In accepting a further research grant from Inner Wheel Australia for ongoing study, Dr Ngaire Elwood said the following:
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Dr Ngaire Elwood and
Inner Wheel Australia President, Carolyn Brown
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"It is an absolute delight to accept this grant from Inner Wheel. I feel very humbled and privileged to once again be the recipient of Inner Wheel’s fundraising efforts. We are very excited about our research findings to date, none of which would have been undertaken without Inner Wheel’s support. We are now eagerly looking forward to the next phase of this study, where we hope to show that what we have discovered can improve the survival outcome for patients undergoing a cord blood transplant.
"Since the first successful CB transplant in 1989, more than 5 000 patients have undergone a CB transplant from an unrelated donor. CB transplants are used for the treatment of leukaemia and other blood disorders. During a transplant, all of the patient's own blood cells are destroyed by drugs or irradiation to make room for the new healthy cells. The CB cells are then given to patients like a blood transfusion, and the CB cells know how to find their way to the bone marrow, where they can settle in and start making new cells to replenish the blood system.
"Umbilical cord blood contains blood stem cells that give rise to all the different blood cells in the body - cells such as white cells that fight infection, red cells that carry oxygen and platelets that help blood clot. There are some major advantages in using cord blood over bone marrow for a transplant. However, a substantial problem with cord blood is that sometimes it can take a long time for the cord blood stem cells to replenish the blood system. Most of the patients that die following a cord blood transplant actually die of infection while they’re waiting for the blood cells to grow. Cord blood from individual babies is extremely variable… cells from some cords grow well, but some grow very poorly. At the moment there is no reliable way to know how well cells from an individual cord will grow following a transplant.
"The aim of our research is to develop a way to determine, prior to transplant, which cord blood units will grow well once transplanted into a patient. Our vision is that, in situations where there may be several suitable CB units available for transplant of a particular patient (as there often is now with the existence of so many CB banks worldwide), based on our discovery, the transplant team can choose the CB unit that is most likely to result in a successful transplant outcome.
"In our previous study that was funded by Inner Wheel we found that when grown in the laboratory, CB stem cells with a certain length DNA, the basic genetic material, grow better than those with shorter DNA or very long DNA. We then went on to see if the length of DNA in CB stem cells can be used to predict how those CB cells might behave once they are transplanted into patients. So far we have studied the CB cells that were used to transplant 15 patients. We have separated the patients into two groups – those that were transplanted with CB cells that had long DNA, and those that received CB cells with short DNA. All seven patients that received transplants from CB cells with long DNA are still alive, some as long as 5 or 10 years. However, of the eight patients that received transplants from CB cells with short DNA, only three are still alive, with the other five having died of infection or disease relapse.
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From Left: Jan Birchall, Pat Puddy, Ngaire Elwood,
Carolyn Brown and Val Corva
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"These early results tell us that looking at the length of DNA of the CB to be used for transplant, may well give an indication of whether a successful outcome will be achieved. With this further funding from Inner Wheel, in collaboration with the BMDI Cord Blood Bank and Dr. KarinTiedemann, the Medical Director of the BMDI CB Bank, we will now undertake a much larger clinical study. In addition to continuing to investigate all CB used to transplant patients at the Children’s Cancer Centre, Royal Children’s Hospital, we have recently established a major collaboration with Dr Joanne Kurtzberg, Director of Duke University Cord Blood Bank, NC, USA.
" Dr Kurtzberg was part of the team that performed the world’s first CB transplant back in 1989 and has since performed hundreds of CB transplants at the Duke University Medical Centre. Based on our study in 15 patients, Dr. Kurtzberg has agreed to send us samples from CB cells that have been used to transplant 200 patients over the past 5 –10 years. We will therefore be able to perform the large scale clinical study that will be necessary if we are to convince the CB banks and transplant centres around the world that DNA length of the donor CB cells should be taken into consideration when choosing which CB units to use for transplant.
"This funding from Inner Wheel will pay for the salary of our research assistant to perform the experiments, and also cover some of the costs of the reagents needed to do the experiments. Because of this funding from Inner Wheel we were also able to attract funding support for this project from the CASS Foundation, which will provide the remaining costs of the reagents to do the experiments. On top of that, my salary support over the years has been provided by the Leukaemia Research Fund of the RCH. To date, we have had no government funding to undertake this project.
"This type of project, that started out as a very simple idea that we examined in a tissue culture dish, would never have been undertaken and progressed without the support of philanthropic groups, such as your own. You should be very proud of your substantial fundraising efforts, and the real difference you may make to improving CB transplantation. It is amazing to see what a group of women who work together towards a common goal can achieve. We are extremely grateful to Inner Wheel for the opportunity to undertake this study and look forward to presenting our findings upon completion of the study. "
Dr Ngaire Elwood
Children's Cancer Centre
Murdoch Children's Research Centre
Royal Children's Hospital
PARKVILLE Vic 3052
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