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Presseinformation Workshop 30.6.2006 in Leipzig

 
 
 
 
 
 
 
 
 
 
 
 

Hematologist John E. Wagner presents new data on umbilical cord blood transplantation at the workshop “Stem Cell Therapy in Germany – Alternative Approaches and Future Prospects" of the German Society for Regenerative Medicine in Leipzig
Regenerative medicine is undoubtedly a promising area for innovative therapeutical approaches. Public discussion on future applications of stem cells, however, often ignores the fact that they are already an established element in the therapeutic regime for certain types of cancer. Hematopoietic stem cells (HSC) collected from bone marrow or peripheral blood are administered to patients following severe radiation or chemo-therapy to rebuild their blood-forming system. An alternative, and superior source of stem cells for the treatment of patients with leukaemia is umbilical cord blood (UCB), as Prof. Dr. John E. Wagner, University of Minnesota, reported at a workshop on stem cell therapy, organised by the German Society of Regenerative Medicine (GRM). Since experience with the clinical use of this stem cell resource is practically missing in Germany, the director of the Division of Hematology- Oncology and Blood and Marrow Transplantation was invited to present the current status of UCB transplants in the U.S. to an audience of about 20 leading scientists from academia and industry. At the workshop, which was moderated by Prof. Dr. Thomas Skutella, Director of the Center of Regenerative Biology and Regenerative Medicine, Univ. of Tübingen, and scientific spokesperson of the GRM, Wagner stated that UCB transplantation is an expanding practice for both pediatric and adult patients and predicted that in the near future unrelated umbilical cord blood will largely replace other sources for HSC transplants – a trend that is already obvious in the USA and Japan, while most European countries, including Germany, drastically lag behind.

In 2005 UCB already surpassed bone marrow and peripheral blood combined as source of stem cell transplants for children in the U.S., and for adults in Japan. At Wagner’s institution alone more UCB transplants were performed than, e.g. in all clinics in Germany combined, where other stem cell sources are favoured.In contrast to adult bone marrow, the stem cell compartment in UCB is less mature, including a higher proliferative rate both in vitro and in vivo, associated with an extended life span and longer telomeres. As Wagner stated, this preference in the U.S. is based on the fact that recent data indicate a poorer survival rate for recipients of peripheral blood stem cell transplants compared to bone marrow, and that UCB, in contrast to the use of stem cells from parents (haploidentical stem cells) only requires well established standard procedures in graft manipulation and therapeutic regime. A major obstacle for an even more extended use of umbilical cord blood transplants is their availability. The estimated 7,000 samples transplanted worldwide in 2005 had to be selected from about 320,000 samples stored in centres around the world. To overcome this shortage U.S. congress recently passed a bill for a national programme that will allocate almost 80 million dollars to augment the national UCB inventory.
Another problem with UCB transplants is the low number of HSC found in many units. In general a patient requires a certain cell dose per kg of body weight for a graft to take and induce hematopoiesis. Below this threshold chances for survival decrease. By transplanting UCB samples form two instead of one donor only – and thus increasing the amount of transplanted cells - Wagner significantly improved the survival rate for juveniles and adults, in particular. This effect is attributed both to better engraftment and a more pronounced anti-leukemia effect of the double transplant, which reduces the frequency of recurrences of the malignancy. However, this new therapeutic regime is not only beneficial to the patient, but it is also economically sound. In spite of the fact that a second unit of transplanted cord blood costs an extra 25,000 dollars, the better overall success rate of the new therapeutic regime actually reduces its average cost per patient. With the fixed amount insurance companies pay per treatment in the U.S., the clinic can thus increase its profit per transplantation by 50 percent.
But Wagner not only predicts a dramatic increase in UCB transplants for the treatment of leukemias. Because of its content of blood cell precursors involved in immune regulation, UCB also holds great promise for therapies of autoimmune diseases, including diabetes. In the more distant future he also expects its multipotent adult stem cells to be used as starting material for tissue regeneration. UCB stem cells could develop into a practical alternative to embryonic stem cells which face opposition for ethical concerns, both in the U.S. and some European countries, as well as for medical reasons since they tend to develop into malignant teratomas in animal models.
At the workshop one of the participants, Prof. Dr. Frank Emmrich from the University of Leipzig, provided a fascinating glimpse of these future applications of UCB stem cells in regenerative medicine. He injected stem cells isolated from human UCB into rats after induction of an artificial stroke. Their recovery of motoric ability was remarkable. In line with these encouriging results USC stem cells may serve as a universal allogenic source for cellular therapy for regenerative medicine. In the final discussion all participants agreed that UCB offers fascinating perspectives to improve established clinical therapies in cancer treatment, and to develop new approaches for the treatment of a number of diseases. Germany, however, runs the risk of – once again- missing out on a biomedical innovation, unless programmes such as the one initiated in the U.S. will help to ensure a wider access to UCB in this country, and clinicians can gain more experience with UCB stem cells.
By opening the discussion on UCB the GRM wants to contribute to an open exchange among researchers from various disciplines with the aim of encouraging a wider use of this valuable source of stem cells, both in basic research and in already practicable therapies.

Excerpts of the presentation given by Prof. Wagner can be downloaded at www.gesellschaft-regenerative-medizin.de under “aktuell”

For more information please contact
Deutsche Gesellschaft für Regenerative Medizin e.V.
Ulrike Schwemmer Laubestr. 34
60594 Frankfurt a.M.
Tel.: 069-61 99 51 19
Info@gesellschaft-regenerative-medizin.de