Minnesota to resume umbilical cord blood donations

Donating umbilical cord blood — a rich source of lifesaving stem cells — hasn't been an option for new mothers in Minnesota for years.

But a new partnership between the University of Minnesota and the St. Louis Cord Blood Bank in Missouri could restore that chance — and accelerate research at the U, a pioneering center for cord blood transplants and stem cell research.

Leaders of the two organizations are meeting Tuesday to finalize a deal allowing the university Medical Center to collect cord blood after childbirth and send it to St. Louis to be stored and matched to patients who need it.

Transplants of the regenerative stem cells in cord blood help fight cancers such as leukemia by killing the cancer cells and rebuilding immune systems that are wiped away by chemotherapy and radiation.

The absence of local donation hasn't hindered Minnesotans in receiving transplants from a national donor pool, but it has hampered the pace of research at the U, where Dr. John Wagner performed the world's first cord blood transplant for leukemia in 1990.

And it is something of an embarrassment, considering the U's prominence in the specialty and the fact that Be The Match, the organization that matches cord blood to patients, is based in Minneapolis.

"Fact is, this is the world's largest cord blood transplant program," said Dr. Jeff McCullough, a U pathologist and specialist in transfusion medicine. "To not even be collecting here for potential transplants? We should be able to do better than that."

Researchers benefit from local collections because they can receive cord blood units that are ruled unsuitable for transplant. Lacking that, Wagner's team has had a limited supply of cord blood for research and has paid a premium to buy discarded units from other states.

U researchers are trying, among other things, to determine if cord blood medicine can move beyond rare cancers and become effective treatments for common diseases such as diabetes. They also are studying ways to coax cord blood stem cells to work faster, especially for cancer patients at risk of fatal infections while their immune systems recover.

Cord blood is the lingering blood in the umbilical cord and placenta after childbirth. Donation involves draining that blood after the cord is clamped and severed from the newborn.

While cord blood isn't the only source of stem cells, it has advantages over stem cells that are commonly obtained from adult bone marrow donors.

Phillip Englund received a stem cell transplant at the U Amplatz Children's Hospital 80 days ago, at the ideal juncture of his chemotherapy and radiation, because a cord blood unit was immediately available.

On Friday, the 20-year-old from Grand Rapids, Minn., learned he is on track to go home after months in the Minneapolis hospital to fight leukemia, and that he can think about resuming college.

"It saved my life," he said. "As weird as it is [to receive stem cells from umbilical cord blood], it was what I needed."

The American Red Cross used to bank cord blood from hospitals in Minneapolis, Coon Rapids and Mankato but got out of the business six years ago.

McCullough directed the Red Cross bank at the time, and tried unsuccessfully to get the U to take it over. Other efforts to maintain cord blood banking in Minnesota fell apart when federal grants were steered toward states with greater demographic diversity, because of the need for cord blood from ethnic and racial minorities.

Starting a new bank would be difficult: It would have to collect hundreds of cord blood units at a cost of $2,000 per donation until it matched one to a patient and sold it to a transplant center.

Instead, existing banks are seeking to increase the national inventory by forming partnerships in other states.

Seeking a satellite donor site in Minnesota is a "no-brainer," said Donna Regan, who directs the St. Louis bank.

"We know they have the infrastructure and the interest and the motivation to collect cord blood."

Under a proposed deal, the St. Louis bank would bear the financial risks and rewards of collecting the cord blood for transplants, and the U would gain free access to discarded units for research.

Among other innovations, U doctors pioneered the "double-cord" transplant by which two cord blood units are mixed for a single transplant. Individual units are sufficient for children, but often too small to treat adults.

They also are studying ways of broadening the "match" between donor and patient. Mismatched stem cells from bone marrow carry the risk of being rejected by patients after transplant — a complication that can be fatal.

But U studies indicate that cord blood stem cells don't need to be as closely matched, and might even offer cancer-fighting benefits when mismatched.

That, ironically, could reduce the need for more cord blood donation, Wagner added, because it would increase the potential uses for every unit in the national inventory.

But other medical developments could have the effect of reducing supply. More mothers, for example, are asking that the clamping of their umbilical cords be delayed 30 to 60 seconds so more cord blood can transfuse into their newborns. The American College of Obstetrics and Gynecology hasn't endorsed the practice, but noted in a policy statement last December that it might offer health benefits. Delayed clamping, however, leaves less blood for donation — often too little for transplants.

Demand for cord blood, meanwhile, could be on the rise — especially if research by Wagner and his colleagues prove that cord blood is effective against a broad new range of diseases.

Jeremy Olson • 612-673-7744