Cord Blood: that other stem cell source. Donna Wall, MD Director, Manitoba Blood and Marrow Transplant Program

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Cord Blood: that other stem cell source. Donna Wall, MD Director, Manitoba Blood and Marrow Transplant Program"

Transcription

1 Cord Blood: that other stem cell source Donna Wall, MD Director, Manitoba Blood and Marrow Transplant Program CBMTG April 2012

2 The problem: In order to perform a BMT from one person to another one needs a sufficiently immunematched donor so that the new blood making system will accepted by the body AND develop a functional immune system Immune matched sibling in only about 20% of families Unrelated adult donor Partially matched donor (haploidentical)

3 Objectives: To review the potential of cord blood as an alternative donor source To identify current limitations and opportunities in incorporating cord blood in your search/transplant strategy

4 What is (umbilical) cord blood? Cord blood is the blood retained in the placenta after delivery of the infant Rich in hematopoietic progenitors Low viral contamination The immune cells contained in the graft are tolerant to fetal-maternal immune differences

5

6 Cord blood and Hematopoietic Stem/Progenitor Transplantation A single cord blood unit contains sufficient hematopoietic progenitors to result in durable engraftment Engraftment/count recovery correlates with the number of cells in the cord blood unit Low viral contamination in cord blood and hence low viral immunity Cord blood immune cells are more tolerant and are associated with less graft vs. host disease especially chronic GVHD

7 Advantages of cord blood: Rapidly available Flexibility in timing of transplant HLA mismatches are tolerated with acceptable GVHD with current inventories 95% of children will have at least a 4/6 HLA antigen matched unit Banks can be adjusted to increased ethnic (HLA) diversity Less chronic Graft-vs-Host disease

8 Limitations of cord blood Limited number of cells in a unit Generally transplanting with one log fewer nucleated cells and CD34+ cells Longer time to recovery of neutrophils and platelets One time infusion No opportunity to collect additional cells from the donor Nonengraftment is a problem must have a nonengrafment plan PRIOR to start of transplant

9 Improved hematopoietic progenitor cell reservoir following cord blood vs. bone marrow transplant 2 groups of children: 12 CB recipients and 12 adult BM recipients Recipients of BM transplants received 10-fold more cells and had significantly faster neutrophil and platelet recovery At 1 year after transplantation, the frequency of colonyforming cells (CFCs) and long-term culture initiating cells (LTC-ICs) were compared Frassoni et al, Blood 102:1138

10 Comparison of marrow hematopoietic progenitors following CB vs BM transplant Cord Blood Recipients (n=12) Bone Marrow Recipients (n=12) CFC/2 x 10 4 BM mononuclear cells P =.007 LTC-IC/10 6 BM mononuclear cells P =.001

11 The supply of unrelated donor cord blood is dependent on the network of public cord blood banks World-wide inventory of over 600,000 units Cell dose in units is increasing Increasing representation of ethnic minorities

12 The quality of cord blood units is improving Accreditation and coordination of cord blood banks NETCORD/FACT accreditation National/international effort to coordinate the banks Strong infectious screening and testing limitations in identifying serious hematologic/immunologic disorders With the long storage periods there has been no indication of loss of potency Approaches developed to confirm product identity and hematopoietic progenitor viability

13 Congratulations Héma-Québec FACT accreditation obtained this year Over 6,000 searchable units 20 units released for transplant Median time to neutrophil recovery days Median time to platelet >50 50 days We are now starting to see potential matches for our First Nations patients Smaller public banks in Toronto and Edmonton Fournier, et al CBMTG 2012

14 OneMatch Public Cord Blood Bank The national model includes at least 4 collection cities and 2 labs for processing, storage and distribution. NOTE we will also be working on cord blood collection kits that can be sent to targeted areas outside of the cities listed below, e.g. Aboriginal communities Canadian Blood Services Medical and Scientific Advisory Committee OneMatch National Public Cord Blood Bank (inventory of 20,000 units within 8 years*) Searching, Matching Ottawa Lab Edmonton Lab CBS Support HLA Testing Transmissible Disease Testing CBS Research Ethics Committee (units unsuitable for transfusion) Marketing & Recruitment Canadian Transplant Programs Ottawa Hospitals Edmonton Hospitals Canadian Research Scientists International Registries Toronto Hospitals Vancouver Hospitals *Optimal size of a national cord blood inventory is currently thought to be approximately 20,000 units, which can be achieved within 8 years using this Model. Courtesy of Sue Smith, OneMatch

