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Wednesday, October 22, 2014         

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Isle umbilical cord blood valuable for its diversity

By Helen Altonn

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Stem cells taken from the umbilical cords of 55 Hawaii babies have saved lives all across the United States as well as in Spain, France and Italy.

"Demographically, Hawaii happens to be at the edge of a worldwide trend going to mixed races," said Dr. Randal Wada, who founded and directs the Hawaii Cord Blood Bank. "I think the units we're collecting go to those kinds of patients."

HAWAII CORD BLOOD BANK

» Screened 6,410 donors from 1999 to April 2010
» Collected 4,786 units of cord blood (each unit has blood from one umbilical cord)
» Banked 1,366 units with the Puget Sound Blood Center in Seattle
» Matched 55 patients for transplantations, including seven in France, one in Spain and one in Italy
» Helped patients with acute myelogenous leukemia, acute lymphocytic leukemia, Hodgkin's and non-Hodgkin's lymphoma, severe combined immunodeficiency and other potentially fatal diseases
» For more information or to sign up as a cord blood donor, call 983-2265, e-mail info@hcbb.org or go to www.hcbb.org.
Wada emphasized the importance of Hawaii's racial and ethnic diversity for potential transplant matches, adding that most of the 55 cord blood donations that gave patients a second chance at life were from minority donors.

A molecular biologist and bone marrow transplant surgeon, Wada says the Cord Blood Bank is saving lives "just by recycling the trash."

Umbilical cords, which connect a baby's navel to the womb, usually are discarded after birth.

Pregnant women are encouraged to donate them as a possible source of stem cells for patients needing transplants for leukemia, lymphoma and other disorders.

"It's so easy to do," says Dr. Christina Kealoha-Lee, medical director at Waimanalo Health Center. She and her husband, Nathan, donated cord blood when their sons were born in April 2005 and August 2008.

Kealoha-Lee, who is of Chinese, Japanese and Hawaiian descent, said she has a Cord Blood Bank sign-up sheet at the Waimanalo Center and encourages pregnant patients to donate their babies' umbilical cords.

"It's not like you're going to do anything with it," she said. "Why throw something away that could save a life?"

The Blood Bank of Hawaii transports cord blood units to the Puget Sound Blood Center in Seattle. Each unit contains the blood of one umbilical cord. There they are processed, stored and entered into the National Marrow Donor Program's cord blood database for patients needing a match.

Lynette Matsumoto lost a 12-year-old son to leukemia in 1994. One of her two daughters was a match for her brother's bone marrow transplant, performed by Wada at the University of California at Los Angeles. However, a fungal infection caused complications, Matsumoto said.

Today she is the Hawaii Cord Blood Bank program coordinator. After Wada did the first cord blood transplant at UCLA in 1996, he asked Matsumoto to join him after he established the Hawaii Cord Blood Bank in 1998 with geneticist Jana Hall.

Matsumoto said it is her mission "to help other children live," adding, "It is a privilege just to tell a mom her unit got matched."

Sharing that mission at the bank are Lisa Wong- Yamamoto, a labor and delivery nurse at Kapiolani Medical Center for Women & Children and a nurse educator, and Nola Faria, nurse coordinator.

Dr. Elenita Alvarez, a gynecologist-obstetrician who delivers babies at Kapiolani and the Queen's Medical Center, said at least three of the 55 matches came from her patients.

"It's a wonderful feeling," she said, describing her patients as a wide ethnic mix, mostly Filipinos, Chinese, Japanese and Laotian. "It's very fortunate we are able to match these minority groups."

Doctors at Castle Medical Center, Tripler Army Medical Center and Kaiser Permanente also participate in the program.

Alvarez tells patients, "This would be a chance to give a second life to an individual in need of stem cells to treat leukemia and lymphoma. This is better than killing embryos for stem cells or bone marrow transplants. This is painless and something that would be discarded if not used for donation."

Wada said the patients who benefited from Hawaii's babies ranged from 3 months to 67 years old. It was believed at first that the cord blood units were so small that they could be transplanted only in children, but "that turned out not to be the case," he said. "More adults than kids are transplanted."

He said cord blood banks generally match 1 percent of their inventory to patients each year. To do that they must have 10,000 to 15,000 units of cord blood, he said, but Hawaii's program has been matching 1 percent with roughly only 1,200 units of cord blood in the bank.

"It's growing," he said. "We add 30 to 40 units a month now."

He said he does not know why Hawaii's small program has such a high matching rate, but suspects it is "because of the richness and diversity" of Hawaii's donors.

More than 15,000 cord blood transplants are done worldwide each year, he said. The rate of minority cord blood transplants has gone up by more than 30 percent, he said.

"The major reason we are able to provide more access to minorities is utilization of cord blood now. Doctors are more comfortable, and technology has evolved to the point where patient size is not so much a limitation."

Cord blood stem cells are the same as bone marrow but can provide equal or better results without having to match a patient as closely, Wada said.

"We can transplant two cord blood units in one patient," he said. "The units don't have to match, and they don't have to match the patient. Eventually, one unit wins and grows in the patient, and the other one helps somehow."






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