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Tamara Durgan
Professor Farkas
WRT 150/Argumentative Essay
25 October, 2010
Umbilical Cord Blood: A Person’s Lifeline
In the future, umbilical cord blood will be a helpful resource to help cure children and
young adults with different ailments. Umbilical cord blood contains a rich source of stem cells. It
is thought that umbilical stem cells are the largest untouched source of stem cells. By inserting a
needle into the placenta and umbilical cord, the physicians are able to retrieve this source of stem
cells and use them for treatments.
Umbilical cord blood has many uses. It is able to restore a child’s blood-forming system.
During chemotherapy, it is said to restore the child’s immune system. With the immune system
being suppressed, the umbilical cord blood can help improve the functioning of the immune
system by regenerating cells that were lost due to radiation and chemotherapy.
It has also been known to repair/and or replace damaged cells. For instance, I read online
that on the popular TV show, “The Doctors”, there was a fifteen-year old girl who had been
diagnosed with Optic Nerve Hypolasia (ONH). ONH caused the girl to be blind, even since child
birth. The girl’s mother and she flew to China to have a procedure done in which umbilical cord
stem cells were injected into the girl’s spinal cord. The Chinese physicians were hopeful that this
would allow regenerating growth of the optic nerve. The treatment was not available here in the
United States, so they raised $30,000 to fly to China and have the operation. Many experts
believe that using stem cells in experimental phase, especially overseas, is dangerous. Before
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Macie’s operation her vision read 20/400; after the transplant doctors claim her eyesight is read
20/200. Macie can now see the color of her mother’s eyes and also a notebook from a great
distance. (“Vision Quest”) Without this operation, her vision would not have improved.
Preparing for umbilical cord blood can be precarious. The prep stage, conditioning
regimen, involves high doses of chemotherapy and in some cases radiation treatment. This is a
process called Total Body Irradiation (TBI). High doses are used to destroy diseased cells as well
as to allow the development of new cell growth. It also enables the suppression of the immune
system. This stage ranges from 4-10 days, depending on the patient's age, nature of the disease,
as well as if the patient has undergone any other types of treatments. Preparation for the
transplant can begin prior to the patient's admission to the hospital. A single TBI can last 10-20
minutes, and can be spread out from one day to a period of seven days depending on the dose.
Common side effects at this stage consist of nausea, vomiting, diarrhea, and decreased appetite.
(“Overview of Cord Blood Transplants”)
After the prep stage, the procedure will start to come in action. The cord blood transplant
procedure is performed one to two days after preparation for the transplant has been completed.
Also known as "Day Zero", it is common for the patient to feel fatigued and feel side effects
from the prep stage. If the stem cells used for cord blood transplant are from an adult donor, the
donation will be completed on the day of the transplant. However, if umbilical blood stem cells
are being used, they will be transferred to the transplant center prior to the procedure. Stem cells
are stored in blood bags and their appearance varies depending on the type of cells: bone
marrow, umbilical cord, or peripheral blood. The appearance also varies depending if it has been
filtered. During the transplant procedure, the cells are infused through an IV. This is usually fed
through a central line. A nurse monitors pulse and blood pressure. During the procedure, the
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patient is awake, but a mild sedative might be administered. After the procedure, the cells move
through the bloodstream and settles in the bone marrow. They begin to produce red and white
blood cells. This process is known as engraftment (“Overview of Cord Blood Transplants”).
After engraftment occurs, the patient's blood cell count will rise, resulting in increased
immune strength. However, the patient's immune system will still be very weak for several
months. While still in the hospital, the patient's temperature will be monitored four times a day.
Fever is in an indication of infection. The patient will be administered antibiotics and be checked
for pneumonia. Blood tests will be ordered to evaluate the patient's recovery and monitor
potential complications like GVHD or graft failure. Sometime within 100 days, patient will be
released and treated as an outpatient. Because different transplant centers have different recovery
plans, release dates vary. Because outpatient care can require daily checkups, it is beneficial for
the patient to choose a transplant center close to his home. After leaving the hospital, the patients
will receive specific instructions for recovery. This includes adequate rest and a healthy diet.
Doctors take extreme precaution due to the fact of being more exposed to illnesses (“Overview
of Cord Blood Transplants”).
There are many pros and cons by preforming this type of procedure. One of the cons that
affect everyone is the small volume of blood in the placenta and umbilical cord. Once a needle is
inserted into the placenta and umbilical cord, about 30 to 100 mL (5 tablespoons) of blood is
collected. Due to this small amount, there are not enough stem cells to treat a large adult.
Transplant centers use only these cells to treat children and small adults (Goldstein and
Schneider, 84-85).
Cord blood transplant has only been around since 1988. This means that the procedure is
experimental. Due to being experimental insurance companies will not pay for the procedure.
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Potential donors would have to pay out of pocket to store core blood. Since the transplant was
first used in 1988, physicians still do not understand the long-term benefits of transplanting cells.
One of the most dangerous side effects of transplants is graft-versus-host disease. GVHD
occurs in bone marrow or stem cell transplants involving a donor and a recipient. There is a
difference between the donor's and recipient's T cells (a type of white blood cell). The T cells
recognize the donor's as a foreign object in the recipient's. When this happens, the transplanted
cells will attack the recipient’s body. Acute GVHD occurs within 3 months after the transplant.
