein, especially when the cord blood has been previously clamped or otherwise traumatized (Hayani, et al, 2007). On the other hand, this method may lead to lower volume and hence lower nucleated cell (TNC) in the cord blood (CB) collection comparing to the first method. The position of the newborn baby prorated to the mother, after the birth and the infant conserving the cord blood affects the volume of the blood that could be stored. If the newborn is placed at the same level as the mother then the volume of the placental transfusion would be bigger than if newborn placed above the mother. Contrary wise, if the infant is placed beneath the mother, production of greater placental blood flow to the newborn raises its blood volume, which ultimately its hematocrit and diminishing the amount of blood lost. There are other supplemental factors that may affect the blood volume, such as the concepts size, the period between the infant birth and the ligament of the cord, the length and conjuncture of the cord to the placenta (blood clots do to releases tissue factor because of the mechanical attrition).
The very first cord blood banking was set in New York in 1993 because of the need to store and free cord blood for long term and future use. The freezing and storage of cord blood would occur below 150 degree Celsius. This procedure was simple and did not require any manipulation (Sullivan, 2008).
Cord blood hematopoietic stem-cell (HSC) unlike bone marrow transplantation could be replacement to a patient from unrelated donor to a patient who has been suffering from a complex of disease. This form of transplantation has been used successfully in diverse cancers that form in bone marrow and blood and this procedure has been showing promising results as well. The transplantation practicability earn the patient chemordiation or chemotherapy that eliminates the cancer cells, pursue the patient by casting of (HSC), reinstall the patient’s bone marrow and immune system graft-versus-leukemia (GVL) or graft-versus-malignancy which reduces the outcomes of cancer on the body (Hayani, et al, 2007). Until today, cord blood has been used as third source for alternative hematopoietic stem calls as well as bone marrow and mobilization of blood. With a superior percentage of stem cells in the cord blood compared to the percentage in the bone marrow or mobilized blood, this comparison acts as a standard therapy for patients who had been treated with cord blood stem cells to compare to patients who have been treated with bone marrow- derived hematopoietic stem cells. Patients with cut leukemia have also been treated and have shown have expressively better results (Hayani, et al, 2007).
Current medical treatment
Once upon a time, the umbilical cord could be discarded as a waste material but in the present, the cord and its contents are known to be useful as a source of stem blood cells. Cord blood ever since 1989 has been used in the treatment of children with specific blood diseases as well as conducting research that can be used to track the progress of adults in treatment.
Cord Blood is used in the treatment of children who have cancerous blood disorders such as genetic blood diseases like Fanconi anemia or leukemia. The process of treatment begins by a transplant into the sick patient, where HSC makes healthy and new cells acting as a replacement of the damaged cells in the patient’s body. Cord Blood is also used in medical treatment and chemotherapy for cancer. In this manner, cord blood provides medical practitioners with a useful alternative in bone marrow transplants for ill patients. Cord Blood makes it easier to collect bone marrow transplants using cord blood and further makes it easier to store frozen bone marrow until its use in a frozen state (De Vries, et al, 2004). In the medical treatment of bone marrow replacement to create a change of immune responses to the individual receiving transplant. This means that in using cord blood cells, medical experts do not necessarily have to find a perfect match for the donor patient and the receiver patient. Even in its useful nature, Cord blood transplants have its drawbacks. Treating adults with the procedure of cord blood characteristically needs about two units of cord blood in treating a single adult. Previous clinical studies have revealed the use of double cord transplant in adults particularly in the bone marrow transplants. Current studies are being modeled to expand a single cord blood unit to be used in adults. Cord blood apart from treating cancer patients can also be used in the treatment of blood diseases such as blood infection (De Vries, et al, 2004).
Current research on blood diseases
In the present research particularly in transplants, a major limitation of cord blood transplant revolves around the inability for stem cells from a single umbilical cord to contain many haematopoetic cells in bone marrow donation (Rubinstein, 2009). Scientists and medical experts have developed a belief that the main reason for the difficulties in treating adult patients with cords blood because of the larger need for more HSCs than in children. A transplant that contains few HSCs might fail or might lead to slow down of the formation of new cells in the body especially in early times of transplantation. The serious complication in bone marrow transplant has been partially overcome by transplanting blood from different umbilical cords into adults and larger children. The outcomes from clinical trials of double cord transplants have revealed that this technique could be very useful in obtaining the number of HSCs needed the whole process of transplant (Rubinstein, 2009).
Current Research in treating other diseases
Scientists have developed a desire to look out for the benefits of using the double procedural transplant on patients. Numerous research teams have reported animal studies in the success of cord blood being used to repair other bodily tissues apart from blood. Body tissues present in medical issues such as strokes and heart attack are the new findings that medical practitioners have produced clear results on (Haller, et al., 2008). The clear results developed in the new research findings reveal positive effects on patients whose heart and nerve cells need replacement. Because of the fact that cord blood cells have the ability to release substances that enable repair of body organ, nerve and heart cells repair and replacement is made possible. A present clinical testing investigation trial of cord blood treatment in children with type 1 diabetes was successful as well (Haller, et al., 2008). However, from this clinical testing, scientists revealed that new cord transplants can make it possible for treatment of children with conditions such as traumatic brain injury and cerebral palsy.
The future of Cord blood cells in treatment
Scientists among other medical experts have believed that the blood in umbilical cord acts as a significant source of blood stem cells and are further expecting a full potential in the treatment of psychological disorders as well. Some other kind of stem cell like induced pluripotent stem cells might prove well suited in treated diseases that are not blood related but this issue can only be addressed in future research of cord blood stem cells. The new technique in the success and treatment using cord blood revolves around the combination of two blood units that would make adult treatment successful. The new practice of cord blood banking is also used by researchers presently to find out compatible samples before a donation of organs is requested (Sullivan, 2008). The cord blood bank acts as a biological insurance and assurance the transplant might be successful in specific life threatening diseases.
De Vries, E.G.E., Vellenga, J.C., Kluin-Nelemans., & Mulder, N.H (2004). The happy destiny of frozen haematopoietic stem cells: from immature stem cells to mature applications. European Journal of Cancer, 40(2004); 1987-1992.
Haller M J; Viener, HL; Wasserfall, C; Brusko, T; Atkinson, MA; Schatz, DA; et al. (2008). “Autologous umbilical cord blood infusion for type 1 diabetes.”. Exp. Hematol. 36 (6): 710–715. doi:10.1016/j.exphem.2008.01.009
Hayani, A; Lampeter, E.; Viswanatha, D.; Morgan, D.; Salvi, S. N. (2007). “First report of autologous cord blood transplantation in the treatment of a child with leukemia”. Pediatrics. 119 (1): 296–300. doi:10.1542/peds.2006-1009
Rubinstein, P. (2009). Cord blood banking for clinical transplantation. Bone marrow transplantation; 44(2009); 636-643.
Sullivan, M. (2008). Banking on cord blood stem cells. Science and society, 8(1), 554.