When he was born at Mount Sinai Hospital, Jack was not breathing. Doctors whisked him away from his mother and started efforts to resuscitate him. They managed to save his life but soon had to deliver some bad news to his parents, Stephen Pankratz and Kim Kucher. Their son had Hypoxic Ischemic Encephalopathy (HIE), brain damage caused by lack of oxygen to the brain and other organs compounded by low blood flow to vital organs. Jack would likely suffer extensive cognitive and physical problems.
Heartbroken, the Oakville, Ont., couple contacted Toronto-based Create Cord Blood Bank, where they had stored blood and tissue stem cells from Jack’s umbilical cord. After a series of meetings with the cord blood bank laboratory director, Dr. Ayub Lulat, and neonatal specialists at the Hospital for Sick Children, the specialists agreed to perform an experimental procedure.
Just 12 days old, Jack was infused with his own stem cells, becoming the youngest person ever to undergo the therapy in Canada and the first in the country to be treated for HIE with stem cells. He may turn out to be the first of many. In scientific and medical circles, stem cell experts are predicting the dawn of a new era in the treatment of HIE, autism and other brain disorders.
Just days after the transplant, Jack was free of multiple intravenous lines for the first time and was drinking from a bottle while cradled in his mother’s arms. “That was the day we finally got to meet our son,” says Kim.
Jack, who celebrated his second birthday this past summer, is now thriving. He has cerebral palsy and faces challenges ahead, but his development has far surpassed doctors’ expectations. He is much more alert and dexterous than expected given the extent of his brain damage at birth. Kim predicts his next MRI will reflect that change. “We think the stem cell transplant has played a role and is continuing to play a role in his progress.”
Jack’s neonatologist echoes that opinion. “Based on descriptions that I have been given by his parents and the physicians who treated Jack at birth, I would have expected him to be much more severely [affected] than he is,” says Dr. Karen Pape, who is also a clinical neuroscientist who has examined hundreds of children with HIE. “He is making steady improvements and responding to his intense therapy programs.”
The use of stem cells — unspecialized cells that can renew themselves and, in certain circumstances, can become tissue or organ-specific cells — have been proven effective in treating blood disorders and certain cancers. More evidence is required to prove they are effective in the treatment of neurological conditions, but early results are promising.
Dr. Joanne Kurtzberg, a pioneering researcher at Duke University in Durham, N.C., and director of the Carolinas Cord Blood Bank in Durham, is conducting clinical trials to determine whether cord blood can help brain repair in patients who have had a stroke or are suffering from cerebral palsy, HIE and autism. Their Phase I trial determined that the therapy is safe. Similar trials are planned or already underway in several other countries.
Steve and Kim came across those findings while researching HIE and cited them in their successful attempt to persuade Toronto doctors to infuse Jack with cord blood stem cells.
When it comes to most neurological conditions, drugs don’t prevent or repair the damage, says Kurtzberg. “I think stem cells are more likely to do that because they’re sophisticated. If that’s proven to be true, it would open a whole new avenue of treatment for serious neurological diseases — and that’s very exciting.”
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