The pediatric bone marrow transplant ward at Duke University Medical Center is filled with stories of hope and healing. Children come in with leukemia, sickle-cell anemia, cancers that are resistant to standard therapy and genetic diseases that affect the development of the brain or other body tissues.
Often the healing comes, not from bone marrow transplants, but from the stem cells in a donor's umbilical cord blood that includes blood from the placenta as well as the cord attached to a newborn baby.
"Cord blood doesn't have to match as closely as bone marrow, so many people who can never find a perfectly matched bone marrow donor can use cord blood instead," said Dr. Joanne Kurtzberg, director of the pediatric bone marrow and stem cell transplant program at Duke.
Kurtzberg is a pioneer in the cord blood stem cell transplant field. Duke runs the Carolina's Cord Blood Bank, which receives donated cord blood from a network of six hospitals in the state. They include Greensboro Women's Hospital, Duke University Medical Center, UNC Hospitals, Durham Regional Hospital, Rex Healthcare in Raleigh and Western WakeMed in Cary.
Nationally, health experts said cord blood is in short supply because the banks operate on limited private donations. They also said collecting cord blood and processing can be expensive.
"On average, it costs approximately $1,600 per unit," Kurtzberg said.
The federal government has committed $10 million to create a cord blood donations coordinating center. An additional $14 million that is still awaiting approval will help current cord blood banks like Duke's.
"We're hoping, with increased funding, that we can open other collection sites, and we've had many hospitals around the state approach us to participate," Kurtzberg said.
Kurtzberg said a larger supply of cord blood units will ensure more patients who need the transplants will get them.
The stem cells found in cord blood are also being used in research for cell therapy. Duke researchers have found cord blood stem cells may be able to replace damaged cells in the heart, pancreas, liver and brain.
Kurtzberg said more adults will benefit from cord blood stem transplants.
"In the beginning of the field, people thought it would only be useful in children because no one believed that a few ounces of cord blood would have enough cells to rescue an adult after a transplant, but it turns out that bigger units have enough cells for an adult," she said.
The flexibility of stem cells from cord blood will also benefit minorities.
"This does benefit minority patients, particularly African-Americans, because it's very unlikely that they can find a fully matched bone marrow donor," Kurtzberg said. "But because cord blood only needs to match part-way, they can almost always find a cord blood donor."
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