Annual Report 2014
By Dr. Sabrina Richards
Bone marrow transplantation was pioneered at Fred Hutch as a cure for many types of leukemias and lymphomas. This groundbreaking procedure has since been performed over 1 million times worldwide, but hope for a cure remains out of reach for many patients who lack genetically matched donors. To help them, Fred Hutch is again nurturing a future cure: a next-generation blood stem cell transplant that could put the lifesaving treatment within reach of any patient in need. The treatment relies on umbilical cord blood.
Cord blood harbors the same blood stem cells that can replace a patient's cancerous bone marrow, but it doesn't need to be nearly as well-matched to the patient as adult blood stem cells do. This makes it a good option for patients who can't find a matched adult donor, many of whom are ethnic minorities or of mixed race.
Dr. Colleen Delaney, who heads Fred Hutch's Cord Blood Program, is designing a product that harnesses cord blood's advantages (no need for perfect matching) while overcoming its disadvantage (the low number of key blood stem cells found in each sample). Her goal is to create an off-the-shelf cord blood product available to anyone, anywhere, in need of a transplant — irrespective of their genetic make-up.
Delaney's progress has been impressive — thanks to critical private support, including contributions from the Bayley family, which shares her vision of a future where no transplant patient goes wanting. It is a dream close to their hearts.
In 2004, Jacquie and Björn Bayley's 17-year-old son, David, noticed an unusual lethargy during soccer practice. Blood tests showed he had acute myeloid leukemia. After initially successful chemotherapy, he relapsed in 2006. Doctors prescribed a bone marrow transplant.
David's medical team found a donor in Germany whose DNA matched at nine out of ten genetic sites. The transplant worked. "I feel so lucky I came through it so well," explains David, who's been cancer-free ever since, with only one lingering side effect, a slight dryness to his eyes, to remind him of the procedure. "But I saw many who weren't as successful." He knew patients whose transplants didn't "take" or who struggled with debilitating graft-vs.-host disease, a complication in which donor immune cells attack the patient's healthy tissues.
The Bayleys knew they wanted to give back and help other cancer patients in need. "I firmly believe if you can give, you do," explains Jacquie.
They turned to Fred Hutch as part of the community that provided care through David's illness. As the family considered three potential projects — two that addressed cancer survivors' concerns, and one related to Delaney’s ambitious cord blood therapy — David had an epiphany: Delaney's research provided hope for a gentler, yet curative, option for cancer patients. Not only could cord blood help save lives, it would help improve them by dramatically reducing the complications that plagued even successful transplants.
"I thought, if Dr. Delaney's project succeeds, you wouldn't need the other two projects," recalls David.
And so a collaboration was born. Over the years, funds from the Bayley Family Foundation have enabled Delaney to buy vital equipment, retain critical laboratory staff, continue her clinical trials, and support basic research investigating exactly how cord blood works its magic.
And in her hands, the material is magical. Building on fundamental discoveries first made in Fred Hutch labs about how blood stem cells divide and mature, Delaney developed a method to multiply, or expand, the few precious blood stem cells from the teaspoon-sized cord blood samples up to 500 times over. The expanded product protects transplant patients against chemotherapy toxicity, infection and cancer relapse, improving not only survival but quality of life.
In addition, Delaney discovered that cord blood's healing power is not limited to transplant patients. Chemotherapy patients who receive her expanded cord blood cells are also protected against infection and see their chemo-impaired immune systems rebound in just a couple weeks, rather than a month or more. This can make a huge difference to the patient's quality of life.
As the possible curative applications keep unfolding, Delaney keeps dreaming bigger, and the Bayleys are helping propel her dreams forward. In particular, their contributions have supported postdoctoral fellow Dr. Jianqiang Li's investigations into double cord-blood transplantation. In this procedure, patients are given cord blood from two different donors. Double cord blood transplants have a higher success rate than transplants from a single donor and they're better at preventing cancer relapse.
Delaney and her team demonstrated that this is because of a battle waged between the immune cells found in each cord blood sample; one donor "wins" the battle, and these donor's cells become the source of new, healthy bone marrow.
"It’s like two different people fighting inside another person," explains Delaney, "and the winner becomes even stronger in its ability to fight the cancer."
But which cells will win? And how does the competition itself help the winner go on to defeat the cancer? Li is working to answer these questions. His insights will help transplant oncologists pick the winning donor cells even before transplantation, and perhaps enable Delaney's team to develop a cord blood-based immunotherapy that can better target cancer cells and enhance protection against relapse.
It is this vision — to understand and utilize all of cord blood's potential, sparking countless more cures — that the Bayleys continue to support, year after year. As Jacquie explains, "I think it's the way of the future."
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