15 Timelines Phase I will take approximately 2 years, as this is when key pieces of infrastructure (i.e. IT and lab), as well as SOPs will be developed and implemented. With those key components in place, Phase II expansion is expected to take approximately 1 year. FY 2011/12 FY 2012/13 FY 2013/14 FY 2014/15 Ottawa Collection Hospital & Lab Phase I Edmonton Collection Hospital & Lab Vancouver Collection Hospital Toronto Collection Hospital Phase II Phase II Phase II Courtesy of Sue Smith, OneMatch

16 Public cord blood banking is costly Despite heavy support by national bodies the cost of units is high and likely to increase $25-40,000/unit This will not be a made in Canada project We need to use the best products for our patients

17 Cell processing laboratory has an important role The cell product is much smaller than the lab is used to working with. Important to practice thaws Minimize cell loss Contingency plan to handle broken bags Validated thaw procedure Most labs use a modified Rubinstein method (dextran/albumin) Thaw and dilute vs. thaw and wash (avoid centrifugation) vs. bedside thaw and infuse

18 Evolving strategies in selecting cord blood unit(s) for transplantation Size matters TNC vs CD34 vs CFU Nucleated red cells (0-50% of TNC) HLA matching Historically low resolution HLA A and B with high resolution HLA DR have been used in cord blood selection

19 Cell dose is the only consistent factor impacting cord blood outcomes For other stem cell sources we are routinely well above engraftment threshold Rich marrow -- > 3x10 8 nucleated cells/kg Minimum 1 x 10 8 nucleated cells/kg PBPC target 5 x 10 6 CD34/kg recipient Minimum 2 x 10 6 CD34/kg Cord blood is much closer to that threshold TNC target 5 x 10 7 TNC/kg Minimum 2-3 x 10 7 TNC/kg

20 Time to count recovery, engraftment, survival, transplant related morbidity all correlate with cell dose. Difficult to find >2 x 10 7 TNC/kg in adults hence the move to double cord blood transplants One unit usually ends up being a bridging unit We take one best match then second largest Issues with possible infusional toxicity complete one infusion prior to thaw of second unit.

21 Other approaches to improving engraftment Expansion of hematopoietic stem/progenitors Bridging grafts Coinfusion of pooled cord blood products (Peletier) Coinfusion of CD34 selected haploidentical cells Coinfusion of expanded cord blood using activation of the Notch signaling pathway Altering SDF1- CXCR4 axis to enhance homing (Marquez-Curtis) Intrabone infusion

22 Is the cord HLA convention correct? Low resolution HLA A and B with high resolution DR NHLBI COBLT trial utilized units selected by convention but then typed to high resolution No impact on survival, GVHD or engraftment

23 CIBMTR analysis of the effect of donor-recipient HLA-A,B,C and DRB1 on survival 92/803 patients receiving single unit CBT for leukemia or myelodysplastic s were matched at HLA A,B,DR 69 patients were matched at HLA C and compared to 23 who had HLA A, B, DR matching but mismatched at C The HLA C matched patients had lower transplant related mortality (HR % CI ; p=0.018) No difference in survival Transplant mortality risk in general increased with increasing degree of mismatch Issue of competing variables (cell dose and HLA matching) Eapen et al Lancet Oncology Oct 2011

24 The noninherited maternal allele The fetus is a half immunologic match to mother If the HLA mismatches in a cord blood transplant results in reexposure of the cord blood to the HLA antigens that it had already seen in utero there is better transplant outcome Van Rood et al, PNAS :19952

