Milano Cord Blood Bank 18 year report on cord blood banking and transplant

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1 Milano Cord Blood Bank 18 year report on cord blood banking and transplant Paolo Rebulla, MD Milano Cord Blood Bank Center of Transfusion Medicine, Cellular Therapy and Cryobiology Department of Regenerative Medicine Foundation Ca Granda Ospedale Maggiore Policlinico, Milan, Italy

2 Issues How to build a public inventory Allogeneic Directed We neither do nor recommend autologous Cord blood unit quality Minimum volume & TNC, sterility, HLA Cryopreservation & storage <15 C Outcome in patients Transplant f-up

3 Milano Cord Blood Bank Inventory (31 Dec 21) of cord blood units available for transplant by year of collection unrelated 418 directed Milano Cord Blood Bank 21

4 Milano Cord Blood Bank Number of cord blood units collected, deferred, and cryopreserved in Deferred Cryopreserved Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Milano Cord Blood Bank 21

5 Bergamo Legnano Mangiagalli Sondrio Lecco Rovereto Varese Chiavenna BS-Poliambulanza Sondalo TN-S.Camillo Arco di Trento Cavalese Magenta CO-Valduce MI-Buzzi Desenzano Cernusco sul Naviglio MI-Sacco Manerbio Merate Melegnano CO-S.Anna Melzo N. of cryopreserved units Milano Cord Blood Bank Cryopreserved cord blood units by delivery room % Milano Cord Blood Bank 21

6 Bergamo Legnano Mangiagalli Sondrio Lecco Rovereto Varese Chiavenna BS-Poliambulanza Sondalo TN-S.Camillo Arco di Trento Cavalese Magenta CO-Valduce MI-Buzzi Desenzano Cernusco sul Naviglio MI-Sacco Manerbio Merate Melegnano CO-S.Anna Melzo 3 Milano Cord Blood Bank Collection efficiency in 21 vs 29: No. of collected units / No. of deliveries x 1 Green: increase Red: decrease 25 2 % Milano Cord Blood Bank 21

7 Milano Cord Blood Bank Banking efficiency in 21: No. of cryopreserved units / No. of deliveries x 1 Bergamo Legnano Mangiagalli Sondrio Lecco Rovereto Varese Chiavenna BS-Poliambulanza Sondalo TN-S.Camillo Arco di Trento Cavalese Magenta CO-Valduce MI-Buzzi Desenzano Cernusco sul MI-Sacco Manerbio Merate Melegnano CO-S.Anna Melzo 5 1,8 1,1,7,7,2,5 1,1,7,5,3,2,1,4 1,9 2,6 2,9 3,6 3,8 4,7 6,6 6, ,1 9,3 Percentage Milano Cord Blood Bank 21

8 Milano Cord Blood Bank Number of collected cord blood units and number of deliveries Year 21 Bergamo Legnano Mangiagalli Sondrio Lecco Rovereto Varese Chiavenna BS-Poliambulanza Sondalo TN-S.Camillo Arco di Trento Cavalese Magenta CO-Valduce MI-Buzzi Desenzano Cernusco sul Naviglio MI-Sacco Manerbio Merate Melegnano CO-S.Anna Melzo Number of deliveries Number of collected units 6471 Milano Cord Blood Bank 21

9 Milano Cord Blood Bank Mean and Standard Deviation (SD) of the unit volume, collected and cryopreserved Nucleated cells (NC) in vaginal delivery and in caesarean section Mean SD Vaginal delivery N=574 Caesarean section N=1814 Volume (ml-cpd) NCx1 7 collected NCx1 7 cryopreserved

10 How many units should we collect in Italy? 75, Fig 3. Prediction of the percentage of patients requesting a donor (2 consecutive patients) at the Anthony Nolan Register finding at least one donor for each predefined donor size inventory according to match categories

11 Issues How to build your public inventory Allogeneic Directed We neither do nor recommend autologous Cord blood unit quality Minimum volume & TNC, sterility, HLA Cryopreservation & storage <15 C Outcome in patients Transplant f-up

12 1998 (n=137) 1999 (n=615) 2 (n=531) 21 (n=37) 22 (n=41) 23 (n=366) 24 (n=465) 25 (n=545) 26 (n=428) 27 (n=466) 28 (N=695) 29 (n=594) 21 (N=786) Milano Cord Blood Bank - Quality control chart of % NC recovery in volume-reduced cord blood units processed with Bottom-and-Top Compoflex bags in the Compomat G4 (NPBI) from 1998 to ,2 1,7 1,82 1,38 1,93 1,4 1,5 12 1,2 83,15 85,92 85,79 89,35 92,6 91,5 88,64 86,8 86,75 86,6 88,5 89,6 9, ,21 62,91 69,53 67,28 68,56 66,9 75,1 72,5 65,3 74,9 71,5 4 49,73 43, Median Max Min Lineare (Max) Lineare (Min) Lineare (Median)

