Cell therapy

Mardaleishvili Medical Centre exclusively offers patients procedures such as: preparation of bone marrow material for cell therapy, immunotherapy with dendritic cell-based  anticancer vaccine and LAK therapy.

Cell therapy is the introduction of cells into the body to treat or prevent disease. Transplantable cells can be obtained from the patient himself or from a donor. Freshly harvested, uncultivated  cells can be transplanted, or cells can be cultivated and manipulated in advance, then stored frozen and transplanted to the patient at the right time. The types of cell therapy are as follows:

  • Stem cell transplantation (bone marrow stem cells, UC blood stem cells, UC tissue stem cells) in hematology (e.g. blood cancers) and regenerative medicine (e.g. neurodegenerative diseases – Parkinson’s, Alzheimer’s, head and spinal cord injuries, for autoimmune diseases (multiple sclerosis, lupus, scleroderma).
  • Immunotherapy, where the patient’s own immune system cells (e.g. lymphocytes or dendritic cells) are cultivated and modified outside the body using special methods in incubators and then injected into the body to strengthen the immune system, e.g. in tumors or for modulation, e.g., in autoimmune diseases.

A stem cell is an immature young cell with the ability  for self-renewal and simultaneous differentiation, i.e. the formation of tissues, cells and organs. The most powerful stem cell is the fertilized egg cell, the onset  of life created by God. More than two hundred types of human cells develop from it, reaching a total of 100 trillion. The term “stem cell” was first used in 1908. It comes from the German word “Stammzelle” (“Stamm” – stem, origin, base, “Zelle” – cell). It is really a base cell, a cell of origin. Its name in Spanish sounds very well: “célula madre” – the mother cell. because the mother is the onset of everything. As the body ages, the potential of stem cells decreases. This is very important. We can also say that ageing is caused by a lack of stem cells because stem cells are the only source of regeneration and self-renewal in the body. The body is constantly deteriorating and without stem cells, of course, ageing and death would occur much earlier.

The clinic has many successful results in treating neurological diseases, when a patient was injured as a result of  an accident, a bullet or a sudden fall, has Parkinson’s disease or multiple sclerosis. At this time it is advisable to enrich your own bone marrow with stem cells. The procedure takes 2 hours and goes as follows: 50-100 ml of bone marrow is taken from the patient and is enriched in the laboratory, concentration of cells  is improved and the same cells are injected either into the injured area during surgery or into the spinal canal. As a result of this procedure, the patient’s condition improves dramatically, limb sensitivity improves, sexual activity improves, etc.

The procedure is very effective in liver cirrhosis, liver function is significantly improved. The therapy is repeated every six months, sometimes once a year for better results. The procedure has been introduced and works with great success in Japan and the United States.

LAK-therapy and the anticancer  vaccine are known as immune therapy.  To improve the immune system blood is taken from a vein and treated to the point where it produces the necessary mononuclear lymphocytes, the natural killer, which are part of the innate immune system and are cells that protect against cancer. They have the ability to destroy cells infected by viruses. It should be noted that the approach to each patient is individual. The exact procedure is as follows: from blood taken from a vein, killer cells are isolated and activated, an active substance is added to them, they expand  and then fight the tumor more effectively. After a 2-week incubation period (freezing in liquid nitrogen) for 5 months, they are injected into the spinal canal, intravenously or subcutaneously as required. The procedure can be repeated in combination, It can be used together  with chemotherapy. For best results, the tumor must be reduced to the smallest possible size, followed by cell therapy. The therapy is actively used for tumors of various  localization, including undifferentiated form of a thyroid gland, gynecologic tumors, squamous cell tumors, head and neck tumors. The patient receives 8 injections as standard, in some cases doctors have to administer all the injections together, depending on the patient’s condition.

A personalized vaccine for a specific tumor is made from dendritic cells. To produce the cells tumor tissue, primary and metastatic, and dendritic cells are requires, which are present in small quantities in the blood. Once the blood is obtained,  the immune system conducting  cells, aka dendritic cells, are released. They are activated against a specific  tumor. If it has remained elsewhere, it will find it and fight it. The dendritic cells are cultivated, then tumor tissue is added, and they are launched  into the remaining tumor cells. It is then injected into the skin once in 2 weeks  4 times. 1 unit is capable of activating 3,000 lymphocytes. According to today’s data, this procedure has  the best results.

Injection of cells is recommended on  1 month after completion of radiation and chemotherapy. There is an immunotherapy center in Japan, where 5000 patients have been cured. In our clinic, LAK therapy was introduced in January 2011, and the use of the anticancer vaccine began in 2013.