25

26 Reduced Intensity Transplantation: Comparison of double cord blood to other donor sources CIBMTR registry report of RIC transplants : 523 AML, 50 ALL Cord blood HLA matching by cord convention 85% were double cords (ducb) 70% mismatched at 2 of 6 antigens Prep regimen TBI200/cy/flu (N=120) vs other (alkylator/flu/ with ATG in most, N=40) 20 centers, only 2 centers >10 One center contributed 89/121 TCF Brunstein, Blood epub April 10, 2012

27 PBPC were separated into 8/8 vs 7/8 1/3 received regimens which included LD TBI No center effect detected ducb-tcf had better pretransplant performance status and greater number in CR at transplant ducb-other were younger, more were CMV positive, 30% had active disease at txp

28 Leukemia-free survival for patients transplanted in remission

29 Transplant-related mortality

30 Probability of neutrophil recovery

31 No difference in relapse agvhd in cords mostly grade II cgvhd is a major difference ducb-tcf vs 8/8 or 7/8 PBPC RR 0.43 ( ) p<0.001 Similar reports from EBMT (Rocha, Curr Opin Onc 2009) and BMTCTN multicenter trial (Brunstein, Blood 2011)

32 Manitoba unrelated donor search strategy Preliminary search identifies if there are many vs. few potential matches on the adult registries Cord search immediately (with separate query to HémaQuébec) if timing is tight or if few/no potential matches on registry We routinely assess both cord and adult donor options In the past 3 years we have had only 2 patients who did not have a graft available at the time they were ready for transplant. During that time approximately 45 unrelated donors and 6 cord blood donors for adult patients.

33 Cost is an issue However with less chronic GVHD the total health care spending may not be different. Importance of a Canadian transplant registry coming soon

34 Special circumstance: the expectant family with a known risk factor for needing an allogeneic transplant Child or known family risk for thalassemia, sickle cell anemia, other inherited blood disorder treated by allogeneic transplant Child with leukemia who may need transplant Manitoba Family Cord Blood Bank Remember the cord blood donor will be an HLA match

35 Cord blood is an important alternative donor option in transplantation Rapidly available, tolerant of immune mismatches, less graft-vs.-host disease especially cgvhd Public banking must be supported Banking cord blood in high risk families is reasonable

36 Thank you and we hope to see you in Winnipeg for CBMTG 2013!

37 The Haunted??? Hotel Fort Garry

38

Preparation of cord blood for infusion: bedside thaw, dilute and wash, or somewhere in between

Preparation of cord blood for infusion: bedside thaw, dilute and wash, or somewhere in between Preparation of cord blood for infusion: bedside thaw, dilute and wash, or somewhere in between Donna Wall, MD Director, Manitoba Blood and Marrow Transplant Program ISCT 2012 Disclosures: none The problem:

More information

The donor search: the best donor or cord blood unit

The donor search: the best donor or cord blood unit The donor search: the best donor or cord blood unit Dr Bronwen Shaw Consultant in haematopoietic cell transplantation Royal Marsden Hospital /Anthony Nolan Overview Where do we find donors/units for transplantation

More information

OneMatch National. Sue Smith, Executive Director, Stem Cells 2011-11- 04

OneMatch National. Sue Smith, Executive Director, Stem Cells 2011-11- 04 OneMatch National Public Cord Blood Bank Blood Matters 2011 Sue Smith, Executive Director, Stem Cells 2011-11- 04 No Disclosures To Declare The presenter does not have any involvement with the industry

More information

Selection of the Optimal Umbilical Cord Blood Unit

Selection of the Optimal Umbilical Cord Blood Unit Karen Ballen, MD Selection of the Optimal Umbilical Cord Blood Unit Massachusetts General Hospital September, 2013 OUTLINE Cell Dose HLA Match Allele Level HLA C KIR Directional Mismatch NIMA HLA Antibodies

More information

Pr Eliane Gluckman, MD, FRCP, Disclosure of Interest: Nothing to Disclose

Pr Eliane Gluckman, MD, FRCP, Disclosure of Interest: Nothing to Disclose Pr Eliane Gluckman, MD, FRCP, Hospital Saint Louis, University Paris- Diderot, France Should Haplo-identical transplantation be preferred to cord blood in patients without a matched donor? Disclosure of

