For black patients, the chances of finding a donor pass from 29% with 8/8 compatibility to 84% with 7/8 compatibility. However, for a small number of patients, the donor remains difficult to find.
“The current ecosystem is based on living volunteers,” says Kevin Caldwell, CEO and co-founder of Ossium. Although the US organ donor system has existed for decades, bone marrow has never been regularly collected from those deceased donors in the same way as hearts, lungs, kidneys and livers. No one had found an effective way to obtain cells from deceased donors or cryopreserve them on a large scale to store them until they were needed.
“Unlike a solid organ, you can’t simply transplant bone marrow to the nearest person who is roughly the right size to need it,” Caldwell points out. “You really have to have a close genetic compatibility between the donor and the recipient.”
The new method of obtaining stem cells, through apheresis, does not work well in deceased people because it depends on blood pressure. Based on research previous Conducted at the University of Pittsburgh and Johns Hopkins University, Ossium developed a way to extract bone marrow from the spine, a part of the body that is not normally used. The company has partnered with American organ procurement organizations to recover spinal columns from cadavers and ship them to the company’s facility in Indianapolis. There the bone marrow is extracted and cryopreserved in liquid nitrogen vapor at about -190 degrees Celsius.
Caldwell says Ossium has “processed thousands of donors” since the company was founded in 2016. Ossium’s frozen bone marrow has now been administered to three people in total, including the Michigan woman, with a fourth transplant scheduled soon.
Robert Negrin, professor of medicine at Stanford University and vice president of the American Society of Hematology, calls the transplants an “important milestone,” but it remains to be seen whether the technique will be useful for cancer patients. “We have other options that work quite well,” he says, referring to partially matched donor transplants and umbilical cord blood transplants. “But there are always situations that can be out of place.”
Negrin sees potential in bone marrow transplants from deceased donors to help organ transplant patients, who currently must take immunosuppressive drugs for the rest of their lives to prevent their immune system from attacking the new organ. But since immune cells originate in the bone marrow, if they could receive a marrow transplant from the same donor, according to Negrin, patients could (in theory) do without immunosuppressive drugs.
Shorter waiting time
Steven Devine, medical director of NMDP, says one potential advantage of Ossium’s product is that it could reduce wait times for patients whose disease is so advanced that they need a transplant immediately. NMDP has partnered with Ossium to conduct its early phase clinical trial.
However, there are indications that the freezing process can decrease the quality of stem cells and increase slightly the risk of cancer relapseso Devine argues that Ossium’s approach may be better suited for other types of patients, such as those with sickle cell anemia, for whom bone marrow transplants may be a cure. “Ultimately, value and demand will be determined by clinical research,” he says.
Ossium will also need a very large and diverse donor pool to be able to offer matches that are not yet available in donor registries. But Abidi is confident that bone marrow transplants from deceased donors could open up an important treatment option for minorities. “Once this becomes standard care,” Abidi says, “this is going to be a game changer.”
Article originally published in WIRED. Adapted by Mauricio Serfatty Godoy.
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