[SCItalk] Cultured Red Cells for Transfusion
Anna Rita Migliaccio
1. Ichan School of Medicine at Mount Sinai, NY, USA
2. University of Bologna, Italy
Blood transfusion represents the first form of cell therapy to enter into clinical use and has played a major role in the development of advanced therapies for genetic form of anemia (that would be otherwise lethal) and for cancer and makes it feasible to perform the extensive surgical procedures developed by modern medicine. In developed countries the blood supply is adequate and sporadically even in excess. However, difficulties exist to finding blood for alloimmunized patients and for patients with rare blood phenotypes. In addition, the human population is progressively ageing. Changes in age affect the blood supply by both increasing demand and reducing donation. It is predicted that if the human population continues to age at the current paste, blood will become scarce by 2050. These considerations establish the need to develop techniques for generation of cultured red blood cells (cRBCs) as transfusion products.
The proof-of-principle in animal models and the first-in-man administration of cRBCs have raised great excitement that cultured cRBCs may be used for transfusion in the near future. One of the most compelling issues related to production of cRBC, however, is the identification of the stem cell sources suitable for their generation. In this regard, the field is experiencing a dichotomy that reflects the two souls of transfusion medicine: On one hand, its outstanding tradition in developing clinical grade procedures is inspiring clinical trials that are assessing feasibility and safety of products derived from primary sources currently discarded (leuko-reduction products and low-volume cord blood). On the other hand, the perception that “canonical” transfusion studies with primary sources would be received poorly by high impact journals is determining that research funding is almost exclusively dedicated to the development of products using genetic engineering approaches (differentiation of induced pluripotent stem cells, direct and forward programming of fibroblasts, etc). This presentation will review the state of the art of the field in order to promote discussion on how to conciliate the clinical and scientific needs of the field.
Prof. Migliaccio has completed her Ph.D. at the age of 22 years from Naples University, Italy and has conducted her postdoctoral studies at the TNO, Rijswijk, The Netherlands and the University of Washington, WA, USA. Currently, she is Professor of Medicine, at the Tisch Cancer Institute, Mount Sinai School of Medicine, NY, USA and “Chiara Fama” Professor at the University of Bologna, Italy. She has published more than 180 papers in reputed journals and serves as Associate Editor for Experimental Hematology and editorial board member of additional prestigious hematology journals.
Host: Alessandra Giorgetti