Over the past few decades, cord blood transplantation has been used as a therapy in various clinical studies to treat medical conditions that lack conventional treatment options. In some cases, they may not show expected results due to various reasons and scientists across the world are trying to make stem cell transplants effective by implementing various research strategies. Recently, Dr. Omar Aljitawi from the University of Kansas Medical center has found that hyperbaric oxygen therapy could improve the outcome of umbilical cord stem cell transplant through his clinical trial study.
Cord blood transplants have shown successful recovery in treating patients affected with medical conditions such as Leukemia, Lymphomas, Hodgkin’s disease, Sickle Cell Anaemia, Thalassemia, Myelodysplastic disorder etc. Usually the umbilical cord stem cells are used in the treatment of blood related conditions and autoimmune disorders through a 2 step procedure:
- The patient undergoes a series of chemotherapy to wipe off the affected immune system.
- Stem cells are transplanted to form new healthy blood cells and immune cells; this will replenish the patient’s bone marrow and immune system.
In most cases, the problem arises in the engraftment of stem cells; it is the process by which transplanted stem cells reach the bone marrow and form new healthy blood cells. The inherent problem with cord blood transplant is that the amount of stem cells present in the sample. While most scientists work on expanding the stem cells in the cord blood sample, Dr. Aljitawi tried to increase the amount of blood cells gravitating to the bone marrow during transplant.
The research indicated that the hormone erythropoietin (EPO) secreted by the kidney is related to the engraftment process. He found the interesting relationship between oxygen levels and EPO hormone contributing to better engraftment of stem cells. EPO levels fluctuate based on the levels of oxygen and less EPO suggests more blood cells gravitating to the bone marrow and thereby better treatment outcome. He realized that he had to find a way to increase the oxygen level in the patient to lower the EPO levels.
Hyperbaric Oxygen Therapy
This therapy is a widely accepted treatment for various medical conditions such as carbon monoxide poisoning, severe skin infections etc. Here, the pressure of oxygen is two and a half times higher than normal level which will help the body to carry more oxygen. In this trial, the patients are provided with a round of chemotherapy and radiation session to destroy the affected blood cells. This is followed by 2 hours of hyperbaric treatment where pressurized oxygen is passed through a tube into the patient. After few hours, umbilical cord stem cells are transfused to them. The stem cell transfusions are provided till the patient’s cell count rises to normal levels.
The trial was initially conducted on animals and then on humans because hyperbaric treatment is already accepted for treating various medical conditions. In his pilot study, Dr. Aljitawi treated 15 patients in which 12 patients were weaned off the stem cell transfusion within 100 days of their transplant therapy. Due to the availability of more oxygen, the stem cells got latched onto the bone marrow and were able to produce new, healthy blood cells in a short span of time. He mentioned that this treatment shows an effective way to improve the engraftment without manipulating the stem cell count. Dr. Aljitawi is planning to begin the Phase II trial soon with more patients. He is a member of the Cancer Biology Program at The University of Kansas and associate professor of Oncology at the Kansas Medical Center.