13 1998 (n=137) 1999 (n=615) 2 (n=531) 21 (n=37) 22 (n=41) 23 (n=366) 24 (n=465) 25 (n=545) 26 (n=428) 27 (n=466) 28 (N=695) 29 (n=594) 21 (N=786) Milano Cord Blood Bank - NC at collection from 1998 to 21 (1 6 ) , ,1 1374, , , ,2 1336, ,9 1351,8 144, ,7 1383,5 141, ,61 92,93 932,88 942,27 942,9 976,3 982,62 916,9 13, ,1 84,44 735,9 Median Max Min Lineare (Max) Lineare (Min) Lineare (Median)

14 1998 (n=137) 1999 (n=615) 2 (n=531) 21 (n=37) 22 (n=41) 23 (n=366) 24 (n=465) 25 (n=545) 26 (n=428) 27 (n=466) 28 (n=695) 29 (n=594) 21 (N=786) Milano Cord Blood Bank - NC at cryopreservation from 1998 to 21 (1 6 ) ,84 186,15 168,6 169,58123,75 135,45 11,1 12,1 16,2 191,13 155,4 138, ,25 552,5 687,7 81,45 81,45 81,45 765,9 726,9 68,4 773,3 687,7 753,4 751,9 2 Median Max Min Lineare (Max) Lineare (Min) Lineare (Median)

15 1998 (n=131) 1999 (n=579) 2 (n=51) 21 (n=362) 22 (n=397) 23 (n=363) 24 (n=449) 25 (n=538) 26 (n=427) 27 (n=474) 28 (n=686) 29 (n=534) 21 (n=797) Milano Cord Blood Bank CFU-GM x 1 3 at cryopreservation from 1998 to ,5 64,5 565,2 461,6 631, ,4 488, ,1 525,2 534,6 498, ,5 32,5 35,3 48,5 48,8 68,4 22,1 36,4 16,3 19,4 33,7 22,3 21,1 Median Max Min Lineare (Max) Lineare (Min) Lineare (Median)

16 1998 (n=126) 1999 (n=581) 2 (n=52) 21 (n=363) 22 (n=394) 23 (n=367) 24 (n=457) 25 (n=549) 26 (n=431) 27 (n=474) 28 (n=696) 29 (n=556) 21 (n=799) Milano Cord Blood Bank CD34+ cells x 1 6 per unit at cryopreservation from 1998 to ,5 3 2,5 2,9 2,7 2,7 2,57 3,3 3 3,2 3,2 3,3 3 3, ,5 1,5,6,3,4,1,3,5,5,1,1,2,5,5,4 Median Max Min Lineare (Max) Lineare (Min) Lineare (Median)

17 Issues How to build your public inventory Allogeneic Directed We neither do nor recommend autologous Cord blood unit quality Minimum volume & TNC, sterility, HLA Cryopreservation & storage <15 C Outcome in patients Transplant f-up

18 Milano Cord Blood Bank Number of unit secondary searches per year Year Milano Cord Blood Bank 21

19 Milano Cord Blood Bank Number of units distributed for unrelated donor transplant during Distributed Total Not used Milano Cord Blood Bank 21

20 Milano Cord Blood Bank 452 units distributed during for unrelated donor transplant Milano Cord Blood Bank 21

21 Milano Cord Blood Bank City of transplant of 18 directed cord blood units released in

22 Single CBT: Overall Survival 36 months: 4%±3 n=249 EUROCORD analysis of MICB data Feb 21

23 Single CBT: Overall Survival by number of nucleated cells infused TNC 4,17x1 7 /Kg, n=17, 51%±4 TNC<4,17x1 7 /Kg, n=17, 33%±5 p=.5 EUROCORD analysis of MICB data Feb 21

24 Single CBT: Overall Survival by age Children at 36 months 48%±4, n=173 Adults at 36 months 19%±5, n=75 p=<.1 EUROCORD analysis of MICB data Feb 21

25 Double CBT: Overall Survival n= 58 EUROCORD analysis of MICB data Feb 21

26 Our appreciation and gratitude go to: 24,34 mothers who donated their babies cord bloods to the Milano Cord Blood Bank, 79 trained midwives and gyn s who collected them, MICB staff who banked our 9,8 units, 146 transplant teams who transplanted 452 of those units worldwide during Our target is to triplicate our inventory with larger cell doses and increase the current 4% K-M survival rate of recipients of MICB units.

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