UMBILICAL CORD BLOOD, STEM CELL BANKING

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1 UMBILICAL CORD BLOOD, STEM CELL BANKING Dr.Sharad Jain MD Blood Transfusion officer, & I/C Transfusion Medicine NSCB Medical College. Jabalpur.MP. Introduction: Every parent during childbirth DREAMS the best for their child. Has anybody ever imagines the possibility of any serious disease? Realize the fact, this is once in a lifetime opportunity. Its the first and last chance for baby and 1st relation family members to have cord blood stem cells banking. Year1970, researchers came out with the fact that cord blood stem cells can generate haemopoitic cells. Stem cells have a capability to regenerate and reproduce different almost 200 tissue types. Presently research proved cure of 75 diseases by using these precious stem cells. Mainly Leukemia s 40 different types Non Hodgkin s Lymphoma Anemia Inherited diseases. Immune deficiency Diseases Possibly In Diabetics Liver disorders. More and more utility of cord blood stem cells identified Success in transplant of cord blood stem cells appearing every year. Hence it is a biological insurance to any family Do you still have any doubt about cord stem cell banking?

2 Basics of cord blood stem cells. Umbilical cord connects the fetus with mother. It is cut and discarded after delivery without any though. Cord blood is a remaining blood in Umbilical cord. It is rich in stem cells. Cord blood cells have similarity with BM cells. BM cells are very well known for treatment of several diseases. History Year Cord blood stem cells firstly transplanted in Fanconi anemia case. The child cured and is still alive. Around more than 6000-cord blood transplants done worldwide. Approx. more than 20-cord blood transplanted in India too. Cord blood cells helpful in management of Diabetes, Kidney, Heart, neurological conditions, Many types of Cancer. Stem cells transplantation is a most promising technology of near future. It is a most precious elixir. Why to plan now? Realize Childbirth is only once in lifetime. Hence one and only one opportunity to get cord stem cells. Brightest future of cord blood stem cell banking. Preservation of stem cells is absolutely harmless. If not opted, cord tissue discarded as bio-waste. What is cord blood? It is a blood, which is left in cord and placenta after birth. It is discarded as bio-waste if not preserved.

3 Cord blood is a richest source of stem cells. It can be safely collected, processed & cryo-preserved for future. It takes only 3-4 minutes for collection. Approx.85ml of cord blood can be collected. Why cord blood is to be preserved? Baby s cord blood rich in stem cells. Cells have similarity with BM cells These are master cells to generate all type of cells i.e. Immune system White cells for control of infection. RBCs. for oxygen transport. Platelets to promote clotting Stem cells transplant is in existence since more than 18yrs. Wide spread use of cord blood Leukemia more than 40 variants Sickle cells disease, Anemia Immune-deficiency syndrome Many more diseases. Important to note, cord blood cells are immunologically naïve. Better than BM cells for transplantation. There are 1:4 chances of matching to sibs. There is 100% match to the baby from which collected. Most promising technology for future programs. What makes cord blood unique? Advantages of cord blood stem cells over BM stem cells Rarely contaminated with virus. Better tolerable than B. marrow cells. B.M. Cells are exposed to several diseases.

4 Low incidence of Graft v/s Host disease. Perfect match to the child whose stem cells collected. Chances of compatibility 1: 4 in sibs. When cord blood collected? Collected immediately after birth of a child. Whether normal delivery or section. Collection is at site. Collection kit is required. Is this procedure painful and risky? It s a painless procedure. No risk to mother. Stem cells collected from clamped cord and placenta. During stem cells collection no interference observed with gynecologist and delivery process. How cord blood is collected? Needs an Umbilical cord collection kit. Umbilical cord clamped after delivery. Using Blood collection bag cord blood is drawn from umbilical cord. Tech. is very easy and effective. What next after cord blood collection? Cord blood and mother blood packed in the kit available. Delivery of cord blood to the center within 36 hrs to 48hrs. Blood received is processed, tested and cells are separated and cryogenic preserved.

5 Who can use preserved cord blood stem cells? Anyone of the family member can use after HLA test. 1:4 chances of compatibility with sibs Perfect match to the sibs. With due consent it can be provided to any other needy. It can be provided for research work. What is the cost in stem cells storage? No charge for retrieval of stem cells. Shipping and handling charges. Over head exp. For cryo-preservation How successful is cord blood stem cell transplant? It is more successful than BM. More advantageous than BM Easy collection Better tolerance of HLA match. What is the future of cord blood stem cells? No body knew this technology 16yrs back. In past few years researches showed success Recently gene therapy has appeared. Cord blood stem cells is a future in gene therapy. Showing a vital role is several diseases. How long cord blood stem cells can be preserved? It s a matter of debate.

6 Scientist has shown viable cells after 18years. It depends upon the center preserving cells. BM cells are cryopreserved since decades and are viable. There is no doubt in stem cells cryopreservation for years. Some detailed aspects of cord blood stem cells. Stem cells to be collected before or after delivery of placenta! No significant difference identified. Better cell content if harvested blood before expulsion of placenta. Which technique is superior for cord blood stem cells collection? a. Gravity drip/syringe Collection of cord cells by syringe. Syringes draw more blood Flushing of blood by N. saline from bags It produces more number of cells Better options Preferred collection technique bag of vials Advantage of bag Close collection less chances of contamination Advantage of vials. Multiple vials with single collection. Can do multiple transfusions.

7 Portion of tissue can be used. Viability of collected cells After 15 years of preservation 90% cells were found viable. Reason for viability of cryo persevered cells. Stem cells are stored at 196degree C. Below 130 degree C. No liquid water exists in cell. At 196 degree C. No thermal energy persist for cell biochemical reaction. There is minimal Radiation and cosmic rays effect present. Time required for cord blood cells to engraft Median time for engraftment of BM cells and cord Blood is 18 & 26days. Difference in GVHD in cord blood cells and other cell line. GVHD is less severe in cord cell than any other cells. Minimum dose of cells required for engraftment. Minimum 20 million nucleated cells/kg body weight Approximately 10-million cells/kg body weights 75% failure rate Approximately 30-million cells/kg body weights 30% failure rate Can stem cells be cultured? Yes, Biotech companies are trying to grow artificially Can mismatched cord cells used in adult for increasing cell number

8 Yes. Apparently quite large It produces chimarism. 2-6 different Cell lines attempted. Initially mixed HLA type seen Over a time single HLA type identified. Can cord stem cells be used in gene therapy? Yes. Stem cells transplant to replace defective gene Autologous cells can be genetically engineered to fix the defective gene Genetic engineering done by using virus Patient owns cord blood is the best answer. Example used in bubble boy syndrome. SCID case Can cord blood cells used for organ regeneration? Yes. Cellular cardiomyoplasty Stem cells used to repair damaged cells. To repair heart muscle cord cells are used. Conclusion. DREAM the best for child and family. Realize the fact, this is once in a lifetime opportunity. Approx.85ml of cord blood can be collected for stem cells. Important to note cord blood cells are immunologically naïve. Cord cells are better than BM cells for transplantation. Cord is cut and discarded after delivery without any though. Cord blood is a remaining blood in Umbilical cord. It is rich in stem cells. Cord blood cells helpful in management of Diabetes, Kidney, Heart, neurological conditions, Many types of Cancer.

9 Stem cells have a capability to regenerate and reproduce different almost 200 tissue types. Presently research proved cure of 75 diseases by using these precious stem cells Stem cells transplant to replace defective gene Stem cells transplantation is a most promising technology of future. It is a most precious elixir. Plan right now!

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