New lifeblood

cover photosept27

cover photosept27Umbilical cord blood bank to bring life-saving potential to Upstate region

By Katherine Long
Sun associate editor

Jared Saya says he can remember — “Clearly!” — the trip to Lourdes, France, he and his mother, Geralyn, made when he was five years old. They visited the holy shrine, drew water from the famous spring and attended a Mass alongside cardinals.

   “And I played soccer with some French people,” the 14-year-old Christian Brothers Academy freshman said, grinning. “I beat them all.”

   It was a trip Jared might not have taken, had a life-saving transplant of stem cells from umbilical cord blood not helped him beat leukemia just months before.

“I knew something was wrong”

   Geralyn took her two-year-old son to the emergency room at Upstate Medical University when she noticed bruising on his arm.

   “I knew something was wrong because I bypassed everyone else in the ER,” she recalled. “There was someone with their eye out, and I even went ahead of them.”

   Doctors gave Geralyn devastating news: They were “99 percent sure” Jared had cancer.

   He was ultimately diagnosed with an aggressive, adult form of leukemia, a cancer of the blood cells centered in the bone marrow. He was treated with “lethal doses” of chemotherapy for six months, Geralyn said. The treatment put him into remission, but a regular checkup 18 months later showed four-year-old Jared had relapsed.

   “At that point, you can’t do chemo again because obviously it didn’t work the first time,” Geralyn said. “Jared’s cancer was so bad we didn’t have the six months it would take to find him a bone marrow donor. His doctors presented us with this last option [a transplant of stem cells from donated umbilical cord blood].”

   The transplant procedure would be surprisingly simple. Cord blood, collected from the umbilical cord and placenta after a mother gives birth, is full of the hematopoietic stem cells that form blood, similar to the cells found in bone marrow. Though usually discarded as medical waste after the birth, when this blood is administered into a patient’s blood stream, it can help generate new, healthy bone marrow. The transplant would be done through a central line and wouldn’t take more than an hour.

   Geralyn had never heard of the treatment before, but gave the go-ahead. Within six days, doctors had found a match for Jared at the New York Blood Center in New York City, the closest public cord blood bank. After about three weeks of chemotherapy and radiation treatments to deplete the cancerous cells in his bone marrow, Jared received the cord blood transplant at Strong Memorial Hospital in Rochester.

   Some 40 days later, tests showed the transplanted cells hadn’t harvested in Jared’s body — the transplant hadn’t worked.

   “We went right back to the Center and found another match,” Geralyn said. “Even though this one wasn’t a perfect match, it took. Twenty-something days later, the cells had grown.” Jared was finally on the long road to recovery. After 107 days in the hospital, countless trips to the chapel and innumerable prayers, the Sayas went home.

Upstate Cord Blood Bank coming to Syracuse

   Fast-forward 10 years to Sept. 17, when Jared and his 11-year-old sister, Mari, dug a gold shovel into the dirt at Upstate’s Community Campus, helping to break ground for the Upstate Cord Blood Bank set to open there in 2014.

   According to a statement from Upstate Medical University, the facility “will collect, process and store umbilical cord blood donated from families throughout Central and northern New York to be used by those in need of life-saving medical treatments and for medical research.”

   The Upstate Cord Blood Bank will be just the second public cord blood bank in the state; there are fewer than 30 in the country. Unlike private facilities, where customers pay to store their own cord blood, public cord blood banks “do not charge fees and make stem cells available to anyone who needs them,” according to Upstate’s statement. The donations are anonymous and donors cannot later “withdraw” their specific donations — just like donating whole blood to the Red Cross.

   “Public cord blood banks also allow us to gather a greater diversity of stem cells, which allows us to serve a more diverse population,” said Dr. Robert Corona, Professor and Chairman of the Department of Pathology and Laboratory Medicine and Director of Neuropathology at Upstate.

   Dr. Corona’s department will oversee the bank, which will ultimately be staffed by about a dozen employees, he said. Operating costs will be partially offset by the sale of blood to researchers and by insurance payments, and the facility will continue to apply for grant money to make up the difference, he added.

   “Public blood banks are not, generally speaking, big money-makers,” Dr. Corona said. “But this is for the common good. You have to take care of the people who need it most.”