More information

Beyond Cell Dose: Selection of the Optimal Umbilical Cord Blood Unit. Karen Ballen, MD Massachusetts General Hospital June, 2012

Beyond Cell Dose: Selection of the Optimal Umbilical Cord Blood Unit. Karen Ballen, MD Massachusetts General Hospital June, 2012 Beyond Cell Dose: Selection of the Optimal Umbilical Cord Blood Unit Karen Ballen, MD Massachusetts General Hospital June, 2012 OUTLINE Cell Dose HLA Typing HLA C and KIR HLA Antibodies ABO and Racial/Ethnic

More information

Umbilical Cord Blood Transplantation

Umbilical Cord Blood Transplantation Umbilical Cord Blood Transplantation V Rocha MD, PhD Hopital Saint Louis, Paris University 7 CIBMTR Milwaukee Umbilical Cord blood transplantation Background History Clinical results in children and adults

More information

A Cure for Sickle Cell Anemia and Thalassemia

A Cure for Sickle Cell Anemia and Thalassemia IV Simpósio Internacional de Hemoglobinopatias A Cure for Sickle Cell Anemia and Thalassemia Bertram Lubin, MD and Mark Walters, MD 4 September 2007 Topics to be covered Cord blood: Importance and biology

More information

Cord Blood for Cellular Therapy: A Snapshot of this Evolving Market Landscape

Cord Blood for Cellular Therapy: A Snapshot of this Evolving Market Landscape GENReports: Market & Tech Analysis Cord Blood for Cellular Therapy: A Snapshot of this Evolving Market Landscape > Enal Razvi, Ph.D. Biotechnology Analyst, Managing Director SELECTBIO US enal@selectbio.us

More information

UMBILICAL CORD BLOOD TRANSPLANTATION: KFSH EXPERIENCE

UMBILICAL CORD BLOOD TRANSPLANTATION: KFSH EXPERIENCE UMBILICAL CORD BLOOD TRANSPLANTATION: KFSH EXPERIENCE HIND AL HUMAIDAN, MD,FRCPA Director, Blood Bank (Donor & Transfusion Services) and Stem Cell Cord Blood Bank Consultant Hematopathologist INTRODUCTION

More information

Pros and Cons of Stem Cell Sources and their availability in Africa. Dr Jaimendra Singh Inkosi Albert Luthuli Central Hospital Durban, South Africa

Pros and Cons of Stem Cell Sources and their availability in Africa. Dr Jaimendra Singh Inkosi Albert Luthuli Central Hospital Durban, South Africa Pros and Cons of Stem Cell Sources and their availability in Africa Dr Jaimendra Singh Inkosi Albert Luthuli Central Hospital Durban, South Africa Introduction The ability to perform a haematopoietic stem

More information

Fetal Maternal Immunity and Antileukemia Activity in Cord Blood Transplant. Recipients

Fetal Maternal Immunity and Antileukemia Activity in Cord Blood Transplant. Recipients Fetal Maternal Immunity and Antileukemia Activity in Cord Blood Transplant Recipients Filippo Milano, 1 J. Lee Nelson, 1, 2 Colleen Delaney 1,3 1 Clinical Research Division, Fred Hutchinson Cancer Research

More information

Cord Blood Market Trends, circa 2014

Cord Blood Market Trends, circa 2014 GENReports: Market & Tech Analysis Cord Blood Market Trends, circa 2014 > Enal Razvi, Ph.D. Managing Director Select Biosciences, Inc. enal@selectbio.us Topic Introduction and Scope The focus of this GEN

More information

Selecting an appropriately matched donor for hematopoietic

Selecting an appropriately matched donor for hematopoietic Transplant Outcomes in Acute Leukemia (I) Mary Eapen a and John E. Wagner b Umbilical cord blood (UCB) has gradually emerged over the last decade as an alternative source of hematopoietic cells for transplantation