Chronic GVHD starts after 3 months. Rates of GVHD vary between 30-40% for donors and
recipients to 60-80%. Some cases are so severe that death is involved. Successful treatment of
GVHD does not guarantee the bone marrow will succeed in treating the original disease. After
transplant the recipient takes a drug that suppresses the immune system which reduces the
chance for GVHD. But with the suppression of the immune system, there are more chances of
catching contagious illnesses such as H1N1 virus, cold viruses, flu viruses, bronchitis, or if
hospitalized MRSA. MRSA is a staph infection that's resistant to antibiotics to treat MRSA
(MayoClinic). There are many symptoms for GVHD. Some common symptoms include
abdominal pain or cramps, diarrhea, fever, jaundice, skin rash, vomiting, and weight loss.
Chronic symptoms include dry eyes and dry mouth, hair loss, hepatitis, lung and digestive tract
disorders, skin rash, and skin thickening (“Graft-Versus-Host Disease”).
With transplants there is a risk for contamination. Cord blood contamination percentage
rate is between 3% and 15%, depending on the system used. Contamination can occur due to
bacteria or other infectious agents during the collection procedure (Carrier and Ledingham, 1617). Before the blood can be used to transplant, the possible contaminated blood must undergo
microbiological testing before usage and the donor infant must be evaluated at six and twelve
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months of age for any evidence of infectious or congenital disease that might not have been
obvious at birth (Carrier and Ledingham, 16). Contamination can occur if the mother has a virus
such as HIV or AIDS, Hepatitis B, or other diseases. Contamination can also occur due to
unsanitary conditions such as delivering the baby in a car, cutting the umbilical cord with
unsanitized scissors or tying the umbilical cord off with an unsanitary object, such as string,
yarn, twist tie, or even a shoe lace. Cord blood may still be collected and used if the researchers
do not find any contamination with the cord blood.
When looking at cons, we must also look at the pros. Recently researchers at the
University of Minnesota announced that they were able to reverse the effects of stroke in lab rats
using stem cells in umbilical cord blood. The transplanted cells took on properties of brain cells
and "rewired" the mice's brains. The researchers almost fully healed the rats after 48 hours of
sustaining brain damage. Doctors need to act within three hours to treat a person with a stroke. It
is not clear if this therapy that was conducted on rats will ever be safe or effective in humans.
But many people are being treated with the collection of stem cells from umbilical cord blood.
Patients with immune-system diseases- like Severe Combined Immunodeficiency (Boy in the
Bubble Disease) - have also responded to cord blood treatment. 6,000 patients worldwide have
been treated with cord blood stem cell transplants, as of 2006. The Center for Cord Blood in
Minnesota is the largest public donor bank in the United States. It reports that the likelihood of
finding a perfect match has doubled in four years, as of 2006. The biggest challenge so far is
getting umbilical cord blood units from minority groups. "Because of limited donor pools,
minorities have had difficulty finding suitable matches." (“Umbilical Cord Blood: The Future of
Stem Cell Research?”).
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When stem cells are used instead of bone marrow, the umbilical cord cells are not as
mature as bone marrow, so they are able to produce more cells. With the production of more
cells it helps speed up the recovery in chemotherapy. With umbilical cord blood, it is quickly
available and ready to be used. With bone marrow, the marrow is withdrawn by inserting a
needle into the bone, where the marrow is located.
On November 19, 2010, a Japanese scientist named Shinya Yamanka will be awarded the
Balzan prize for biology, "[He] found a way to give adult cells certain characteristics of
embryonic stem cells." According to Nicole Le Dourin, he has used its findings to treat spinal
cord lesions in mice. "This process allows adult cells that have already been differentiated into,
say, kidney cells or neural cells, be transformed back into cells with characteristics of embryonic
cells- a breakthrough that could provide an alternative to the controversial use of human embryos
in stem cell research." Yamanka works for the Institute of Cell-Material Sciences at Kyoto
University and the Gladstone University at the University of California, San Francisco. He will
be receiving 750,000 Swiss Francs ($740,000 USD); this prize was reduced from $1 million
Swiss Francs. The International Balzan Foundation says that Yamanka will be presented the
award in Rome, Italy (“Japanese Stem Cell Researcher Wins Balzan Prize”).
Umbilical cord blood has been shown to help cure illnesses and diseases. Even though
there is a small volume, umbilical cord blood is powerful enough to start regenerating new cells.
Although there are many side effects, the outcome is beneficial when the umbilical cord cells
fight the diseases. Studies are still being conducted to determine the long-term benefits.
Hopefully one day, we will live in a society where umbilical cord stem cells will be able to treat
all illnesses and ailments.
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Works Cited
Carrier, Ewa and Ledingham, Gracy. “What is Cord Blood Transplant?” 100 Questions
and Answers about Bone Marrow and Stem Cell Transplantation. 2004: 16-17. Print.
Goldstein, Lawrence S.B. and Schneider, Meg. Stem Cells for Dummies. 2010: 84-84.
Print.
“Graft-versus-host disease.” MedlinePlus. 1 Oct. 2010. Web.
“Japanese Stem Cell Researcher Wins Balzan Prize.” Click on Detroit. WDIV. Detroit.
21 Sept. 2010. Web.
“MRSA Infection.” MayoClinic. Mayo Foundation for Medical Education and Research.
1 Oct. 2010. Web.
“Overview of Cord Blood Transplant.” PregnancyInfo.net. Web.
“Vision Quest.” The Doctors. Stage 29, LLC. 20 Sept. 2010. 5 Oct. 2010- 7 Oct. 2010.
Web.