Cord Blood Science and its Frontiers

Book Introduction
Cord blood haematopoietic stem cell is now an attractive proposition for allogeneic transplantation studies and treatment. The first cord blood-derived haematopoietic stem cell transplantation from an HLA-identical sibling in treating Fanconi’s anaemia was conducted by Prof. Eliane Gluckman in 1988. Since then the advent of cord blood banking, cryopreservation and characterization of cord blood stem cells have come a long way. Till date, more than 8000 unrelated cord blood transplants are performed till date. The distinct advantages of cord blood derived stem cells like hypo antigenic, better engraftment and superior properties of cord blood compared to adult blood has helped in the emergence of a new field of medicine also known as Cord blood therapeutics or Cord blood medicine. Cord blood is easily available and the absence of noticeable ethical problems, cord blood is fast becoming the best and standard source for regenerative and cell therapy procedures. The following book is edited by world-renowned clinician cum scientist in the field of stem cell and regenerative medicine Prof. Dr. Niranjan Bhattacharya, Head of The Department, Calcutta School of Tropical Medicine and Prof. Dr. Phillip Stubblefield, Emeritus Professor, Ob/Gyn, Boston and Harvard University and deals with the science of cord blood and its application in Regenerative Medicine. The foreword of this book is written by Prof. Eliane Gluckman, who conducted the first cord blood-derived haematopoietic stem cell transplantation in Fanconi’s Anaemia in 1988.

Highlights of the Book and Chapters
Placental umbilical cord blood has a tremendous opportunity in the field of regenerative medicine and stem cell therapy and many of it is still unknown. The following book “Frontiers of Cord Blood science” is a compilation of works conducted by various scientists and distinguished investigators in the field of cord blood transfusion and transplantation and their future applications in the treatment of diseases and conditions. Chapter 13 in this book deals with the clinical uses of cord blood where Chapter 11 deals with the application of cord blood in neurological defects. Newer concepts involving the use of cord blood transfusion and cell therapy in the area of biomaterials, prosthetics and implants are dealt in Chapter No.16 and Chapter No.17. Chapter No.10 details the clinical works of Prof. Dr.Niranjan Bhattacharya conducted for the first time in the field of blood transfusion using whole umbilical cord blood transfusion in rectifying anaemia at the background of various diseases. There are 13 chapters that deals with the basic science and the application of cord blood as a cell therapy prospect along with it's in vitro and in vivo expansion, characterization and application in animal models and translational research. Ethics of cord blood which is another important aspect of Cord blood science has also been dealt with great details.

Dr. Peter Hollands, a senior scientist in the field of cord blood and embryonic stem cells for more than 2 decades of the UK Cord Blood Bank has in details described the advantages and disadvantages of cord blood as a source of stem cells in Chapter No.2. In chapter no.16, Dr G.N Stacey, the director of the UK Stem Cell Bank discussed the problems and advantages of different stem cell lines practised in the UK Stem Cell Bank and how these banks can be used as a potential source of stem cells in regenerative medicine and other therapies. (Niranjan Bhattacharya,Phillip Stubblefield: Editors, Frontiers of cord blood Science, Springer; 2009, page no. of introduction.)

Chapter No.17 is written by Dr. Carolyn Troeger and colleagues pertaining to repopulation of the bone marrow using cord blood stem cells in the treatment of malignant and non-malignant disorders in children and adults and a continuing debate pertaining to the role of public versus private cord blood banks.Chapter No.3 has been written by Prof. Patricia Pranke and Dr. Raquel Canabarro from Brazil suggested the use of umbilical cord blood stem cells as an alternative to the Haematopoietic progenitor cell transplantation and its parameters such as total nucleated cell count, lack of CD38, HLA-DR and lineage-committed antigens and co-expression of the CD90/Thy-1 and c-kit receptor (CD117) and also its hypo-expression.

Dr. Karen Quillen of the Boston University Blood Bank director has done a comparative analysis and study of 113 cord blood transplants and 2052 bone marrow transplants in children with above 15 years of age between the period of 1990-1997 in Chapter No.8 Also it is described in the chapter than a smaller dose of umbilical cord haematopoietic stem cells is required as against a larger dose for efficient repopulation and engraftment of the cord blood haematopoietic stem cells although the rate of engraftment was slower in case of cord blood stem cell transplant and the three-year survival was similar to that of bone marrow transplantation. However, the main advantage of this therapy was the non-use of any steroid or immunosuppressant. The scientists described that in 72% of the cases methotrexate was not used and how these transplants had a lower risk for acute and chronic GvHd or Graft versus host disease was also observed post transplantation with cord blood stem cells and a better recovery in terms of neutrophil and platelet. Chapter No.9 is authored by Prof. Karen Ballen of the Harvard University outlining that how in the last 17 years there has been a massive rise in the use of without matched related or unrelated cord blood stem cell therapy.