More information

Cord Blood Transplant. E. Gluckman Eurocord ESH-EBMT training course Vienna 2014

Cord Blood Transplant. E. Gluckman Eurocord ESH-EBMT training course Vienna 2014 Cord Blood Transplant E. Gluckman Eurocord ESH-EBMT training course Vienna 2014 Background Since 1988, umbilical cord blood (CB) has been successfully used to treat children and adults needing stem cell

More information

Public Cord Blood Banking at the National Cord Blood Program (NCBP)

Public Cord Blood Banking at the National Cord Blood Program (NCBP) Public Cord Blood Banking at the National Cord Blood Program (NCBP) A. Scaradavou, MD Medical Director, National Cord Blood Program, New York Blood Center Associate Attending, Pediatric BMT Memorial Sloan-Kettering

More information

Bone Marrow, Peripheral Blood Stem Cells or Umbilical Cord Blood transplantation? Federica Giannotti, MD Eurocord-Hôpital Saint Louis, Paris

Bone Marrow, Peripheral Blood Stem Cells or Umbilical Cord Blood transplantation? Federica Giannotti, MD Eurocord-Hôpital Saint Louis, Paris Bone Marrow, Peripheral Blood Stem Cells or Umbilical Cord Blood transplantation? Federica Giannotti, MD Eurocord-Hôpital Saint Louis, Paris Background Hematopoietic stem cell transplantation (HSCT) is

More information

The Value of Cord Blood Stem Cells. Mona Shafey, MD, FRCPC Medical Grand Rounds October 25 th, 2011

The Value of Cord Blood Stem Cells. Mona Shafey, MD, FRCPC Medical Grand Rounds October 25 th, 2011 The Value of Cord Blood Stem Cells Mona Shafey, MD, FRCPC Medical Grand Rounds October 25 th, 2011 Objectives To discuss umbilical cord blood as a stem cell source and the role of umbilical cord blood

More information

An Introduction to Canada s National Public Cord Blood Bank

An Introduction to Canada s National Public Cord Blood Bank An Introduction to Canada s National Public Cord Blood Bank Dr. Heidi Elmoazzen Director, National Public Cord Blood Bank Hematopoetic Stem Cells Hematopoetic stem cells are not yet mature (undifferentiated)

More information

Myeloablative versus Reduced Intensity Conditioning Regimen Cord Blood Transplants

Myeloablative versus Reduced Intensity Conditioning Regimen Cord Blood Transplants Educational 2 Cord Blood Transplantation Myeloablative versus Reduced Intensity Conditioning Regimen Cord Blood Transplants William Arcese University of Rome Tor Vergata Rome Transplant Network 4th April

More information

Canadian Blood Services National Public Cord Blood Bank

Canadian Blood Services National Public Cord Blood Bank Canadian Blood Services National Public Cord Blood Bank Dr. Heidi Elmoazzen Director, National Public Cord Blood Bank Hematopoetic Stem Cells Hematopoetic stem cells are not yet mature (undifferentiated)

More information

Stem Cell Transplantation and the Canadian First Nations Community. Becky Luk (PTLS) Tanya Petraszko, MD

Stem Cell Transplantation and the Canadian First Nations Community. Becky Luk (PTLS) Tanya Petraszko, MD Stem Cell Transplantation and the Canadian First Nations Community Becky Luk (PTLS) Tanya Petraszko, MD Why is there a need for stem cells? Our Story Why are we engaging the First Nations, Metis and Inuit

More information

Navelstrengbloed tegen kanker

Navelstrengbloed tegen kanker Navelstrengbloed tegen kanker THERAPIEDAG 2008: "Zorgtrajecten in kanker" Zaterdag 27 september 2008 Gasthuisberg, Leuven. Hélène Schoemans, MD KUL, Stem Cell Institute Leuven Cord blood Collection and

More information

BCSLS Telehealth Stem Cell Transplantation. Becky Luk, Patient & Transplant Liaison Specialist

BCSLS Telehealth Stem Cell Transplantation. Becky Luk, Patient & Transplant Liaison Specialist BCSLS Telehealth Stem Cell Transplantation Becky Luk, Patient & Transplant Liaison Specialist Our Story Why is there a need for stem cells? What is OneMatch Stem Cell & Marrow Newtork s role in Stem Cell

More information

BCSLS Telehealth Stem Cell Transplantation. Our Story. Diseases treated with stem cell transplants. Why is there a need for stem cells?

