UMBILICAL CORD MIRACLE?

Byline: Gary Mays Chicago Tribune 

Upon the birth of their third child in December, Jeanne and Everett Simons spent $1,500 on a new and controversial medical procedure that they hope, in Everett's words, "will be a waste of money."

The couple from the Chicago suburb of Palatine, Ill., asked an obstetrician to painlessly harvest several ounces of blood from the newborn's umbilical cord for long-term storage so that if the child ever contracted leukemia or any other disease requiring a bone-marrow transplant, the baby's own blood cells would be available.

The umbilical cord contains a dense concentration of critical stem cells, which generate healthy blood cells. Once a baby is born, these stem cells are found chiefly in bone marrow, where they are difficult to harvest and to match.

The Simonses will also spend $95 per year to store baby Laura's cord blood. "I hope we never need it," said Everett Simons, an engineer whose baby was born Dec. 26. "But it's possible."

At a time when bone marrow donor banks have expanded but are still unable to meet the heavy demand from gravely ill patients, cord blood may be a solution that saves hundreds of lives each year.

It could be a particular boon to African-Americans, for whom the shortage of donors is most acute, say experts at the University of Chicago's Wyler Children's Hospital, which was among the first hospitals in the area to perfect the cord blood transplant technique.

Still, the so-called "cord bank" program to harvest umbilical cord blood and store it to be used either for the original donor or someone else, is also beset by questions. Some doctors say there is no proof that the cryogenically frozen stem cells will be viable decades later, and others worry about the opportunity for ethical land mines as for-profit firms begin to vigorously market the procedure.

"It is the perfect source in children and, hopefully, adults," says Dr. Richard Harris, who performed the nation's first cord blood transplant in 1990 at Cincinnati's Children's Hospital Medical Center.

While the procedure is relatively new, cord blood has been used successfully instead of donated bone marrow to help replace stem cells lost to disease in approximately 200 cases.

Any father who has taken part in the time-honored ritual of cutting the umbilical cord in the delivery room knows it is filled with dark red blood.

Before birth, stem cells are stored in the umbilical cord, and as the fetus develops, they are circulated throughout its tiny body. Some stem cells become red blood cells, which transport oxygen, while others turn into white blood cells - those that are responsible for fighting off viruses and other diseases. Still others turn into platelets, the cells that allow blood to clot.

Medical experts say cord blood has some distinct advantages over bone marrow as a source of stem cells. For one thing, it is 10 times as rich in valuable stem cells as bone marrow. And it is "immunologically naive," meaning it is less likely to attack the body's own cells - a syndrome known as "graft vs. host" that can render the treatment a failure, according to Dr. Stephen D. Smith, a pediatric cancer specialist at Wyler.

Moreover, unlike bone marrow, a perfect match with the patient's own blood is not always necessary with umbilical cord cells, which makes it a promising source of transplant material.

"It is still experimental but there's lots of excitement about this in a lot of different areas," says Smith. "From my medical perspective, and I've been doing this for 20 years, I don't see any tragic flaw with it."

In the past, blood from the placenta and umbilical cord was simply thrown away. Now hospitals and private companies are setting up their own cord blood storage facilities. That has prompted the U.S. Food and Drug Administration to begin the process of drawing up guidelines for the proper collection, storage and use of cord cells.

And in an effort to make cord blood transplants an option for patients across the country, the National Institutes of Health is working with several leading blood centers on a multimillion-dollar effort to establish a national cord blood bank, similar to the National Marrow Donor Program now in operation.

When the Simonses needed a company to store baby Laura's umbilical cord blood, they turned to Boston-based ViaCord, perhaps the largest firm of its kind in the nation.

The procedure was fairly simple: Before their baby was born, Jeanne Simons' blood was screened for viruses. After Laura was born, the doctor used a syringe to collect about 5 ounces of cord blood material and placed it into a plastic bag. A courier then rushed it to a ViaCord-affiliated blood center in Cincinnati, where technicians put it on ice indefinitely.

There is only about a 1 in 10,000 chance that their baby will ever contract a disease for which a stem cell transplant is an option, but the Simonses say the cord blood could someday save the life of another family member or even a complete stranger.

"I've worked in a hospital, and I've seen enough cancer to decide it was just one of those things I wanted to do," said Jeanne Simons, a microbiologist whose previous jobs were in medical laboratories where cancer is often identified.

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PHOTO

Photo Jeanne and Everett Simons share a moment with newborn baby Laura as 3-year-old daughter Jessica looks on. Blood from Laura's umbilical cord could help her or, potentially, someone else as an alternative to bone marrow. Chicago Tribune