In chapter No.6, Dr. Karen Bieback from The University of Heidelberg, Germany explained the massive underutilization of non-hematopoietic stem cell population which can be easily accessible with a number of advantages and superior properties compared to stem cells obtained from other sources. Prof. Ian McNiece and Dr.Elizabeth J.Shpall of Johns Hopkins University explained the similarity in cell populations between the peripheral blood progenitor cells and bone marrow with cord blood-derived stem cells in Chapter No.4.

Prof. Shaw from Australia in Chapter No. 7 also discussed the potential use of cord blood transplants in non-malignant paediatric diseases for unrelated transplants. Prof. Burd, Dr. Ayyappan and Dr.Lin Huang in Chapter No.12 opined that there is an increase in the vascularity of the chronic wound contracture and wound closure with a skin graft.

The main feature of this book also includes the role of whole umbilical cord blood transfusion in underdeveloped countries where getting properly screened blood especially in cases of emergency is a big menace. Every year approximately 10 billion millilitres of cord blood are produced and a majority of it is being thrown in the trash. This trend was however changed since 1999 when Prof. Dr Niranjan Bhattacharya for the first time showed successfully the safety and efficacy of HLA randomized, blood group matched cord blood transfusion in more than 1000 patients suffering from different diseases with no immune disorders and massive change in blood parameters and alleviation of symptoms till date after stringent follow-ups. There is no graft versus host disease and no immune rejection post cord blood transfusion from follow-up studies till today also indicates a potential for immunotherapy which has also been explained by the editor of this book Prof. Niranjan Bhattacharya in Chapter no.10 Further the book details the advantages of cord blood and its blood components over the use of adult blood for transfusion and the presence of cytokines and growth factors which are not in the case of adult blood. Prof. Himanshu Basu, a senior consultant in Ob/Gyn, UK has given this overview of the cord blood and its component n one of the chapters along with the editor of the book Prof. Dr.Niranjan Bhattacharya. The future potentialities of cord blood in bioengineering and medicine has been written by Dr A.Chaudhuri who is a senior neurologist consultant in Essex, U.K.

The potentialities of cord blood in bioengineering applications and an alternative to orthopaedic implant has been detailed by a globally renowned scientist group from India, Dr.D.Basu in Chapter No. 17. Chapter no.16 is again written by renowned bio-engineering scientists like Dr K.Kaladhar and Dr.Chamdra P.Sharma in Chapter No. 16.

The renowned Indian surgeon Prof. Dr.Ranesh Chakraborty who is the former Chairman of Surgical Sciences, The University of Virginia has highlighted on the stem cell ethical aspects involving cord blood stem cells n the final chapter.

Reviews and Scope of the book
The following book titled “Frontiers of Cord blood Science” is intended for biomedical, medical students and professions coming from broad backgrounds. The book is written in a simple, lucid and in a simple language with flair. This book is also intended for starters in the field of stem cell therapy and regenerative medicine using cord blood stem cells and its history. The book received a number of applauds from individuals and different High peered medical journals and communities such as NEJM, Clinical and Experimental Obstetrics and Gynaecology which are mentioned as below: "The editors and authors of this book not only address current clinical science and banking of umbilical-cord blood, but also advance new concepts in medical therapeutics that use umbilical-cord blood. … This book provides a clear summary of work that provides clues to the unique molecular and cellular biology of stem cells … . The editors of this book … making Frontiers of Cord Blood Science a valuable reference for researchers and clinicians who are interested in the evolving field of cellular therapies." Mary J. Laughlin, New England Journal of Medicine, Vol. 361 (3), July, 2009 "Studies with cord blood present a new field of science. It is a source of hematopoietic progenitor and stem cells, and enables investigation in genetics, immunology, etc. The book also explores possible future uses for stem cell transplantation and other therapeutic applications. A timely text." Pediatric Endocrinology Reviews, Vol. 7 (3), March-April, 2010 "The contents of this book are extremely important for … the field of transplantation of umbilical cord blood stem cells. … The extensiveness of the topics covered makes it a useful guide for specialists in this sector. … text shall be responsible for spreading the knowledge acquired to date and, therefore, for inducing researchers to explore all possible fields of future applications … . text to be of high scientific importance and are certain it will lead to further progress in clinical research and application."