Rumbo, Liliana Cadavid

Audience served: Latino community in San Antonio, Texas

A Medical Option That’s Now Available: Cord Blood Stem Cells Give Life by Liliana Cadavid.

Cord blood stem cells treatments are a feasible, accessible and increasingly available option in modern medicine that helps to save hundreds of lives.

Camilla Alecia Diaz-Weber, 2 years old, had a big smile when she came in to the transplant clinic at the Methodist Hospital in San Antonio for her monthly checkup.

She moved her little arms hurriedly, excited to see the clinic staff. Everybody was very familiar for her. She has been there many times after the cord blood stem cells (CBSC) transplant that she received four months ago.

When Camilla, from Eagle Pass, Texas, was 19 months old, she was diagnosed with severe combined immunodeficiency (SCID), a rare genetic disease that according to the National Human Genome Research Institute (NHGRI) affects 40 to 100 children in the United States each year.

Children with SCID are very susceptible to any type of infection because they lack an immune system, according to hematologist Jaime Estrada, member of the Transplant Program at the Texas Transplant Institute in San Antonio (TTI). “The only treatment that can cure these children is the bone marrow or cord blood stem cells transplant. If they are not treated the prognosis is fatal,” he said.

Stem Cells have the ability to develop into other types of cells with specific functions, explained hematologist Anthony Infante, professor of Immunology at the University of Texas Health Science Center in San Antonio. The blood from the umbilical cord, he added, is particularly rich in cells that have the ability to mature into others cells that form blood.

“Currently, CBSC are widely used to treat leukemia, diseases of the immune system and other inborn related disorders in children,” he said.

Camilla was fortunate. On July 14 2007, she received a transplant at the TTI, covered by her family’s private health insurer. The transplant saved her life.

“Her doctor told us that in about a year she should be totally cured,” said Lori Diaz Weber, Camilla’s mother.

Similarly to Camilla, Ithzbel Aurora Huerta, 3 years old, from Laredo, Texas, was treated with CBSC, was covered by Medicaid, but suffered from a different disease. When she was two months old, she was diagnosed with an inborn bone marrow failure known as Severe Aplastic Anemia and received the transplant. “If it had not been for the CBSC transplant, I would not have her with me today,” said Arizbel Perez, Ithzbel’s mother.

Arizbel said she never heard of treatment with CBSC, but now that she has learned about it, she tells all her girl friends if they decide to become mothers, they need to plan on donating their babies’ cord blood to a public bank. “Someone who did this at a certain moment, saved my daughter life,” she said.

The CBSC transplant has many advantages, according to Donna Wall, Director of the Bone Marrow and Cord Blood Stem Cells Children’s Transplant at TTI. The most important thing in a transplant, she explained, is to find a donor who is compatible and certainly one of the things that we like the most about CBSC is that we don’t have to find a donor that has exactly the same type of immune system.

Also, she added, it is easier to find a cord blood unit in a public bank than it is to find a live bone marrow donor. “When we perform transplants in children, the CBSC is our preferred source from an individual outside the family.”

But when it comes to treating adults, the CBSC might not always be so helpful.

The problem of CBSC transplants is that the cells that are available are the ones that were obtained at the baby’s delivery; there are no more, said Dr. Yago Nieto, professor of the Department of Stem Cells Transplant at MD Anderson in Houston.

“Sometimes, a unit of cord blood can be very small to treat an adult patient”, Yago said. “It can work well but we have to make sure that the number of cells will be enough according to the patient’s weight.” Right now, scientists are studying an option to work in laboratories to expand the number of stem cells in a cord blood unit, said Infante, but “the idea is being able to do so without altering the stem cells’ ability to function properly.”

To Store or To Donate: A Dilemma

Is it better to pay for storing a cord blood unit of a newborn baby or to donate it to a public bank? That’s a common question among mothers- to- be. It is also a frequent question that Dr. Donna Wall of the Texas Transplant Institute in San Antonio is asked by doctors, lawyers and moms. “Public Banks have an important purpose: provide units of CBSC to those that need them."

The majority of people, she continued, are not going to ever need a transplant. “So, why pay to store a baby’s cord blood in order to use it for that same baby in the future, if that is not likely to happen”, she said. “On the other hand, many of the disorders we treat are inherited, so the blood is going to have the same problem.”

Doctor Yago Nieto, from MD Anderson in Houston, suggested that people should donate cord blood to a public bank. “Doing this causes no harm to health, it can help save lives and it does not cost anything. To store cord blood in a private bank will cost a lot."

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