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Significant benefit of cord blood therapy for cerebral palsy


The latest issue of the Parent’s Guide To Cord Blood Foundation® newsletter included information about a study published in November 2020 on cell therapy for cerebral plays [1].

The study concludes that there is a significant benefit for cord blood therapy for cerebral palsy.

It also confirms that there is a major trend in cord blood therapy for cerebral palsy and that younger children tend to respond better, bigger cell doses are better, and cord blood that is a closer HLA match to the patient is better (the closest match is their own cord blood).

What is cerebral palsy?

Cerebral palsy (CP) is a group of disorders that affect a person’s ability to move and maintain balance and posture. CP is the most common motor disability of childhood. About 1 in 323 children has been identified with CP according to estimates from CDC’s Autism and Developmental Disabilities Monitoring (ADDM). [2]

How did the study work?

In the study patients were assigned randomly to one of 4 treatment arms, and careful procedures were used to keep the doctors and patients “blind” as to who was in which group. The study was first registered as a clinical trial in 2013 and eventually treated 88 patients.

Intravenous infusions of donated cord blood from a public bank are used for treating cerebral palsy at the CHA Bundang Medical Centre near Seoul, South Korea where the study was led by MinYoung Kim MD, PhD.

The cord blood is matched to the patient on at least 4 of 6 HLA types, and they may use up to two cord blood units to achieve their target dose of at leat 40 millions cells per kg of body weight.

A second important study

In the United States, Joanne Kurtzberg, MD at Duke University, also carried out a treatment protocol based on intravenous infusion of cord blood.

The key difference here is that the children were treated with their own cord blood. The study started in 2005, and was first published in 2017.

Since then the programme has been expanded giving sibling cord blood to children with cerebral palsy, called ACCeNT-CP. This study started in 2018 and recently completed with preliminary results. [4]

The two studies were very different. While the USA study used personal cord blood, with South Korea using donated, they also used erythropoietin (EPO) in a different way.

The use of EPO

Erythropoietin is used as part of blood therapy for cerebral palsy and is a natural human hormone that stimulates bone marrow to produce more red blood cells.

It’s been manufactured by pharmaceutical companies for decades. Artificial EPO is used for kidney dialysis, during cancer therapy, and has also been implicated as a performance enhancing drug in athletics.

Dr MinYoung Kin’s group were given an injection of EPO just before the umbilical cord blood (UCB) infusion with five follow up injections of EPO at three day intervals.

There were three study groups – UCB + EPO (31 patients); EPO alone (33 patients) and a control group (32).

The study was published in 2013 and showed a clear benefit of UCB + EPO. However, researchers are skeptical whether the UCB or EPO is the more important component in the therapy.

Dr MinYoung Kim’s latest study [1] shows that UCB +EPO is 50% better than UCB alone, and three times better than EPO alone or control.

However, for parents of children with CP, the biggest challenge is finding a study or clinics where they can access treatment.

Both Dr MinYoung Kim and Dr Joanne Kurtzberg are in agreement about a major trend in cord blood therapy for CP and the closer the HLA match to the patient is better

References

1. Min K, Suh MR, Cho KH, Park W, Kang MS, Jang SJ, Kim SH, Rhie S, Choi JI, Kim HJ, Cha KY, & Kim MY. Potentiation of cord blood cell therapy with erythropoietin for children with CP: a 2×2 factorial randomized placebo-controlled trial. Stem Cell Research & Therapy 2020; 11:509 To learn more about cord blood banking, visit Parent’s Guide to Cord Blood Foundation at https://parentsguidecordblood.org/en/news/cord-blood-plus-erythropoietin-better-cerebral-palsy-either-alone

2. Cerebral palsy (CP) is the most common motor disability in childhood, and children with CP and their families need support. Learn more about CP and what signs to look for in young children at https://www.cdc.gov/ncbddd/cp/features/cerebral-palsy-11-things.html

3 TCT | Transplantation & Cellular Therapy Meetings of ASTCT and CIBMTR at https://www.cdc.gov/ncbddd/cp/features/cerebral-palsy-11-things.html

4. TCT | Transplantation & Cellular Therapy Meetings of ASTCT and CIBMTR https://www.cibmtr.org/Meetings/TCT/Pages/index.aspx

5. Maiese K, Li F, & Chong ZZ. New Avenues of Exploration for Erythropoietin. JAMA 2005; 293(1):90-95. To learn more about cord blood banking, visit Parent’s Guide to Cord Blood Foundation at https://parentsguidecordblood.org/en/news/cord-blood-plus-erythropoietin-better-cerebral-palsy-either-alone

BSc (Hons) Microbiology

Chief Executive Officer | Biovault Family

Biovault Family CEO, Kate Sneddon, joined Biovault in July 2009 and became Chief Executive Officer in 2016. As health industry professional her experience includes working as a microbiologist and leader at GSK for over 10 years. Her expertise in cord blood banking has been recognised in her awards, features in Parliamentary Review and Parents Guide to Cord Blood, as well as contributions to research with UCL and others.


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