– Speakers and Session Chairmen –
Reem Al-Daccak, Prof, Institut Universitaire d'Hématologie, Paris, France
Hal E. Broxmeyer, PhD, MD, Distinguished Professor, Chairman and Mary Margaret Walther Professor of Microbiology/Immunology, and Professor of Medicine at the Indiana University School of Medicine. Scientific Director of the Walther Oncology Center, Indianapolis, USA.
Karen Ballen, Prof, MD, Division of Hematology, Massachusetts General Hospital, Boston, MA, USA.
Cesario V. Borlongan, PhD, MD, Professor and Vice Chair of Research for the Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, Center of Excellence for Aging and Brain Repair Florida, USA.
Claudio Brunstein, PhD, MD, Assoc. Prof. Hematology, Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, USA.
Gottfried Dohr, Prof, MD, Director of the Institute of Cell Biology, Histology and Embryology/Center of Molecular Medicine, Medical University Graz, Austria.
Günther Gastl, Prof, MD, Director of the Department of Internal Medicine V, University of Innsbruck, Austria.
Markus Hengstschläger, Prof, PhD, Chair of the Department of Human Genetics, University of Vienna, Austria.
Uwe Lang, Prof, MD, Head and Chair of the Department of Obstetrics and Gynecology, Director of the Division of Obstetrics and Maternal Fetal Medicine, Medical University Graz, Austria.
Anthony-Dick Ho, Prof, MD, Chair of the Department of Medicine V, University of Heidelberg, Germany.
Werner Linkesch, Prof, MD, Chair, Department of Hematology, Medical University of Graz, Austria.
Arnon Nagler, Prof, MD, Professor of Medicine at the Tel Aviv University, Sackler School of Medicine and the Director of the Division of Hematology, Bone Marrow Transplantation and Cord Blood Bank at Chaim Sheba Medical Center, Tel Hashomer, Israel.
Jun Ooi, MD, Department of Hematology and Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
Vinod K. Prasad, Prof, MD, Division of Pediatric Blood and Marrow Transplant, Duke University of Durham, USA.
Karl-Heinz Preisegger, Prof, MD, Chief Medical Officer, Vivocell Biosolutions, Graz, Austria and Langenfeld, Germany.
Mariusz Z. Ratajczak, PhD, MD, DSci, Professor in the Department of Medicine, Head of Stem Cell Biology Program, James Graham Brown Cancer Center, University of Louisville, USA.
Vanderson Rocha, PhD, MD, Scientific Director of Eurocord, Department of Hematology BMT, Paris, France.
Agatha Rosenmayr, Prof, MD, Director of the Austrian Stem Cell Registry, Division of Blood Group Serology. Medical University of Vienna, Austria.
Peter Wernet, Prof, MD, Co-Founder and President of Netcord, Director Emeritus of Institute for Transplantation and Cell Therapeutics University Medical Center, Heinrich-Heine-University, Düsseldorf.
Nina Worel, Prof, MD, Associate Professor, Department of Hemato-Oncology, Medical University of Vienna, Austria.
Nicolas H. Zech, PD, MD, Deputy Medical Director, IVF Centers Prof. Zech, Bregenz, Austria.
"STEM CELLS: FROM BENCH-TO-BEDSIDE"
The Success of Cord Blood
On September 10th and 11th 2010 worldwide leading scientists in the field of cord blood stem cells came to Gmunden (Austria) to participate in the conference „Stem Cells: From bench to bedside. The success of cord blood“.
Every year hundreds of thousands of people are diagnosed with leukaemia, lymphoma or severe metabolic disorders. In Austria about 700 newly diagnosed leukaemia patients are registered annually. For many of these patients stem cell transplantation is the only chance for survival. However, applicable stem cells are unfortunately often not available. Therefore a lot of people waiting for a life-saving stem cell transplants are waiting unavailingly. Cord blood stem cells can change this unfortunate fact.
Cord blood donation nowadays
For the treatment of leukaemia, lymphoma and a multitude of congenital disorders, cord blood stem cells are increasingly used as alternative to bone marrow. However, in 97% of all cases, cord blood is still carelessly discarded after birth, regardless of the increasingly obvious advantages of cord blood over bone marrow. Among these are immediate availability, decreased Graft versus Host Disease or lower risk of disease transmission. Even initial reservations due to the relatively small amount of stem cells contained in a single cord blood unit could meanwhile be resolved. “Hence umbilical cord blood has also become a valuable alternative to bone marrow for the treatment of adult patients”, reported Dr. Karen Ballen from Massachusetts General Hospital in Boston. Nowadays cord blood is therefore playing an increasingly important role for transplantation of adults. At Boston General Hospital for example, 26% of all patients in need of allogeneic stem cell transplantations are treated with cord blood.