UC  blood bank – Geocord

The global history of umbilical   cord blood banking began in the sixties of the twentieth century. Decades of research have shown that UC blood contains a large number of stem cells that can be used as a viable alternative to bone marrow transplants. After years of experimental research the ground was prepared for its transplantation, and on 6th  October 1988 Eliane Gluckman’s team in France performed the first successful cord blood transplant on a 6-year-old patient with Fanconi anemia. The patient was cured and feels well to this day. In 1991 a patient with chronic myelogenous leukemia was cured with an umbilical cord blood transplant. It became clear about the great promise of this method. Subsequent transplants proved that cord blood stem cell transplantation was a viable alternative to bone marrow transplantation. The issue of establishing a cord blood bank was raised.

In 1992, the first international registry was established in the US and the first cord blood banks were  created – New York Cord Blood Bank and the University of Arizona Cord Blood Stem Cell Bank. There are now 55 cord blood banks in the United States. A cord blood registry and bank were soon established in Europe as well. These institutions soon gained popularity both in medical circles and among the public. Today there are at least 150 banks around the world where both autologous and allogenic cord blood is processed and stored for long periods. Every day, up to one million samples are stored worldwide. In the meantime, transplantation has become even more widespread, with around 6,000 transplants worldwide by 2003. The figure is now as high as 40,000 a day. Most patients are children, but at least 10% are adult patients. In the future, other tissues (nerve, myocardium, liver, pancreas, bone and cartilage) may also be obtained from umbilical cord blood. The use of umbilical cord blood in regenerative medicine is increasing. It is already used in clinical trials in cerebral palsy (more than 200 patients), head and spinal cord injuries, type I diabetes, obliterating endarteritis, atherosclerosis, arthrosis.

On December 20th, 2005 the US Congress passed the STEM CELL THERAPEUTIC AND RESEARCH ACT OF 2005. It provides for the collection of 150,000 new materials from families of patients with blood diseases, malignancies, metabolic diseases, haemoglobinopathies and congenital immunodeficiencies, funding for cord blood collection and umbilical cord stem cell research. Between $50 million and $54 million was allocated annually to fund the program until 2010. Between 2011 and 2015, an additional $43 million was allocated for this purpose.

What is umbilical cord blood?

Umbilical cord blood is the blood that remains in the umbilical vein and placenta after the baby is born and the umbilical cord is crossed. This blood can be collected. Its volume usually ranges between 20-200ml. These cells can be stored almost indefinitely in liquid nitrogen and can be used by your child in case of medical need.

What are stem cells?

The umbilical cord blood is rich in stem cells, which are essential for the constant renewal of the body. The stem cells have the ability to self-renew and, at the same time, can mature into different cell types (e.g. skin, bone, blood, cartilage, muscle, liver, nervous system) and, as a result, ensure the continuous regeneration and self-renewal of tissues and organs. The stem cell is thus a source of continuous regeneration of the body. In the first days after conception, the body consists only of stem cells, and then their percentage gradually decreases as they form differentiated cells that perform specific functions in the body.

The percentage and regeneration potential of stem cells is much higher in the infant’s body and decreases with age. Umbilical cord blood is rich in hematopoietic stem cells. These are so-called mesenchymal and endothelial (blood-forming) stem cells. The potential of CD34+blood hematopoietic stem cells in umbilical cord blood is twenty times greater than the potential of CD34+haematopoietic stem cells of adult bone marrow.

Advantages of umbilical  cord blood stem cells

The collection of cord blood stem cells is absolutely safe for the mother and the newborn, while the collection of stem cells from bone marrow is a very painful and risky procedure.

The cord blood stem cells have a high capacity for implantation in damaged tissue, long telomeres and high telomerase activity (both these components are characteristic of young cells with a high production capacity), a low cytotoxic effect of  lymphocytes and a low production of inflammatory cytokines (interferon gamma, interleukin 4, 5, 10), so that immune incompatibility reactions are rare and proceed easily. Unlike bone marrow transplants, cord blood transplants do not require a complete match between the HLA systems of the donor and recipient. This is especially important for patients who cannot find an immunoidentical adult donor..

What disease is cord blood used to treat?

The first blood transplant was performed in 1988. Up to 40,000 transplants are performed daily for the treatment of blood cancers (leukemia, lymphoma), autoimmune diseases, congenital anemias and immune deficiency disorders and in regenerative medicine. Cord blood transplantation is a valid alternative to bone marrow transplantation.

There are several clinical trials using your own cord blood stem cells in regenerative medicine: cerebral palsy, brain injury, spinal cord injury, autism, vasoconstriction (atherosclerosis and endarteritis), diabetes and acquired hearing loss. Your own stem cells are a guaranteed best choice when it comes to repairing damaged tissue.

Don’t miss out on a once-in-a-lifetime chance to save your baby’s cord blood. By preserving the stem cells, you ensure your baby has a healthy future!

What tests are performed with the cord blood?