   The capital funding to build and equip the facility will come from a $15 million state grant. New York State Senator John DeFrancisco played a key role in securing and preserving funding for the bank, beginning in 2005. The economic downturn and administrative logistics stalled progress on the project for several years, he said, but he is glad to see it moving forward now.

   “Here is medical waste that can be used to save lives,” he said. “It’s a win-win.”

   The two-story addition on the campus of the former Community General Hospital, designed by architecture firm Francis Cauffman, will measure between 10,000 and 15,000 square feet. It will contain four freezers, each capable of holding 14,400 units of cord blood, Dr. Corona said. The blood can be stored frozen for up to 15 years, though literature indicates most transplants use blood less than six years old, he said.

   The bank will initially collect donations from Syracuse-area hospitals. Once the facility opens, Upstate hopes to receive donations from 50 percent of the approximately 20,000 annual live births in the area, Dr. Corona said.

   Upstate will make the donations available to transplant centers around the U.S.; units will be listed on the Be The Match registry. Donations not suitable for transplantation will be available to researchers at Upstate and around the country, according to the statement from Upstate.

“What was going to die becomes life”

   The New York State Catholic Conference, which represents the bishops of New York State in public policy, “strongly supports ethical scientific inquiry using adult stem cells, umbilical cord blood cells, iPS cells, and other non-embryonic sources in the fight against disability and disease.”

   Bishop Robert J. Cunningham called the new bank “a wonderful gift to Upstate New York.”

   “Through this blood bank,” he continued, “women will now be able to take what had otherwise been treated as medical waste and donate it to our very own local cord blood bank to help treat diseases and save lives. There are no other words to describe it…. it is simply ingenious.”

   Dr. Corona echoed similar sentiments. “I don’t really see a downside,” he said. “These are live cells that would otherwise go into a medical waste bag. Instead they’re saving lives. What was going to die becomes life.”

   The process for collecting the blood is simple, painless and relatively quick, he continued.

   “The baby is delivered and the umbilical cord is cut and clamped,” he said. “The baby goes off to be cleaned up and mom stays put for a couple of extra minutes. The umbilical vein is infiltrated with a needle and we draw about 150 mLs of blood. Mom doesn’t feel a thing, except for relief that delivery is over.”

   The hematopoietic stem cells found in cord blood are particularly interesting to researchers and physicians, Dr. Corona said, because they have “plasticity and can morph into many things.” They are primitive, immature cells with the “ability to hone into areas and secure themselves where they need to be…. They have inherent abilities to ‘know’ where to go and how to differentiate,” he said. The immaturity of the cells also means they elicit less of a “graft versus host response,” Dr. Corona said, meaning they irritate the patient’s immune system less and are less likely to be rejected. That’s why doctors can use blood that is less than a perfect match for transplants and still achieve successful treatment.

   Leukemia, being a blood-borne disease, is one of the diseases most commonly treated with umbilical cord blood stem cells. But Dr. Corona says the possible applications for research and treatments are “very promising in a number of areas.”

   Cord blood stem cells have already been used in the treatment of more than 60 diseases, including multiple sclerosis, Alzheimer’s disease, Huntington’s disease and Crohn’s disease, to varying degrees of success. Treatments will only get better as researchers have more opportunities to learn about how the cells operate, Dr. Corona added.

“God must have a plan”

   The State Department of Health will begin efforts to raise awareness about cord blood banking among pregnant women and the general public, something Geralyn is glad to hear.

   “So many people have asked me how to donate [cord blood], but there was nothing around here,” she said. “Jared has lost 33 friends to cancer. I’m not saying all of them would have needed a transplant, but a lot of them, probably. So to know that this bank will be right here.… I think it’s just fabulous.”

   Geralyn does see one disadvantage to the public banking system, though.

   “I’ll never know who donated the blood Jared got,” she said. “There’s someone out there who doesn’t even know what they’ve done and there’s nothing I can do. So I just thank every person who’s done it and who is going to do it.”

    Jared, too, is thankful to the stranger who saved his life. He doesn’t dwell on it every day, he said, choosing to focus instead on school and soccer and figuring out his future.

   “I think, ‘Why would God keep me here if I didn’t have something special to do?’” he said. “God must have a plan for me.”

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