Cord blood transplantation in Austria and internationally
Prof. Dr. Rosenmayer, director of the Austrian bone marrow transplantation registry, gave an overview on cord blood transplantations worldwide. So far about 20.000 cord blood transplantations have been carried out worldwide. France and Spain are European leaders. Approximately one fifth of all allogeneic stem cell transplants in these countries are carried out using cord blood derived stem cells.
Dr. Ooi from Tokyo reported, that over 6000 patients in Japan could already benefit from cord blood transplantations. Compared to these numbers Austria is way behind although stem cell transplantations are the second most often performed transplantations in Austria. Only kidney transplantations are performed more frequently.
Exchange of ideas between obstetricians, cord bood banks and haemato-oncologists – at the conference in Gmunden all were gathered around “the same table”
The future main focus of cord blood transplantation research will be further improvement of the overall treatment results and of in vitro expansion protocols for cord blood derived stem cells. Another essential point will be the encouragement of communication between haemato-oncologists and obstetricians who are collecting cord blood. Although obstetricians and gynaecologists are playing a crucial role in the production of the valuable pharmaceutical cord blood – their work decisively influences the quality of a cord blood charge – they don´t have contact to the patients in need of a stem cell transplantation. Haemato-oncologists in turn know about the criteria and importance of a “good” cord blood unit but they are hardly ever able to give any feedback to the cord blood collecting obstetricians.
The conference „Stem Cells: From bench to bedside. The success of cord blood“ in Gmunden, aimed at the first time participation of both obstetricians and haemato-oncologists. Within the scope of this conference worldwide leading scientists in the field of cord blood stem cells came to Gmunden on September 10th and 11th.
Progress and controversies in the field of cord blood transplantations
Prof. Broxmeyer from Indiana University School of Medicine, one of the pioneers in the field of cord blood transplantation, reported about the very first cord blood transplantation in 1988. Thanks to the transplantation his former patient has been living a healthy life for the past 21 years. Prof. Broxmeyer is furthermore one of the leading experts in the field of cryopreservation and stated that umbilical cord blood absolutely fulfils all requirements in this field. Even after long time cryostorage the cells can be thawed and still show a very good quality.
Dr. Vinod Prasad from Duke University in Durham presented his experiences regarding the application of cord blood for non malignant diseases like hemoglobinopathies (e.g. thalassemia, sickle cell disease), bone marrow failure syndromes (e.g. congenital or acquired aplastic anemia, Fanconi anemia), primary immunodeficiency diseases (e.g. severe combined immunodeficiency, chronic granulomatous disease, Wiskott-Aldrich syndrome) or inherited metabolic disorders (e.g. leukodystrophies, mucopolysaccharidoses). Currently standard therapies include compensation of deficiencies through application of specific enzymes. However these therapies can not reverse the underlying defect. Dr. Prasad further explained that cord blood stem cells on the other hand are able to permanently repair the underlying immune defect and to regenerate affected organs. In this context he also pointed out the important role of the fast availability of cord blood stem cells. A crucial factor for the successful treatment of these diseases is to perform transplantation before major damage occurs. Especially in case of diseases like Hurler´s, Krabbe or leucodytrophies he would therefore consider cord blood transplantation as gold standard.
Cord blood stem cells in regenerative medicine
Progress was also made in regenerative medicine. Prof. Dr. Peter Wernet, cofounder of Netcord, reported on the regenerative potential of certain cord blood cells.
A specially promising field is the use of cord blood stem cells for the treatment of brain injuries due to oxygen deprivation or stroke. Dr. Caesar Borlongan from the University of South Florida presented new promising data in this field. A clinical trial for the treatment of such injuries in children is currently undertaken at Duke University using autologous cord blood.
Precious cord blood stem cells – future increase of transplantations
All the scientists who came to Gmunden agree in one point: Cord blood derived stem cells are a valuable alternative to bone marrow or peripheral blood stem cells. Prof. Dr. Linkesch from Graz, one of the most experienced haemato-oncologists providing cord blood transplantations in German speaking community, is convinced that the amount of cord blood transplantations for patients with a clear indication will significantly increase in the future. Dr. Brunstein from Minneapolis even said that he thinks cord blood will soon be considered the first choice for transplanting children.
In contrast the ethically questionable embryonic stem cells as well as induced pluripotent stem cells which can be recovered from adult somatic cells are not applicable for clinical use because of their teratoma inducing potential (Teratomas are tumors composed of tissues originating from different germ layers). “And at this stage nobody can say if they will ever be. Cord blood stem cells on the other hand have already proven their potential for the treatment of a variety of diseases”, stated Prof. Broxmeyer.