The collected blood is tested for the presence of various bacterial (aerobic and anaerobic), fungal and viral pathogens. The following viruses are tested according to a global standard by means of a polymerase chain reaction (PCR): human immunodeficiency virus type 1 and 2 (AIDS virus), hepatitis C virus, hepatitis B virus, human lymphotropic T virus (type 1 and 2), cytomegalovirus. Blood is also tested for the syphilis pathogen, treponema pallidum, using the serological RPR method. The sample is immunophenotyped by flow cytometry, quantitative and percentages of nuclear and stem cells are determined, and cell viability is checked.

For a successful stem cell transplant, the HLA systems of the donor and recipient must be matched, i.e. their immune systems shall be compatible. In the case of unrelated people, the chance of immunocompatibility is very low, at 1:70,000. In siblings  the ratio is very high: 1:4, i.e. on average about 25% of the stored cord blood can be used for sibling’s treatment. Recently, cord blood transplants with 50% compatibility, so-called haploid transplants, have become increasingly common. In a study at Duke University that began in 2015, patients with cerebral palsy are being transplanted with the blood of their cousins, even if their immunocompatibility is only 50% (see here). This approach increases the chance that instead of 25% umbilical cord blood for treatment of  siblings  , 75% is useful.

The UC blood bank is contractually responsible for storing the stem cells from your baby’s umbilical cord and, if necessary, making them available exclusively for the treatment of your family members. The transfer of umbilical cord blood stem cells to another patient is excluded.

If you are expecting a child

If you would like to store your baby’s cord blood, you may contact us 2-3 weeks prior to the expected delivery date or, if necessary, contact your OB/GYN prior to the birth who will arrange for the collection of your baby’s cord blood in a special container and its delivery to our bank.

Diseases

Today, cord blood transplants are the standard treatment for oncological and non-oncological blood diseases. Oncological diseases of the hematopoietic system:

  • Acute leukemia
  • Acute lymphoblastic leukemia
  • Acute myeloid leukemia
  • Chronic leukemia
  • Chronic myelogenous leukemia
  • Chronic lymphocytic leukemias
  • Lymphomas:
  • Hodgkin’s
  • Non-Hodgkin’s
  • Myelodysplastic syndrome
  • Myeloproliferative disorders
  • Acute myelofibrosis
  • Angiogenic myeloid metaplasia
  • Polycythemia vera
  • Essential thrombocythemia
  • Plasma cell diseases
  • Multiple myeloma
  • Plasma cell leukemias
  • Waldenstrom’s macroglobulinemia.

Non-oncological diseases of the hematopoietic system:

Congenital anemias:

  • Beta-thalassemia
  • Blackfan-Daimond anemia
  • Erythrocyte aplasia
  • Sickle cell anemias
  • Paroxysmal nocturnal hemoglobinuria
  • Congenital platelet disorders
  • Congenital thrombocytopenia
  • Glanzmann’s thrombasthenia
  • Congenital diseases of the immune system
  • Severe combined immunodeficiencies
  • Ataxia-telangiectasia
  • Bare lymphocyte syndrome
  • DiGeorge syndrome
  • Leukocyte adhesion deficiency
  • Wiskott-Aldridge syndrome
  • Chediak-Higashi syndrome
  • Neutrophil actin dysfunction
  • Reticular dysgenesis
  • Congenital neutropenia
  • Kostmann syndrome
  • Mucopolysaccharidoses
  • Hurler syndrome
  • Scheie syndrome
  • Hunter syndrome
  • Sanfilippo syndrome
    • Morquio syndrome
    • Maroteaux-Lamy syndrome
    • Beta-glucuronidase deficiency
    • Mucolipidosis Type II
    • Leukodystrophic diseases
    • Adrenoleukodystrophy
    • Krabbe disease
    • Metachromic leukodystrophy
    • Lysosomal diseases
    • Gaucher disease
    • Niemann-Pick disease
    • Sandhoff disease
    • Tay-Sachs disease
    • Wolman’s disease.
    • Other congenital diseases
    • Lesch-Nyhansyndrome

Outlook for the near future

In the near future cord blood will be used for the treatment of the following diseases

  • Myocardial infarction
  • Strokes
  • Alzheimer’s disease
  • Parkinson’s disease
  • Multiple sclerosis
  • Other neurodegenerative and muscular diseases
  • Diabetes mellitus
  • Liver cirrhosis.

Currently, many laboratories worldwide are intensively cultivating umbilical cord stem cells in vitro and producing various tissues for use in regenerative medicine, including liver cells (hepatocytes), nerve cells, blood vessel cells (endotheliocytes), cartilage cells, skin cells, etc.. In the near future, UC  blood stem cells there will be a real possibility to grow from the umbilical cord blood stem cells, the cells  and tissues of the patient’s choice.