The establishment of cord blood units will facilitate the establishment of vast majority of the potentially matching blood units that will play a critical role in transplantation.
However, to achieve the best efficacy in the utilisation of these cord blood units, the screening of these units based on total nucleated cells and HLA match levels, as well as the cord blood bank origin, is vital. This will ensure a smaller list of potential units can be generated. Once this is achieved, a detailed evaluation of the unit will inform the decision to opt for the selection of the most suitable blood for the graft.
It has been Immunologically established that cord blood B cells are immature and naive with an increased percentage of CD5+ B cells and B cells which makes it suitable for transplantation.
Here in Kenya, cord blood is still handled as part of medical waste, despite the recent discovery that this blood is a perfect source of hematopoietic stem cells for patients undergoing treatment of both malignant and non-malignant disorders.
Medical research has revealed a higher survival rate in transplants with cells from cord blood, compared to the ones from other sources.
The transplantation of double cord blood units has overcome the dose limitation inherent in a single cord blood unit thereby extending the use of cold blood in both children and adults. Similarly, the use of cord blood reduced intensity conditioning in the transplants, thus allowing treatment of the older patients to be possible.
Currently, there is a good number of strategies applied clinically aimed at reducing graft vs host disease thereby improving cord blood homing, engraftment and immune reconstitution.
As families rally to raise funds to fly their patients to India - which is the most affordable option - there is hope. But these proposals can only be crystalised if, and when, the government establishes and finances research Centres for Disease Control which is a key step in dealing with Cancer, which is now emerging as the next frontier since it is fighting to be a top killer with huge financial ramifications for families.
Prof Ben Fadhili Jilo and Dr Samson Aluda Mbati.
Prof Ben Fadhili Jilo is a Fellow and a Professor of Neural Stem Cell, UK.
Dr Samson Aluda Mbati is a Fellow at the University of Nottingham, School of Medicine - Stem Cell and Regenerative Medicine.
Additional information by Alex Kiarie, Standard Group.