The usage trend of autologous stem cell


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The usage trend of autologous stem cell

  1. 1. - Hematopoiesis - -The growth of autologous cord blood usePosted By Alex On May 30, 2010 @ 12:21 am In clinical trials | 1 CommentThis is a guest post by:Frances Verter, PhD (Parent’s Guide to Cord Blood Foundation, USA) and J.J. Nietfeld, PhD (Dept.of Pathology, Univ. Medical Center Utrecht, Netherlands)The significance of autologous use of cord blood is a matter of constant debate. Therefore, thegrowth rates of autologous use versus allogeneic use of cord blood were compared.Parent’s Guide to Cord Blood Foundation [1] (PGCB) maintains the only international database ofchildren who received autologous treatments with cord blood that was stored in family banks.Starting in 2005, cord blood infusions have been used for experimental “regenerative medicine”;treatments where it is hoped that the infusion of cord blood stem cells will help the patient’s body torepair itself. By the end of 2009, the database had cataloged 211 autologous treatments around theworld; 73% of them took place in 2008 and 2009.Correction: Because some cases were just presented at the ISCT 2010 [2] and not included in ourdatabase yet, we estimate that the actual number of autologous treatments by the end of 2009 is atleast 211 + 44 = 255.We compare the autologous and allogeneic use of cord blood by plotting the cumulative number of
  2. 2. cord blood treatments versus time, for the autologous data from PGCB and the allogeneic data fromthe WMDA [3] . Looking at 2008, the number of autologous treatments is about 100 times lower thanthe number of allogeneic treatments. However, the rise in the cumulative number of allogeneic cordblood use is linear over the last few years, whereas that number for autologous use is rising fasterthan exponential.Forecast of the future comparison of autologous and allogeneic use of cord blood:Allogeneic use of cord blood among USA children can be predicted based on the actual transplantrates compiled by CIBMTR [4] for 2001-2003. The cumulative probability that a child will receive (notrequire) an allogeneic stem cell transplant by age 10 is 0.02% or 1 in 5000. If all allogeneictransplants used cord blood as the graft source, that would be the maximum rate of use.(Reference: Nietfeld JJ et al. 2008; Biology Blood Marrow Transplantation 14:316-322 [5] )Autologous use of cord blood among USA children can be estimated based on the prevalence (ie:cumulative probability) of those indication for which autologous cord blood is currently being used inclinical trials. For the sake of argument, let us consider only Cerebral Palsy (CP) and Hypoxic-Ischemic Encephalopathy (HIE): The prevalence of CP among elementary school children (ages5-10) in the USA is 1 in 300. (Reference: Centers of Disease Control)If autologous cord blood therapy should prove efficacious for only 12% of children with CP, thedemand for autologous cord blood would still be 1 in 2500, double the 1 in 5000 use of cord bloodfor all pediatric allogeneic transplants combined.
  3. 3. Conclusion:Medical societies or individual physicians who issue opinions on cord blood storage thatignore the fast growing autologous use of cord blood for mainly regenerative medicine arenot making evidence-based recommendations.PS: These data were presented at the International Society for Cellular Therapy annual meeting [6] .Philadelphia, May 23-26, 2010.How to cite: Verter F, Nietfeld JJ. The growth of cord blood use. Cytotherapy 2010; 12: suppl. 1,abstract #157 [7]Article printed from Hematopoiesis: http://hematopoiesis.infoURL to article: in this post:[1] Parent’s Guide to Cord Blood Foundation:[2] ISCT 2010:[3] WMDA:[4] CIBMTR:[5] Biology Blood Marrow Transplantation 14:316-322:[6] International Society for Cellular Therapy annual meeting:[7] Image: Click here to print.
  4. 4. Copyright © 2009 Hematopoiesis. All rights reserved.