Our Cord Blood Research

Cord Blood Program

Our Research

chart showing comparison of standard transfusion with expanded cord blood transfusion

Comparison of standard transfusion with expanded cord blood transfusion based on initial trial.

Improving transplant outcomes

The laboratory and clinical research components of our Cord Blood Program work together and in collaboration with our colleagues across the Hutch to improve outcomes for cord blood transplant recipients. This collaboration emphasizes better understanding of how cord blood cells engraft (take hold in a patient), improving conditioning regimens, and developing standards of care for infection prevention. Our work has explored conventional as well as innovative approaches to achieving these goals. The Cord Blood Program has conducted over 300 cord blood transplants to date. Outcomes for our patients reflect this effort, with survival rates equivalent to patients receiving unrelated donor bone marrow or peripheral blood hematopoietic cell transplants.

Developing revolutionary techniques

Laboratory and clinical research components of the Cord Blood Program, led by Dr. Colleen Delaney, are focused on the development of revolutionary techniques for improving outcomes from transplantation and changing the standards of care to help prevent infection and speed recovery after transplant or chemotherapy.  This is being done by harnessing cord blood's lifesaving power.

Cord blood as a source of donor cells for transplant offers many benefits: it can be collected easily and stored for later use, it does not have to be as well matched as bone marrow or peripheral blood to a patient’s tissue type for transplantation, and there is a lower risk of viral transmission or a serious complication known as graft-versus-host disease. However, a major drawback is the low number of blood stem cells found in each cup-sized donation.  

Expanding the number of cord blood stem cells

Based on findings from Dr. Irwin D. Bernstein’s lab at Fred Hutch and in collaboration with his group, Dr. Delaney has developed a breakthrough technique that significantly multiplies, or expands, the number of stem cells in each cord blood donation.

These expanded cord blood stem cells, which are being tested in clinical trials now, may be used in conjunction with other therapies to provide patients going through transplant or chemotherapy with a bridge of infection-fighting cells while they wait for blood and immune system recovery. Delaney's vision is to create a therapy that can become FDA approved and be given to patients around the world.

graphic showing the process for multiplying cord blood cells

The clinical trials have shown that patients who receive expanded cord blood cells as part of their cord blood transplant recover their infection-fighting white blood cells about twice as fast as patients receiving non-expanded cord blood transplants — ultimately resulting in fewer infections and less-severe side effects.

Current project snapshots

  • Investigating how the expanded cord blood product prevents infection after chemotherapy.  Using preclinical models, we are testing whether or not expanded cord blood cells protect the body by preventing damage to the lining of the gut. Patients whose immune systems are damaged by their cancer treatment often have mucositis in the entire digestive tract, from mouth to intestines. We hope to prevent these sores from developing, which would keep potentially dangerous bacteria in the gut from entering the bloodstream and causing infections. These efforts could lead to yet another potential use for expanded cord blood product: to help prevent organ rejection after patients receive a transplanted kidney, heart or other solid organ. 
  • Understanding how double cord blood transplants work against blood cancer. In a double transplant, a patient receives units of cord blood from two different donors — but as the Delaney Lab’s research has shown, only one unit eventually survives and engrafts in the recipient’s body. The “winning” cells then attack the recipient’s cancer much more effectively than they would have if they had been transplanted by themselves.  We are working to understand exactly what is happening with these cells in the days and weeks after a double cord blood transplant. Analyses show how these cells interact with each other and with the recipient’s body to influence outcomes.  Our insights that will help to make combination therapy more effective for more patients.

CORD BLOOD TRANSPLANTS GIVE HOPE

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