BCSLS Telehealth Stem Cell Transplantation. Our Story. Diseases treated with stem cell transplants. Why is there a need for stem cells? BCSLS Telehealth Stem Cell Transplantation Becky Luk, Patient & Transplant Liaison Specialist Our Story Why is there a need for stem cells? What is OneMatch Stem Cell & Marrow Newtork s role in Stem Cell

More information

Bone Marrow, Peripheral Blood Stem Cells or Umbilical Cord Blood transplantation? E. Gluckman WBMT meeting Cape Town November 14-16, 2014

Bone Marrow, Peripheral Blood Stem Cells or Umbilical Cord Blood transplantation? E. Gluckman WBMT meeting Cape Town November 14-16, 2014 Bone Marrow, Peripheral Blood Stem Cells or Umbilical Cord Blood transplantation? E. Gluckman WBMT meeting Cape Town November 14-16, 2014 The ideal HSCs source Immediate availability Few HLA restrictions

More information

CHAPTER 1 BACKGROUND AND CORD BLOOD BANK (CBB) ORGANIZATION

CHAPTER 1 BACKGROUND AND CORD BLOOD BANK (CBB) ORGANIZATION CHAPTER 1 BACKGROUND AND CORD BLOOD BANK (CBB) ORGANIZATION Chapter 1 BACKGROUND AND CORD BLOOD BANK (CBB) ORGANIZATION 1.1 OVERVIEW OF THE CORD BLOOD TRANSPLANTATION STUDY Bone marrow transplantation

More information

CBS National Public Cord Blood Bank. Did you donate your cord blood?

CBS National Public Cord Blood Bank. Did you donate your cord blood? CBS National Public Cord Blood Bank Did you donate your cord blood? Tanya Petraszko MD FRCPC October 2014 Overview What is a stem cell? The importance of HLA Need for cord blood stem cells For all Canadians

More information

Overview of OneMatch, including the OneMatch Public Cord Blood Bank

Overview of OneMatch, including the OneMatch Public Cord Blood Bank Overview of OneMatch, including the OneMatch Public Cord Blood Bank Dr. Heidi Elmoazzen, Director OneMatch Public Cord Bank 2012-09-27 Outline Overview and Introduction Overview of the need for stem cells

More information

EUROCORD. in 49 countries and 484 transplant centres* 264 EBMT 4847 (73%) cases 220 Non-EBMT 1797 (27%) cases

EUROCORD. in 49 countries and 484 transplant centres* 264 EBMT 4847 (73%) cases 220 Non-EBMT 1797 (27%) cases ! 21%! EUROCORD 6756 cord blood transplantations performed from 1988 to March 2010 in 49 countries and 484 transplant centres* 264 EBMT 4847 (73%) cases 220 Non-EBMT 1797 (27%) cases * missing center

More information

Corporate Medical Policy Cord Blood as a Source of Stem Cells

Corporate Medical Policy Cord Blood as a Source of Stem Cells Corporate Medical Policy Cord Blood as a Source of Stem Cells File Name: Origination: Last CAP Review: Next CAP Review: Last Review cord_blood_as_a_source_of_stem_cells 2/2001 3/2015 3/2016 3/2015 Description

More information

Cord Blood Transplant Past and Future. E. Gluckman Eurocord ISCT Paris 24/04/2014

Cord Blood Transplant Past and Future. E. Gluckman Eurocord ISCT Paris 24/04/2014 Cord Blood Transplant Past and Future E. Gluckman Eurocord ISCT Paris 24/04/2014 Background Since 1988, umbilical cord blood (CB) has been successfully used to treat children and adults needing stem cell

More information

Corporate Medical Policy Cord Blood as a Source of Stem Cells

Corporate Medical Policy Cord Blood as a Source of Stem Cells Corporate Medical Policy Cord Blood as a Source of Stem Cells File Name: Origination: Last CAP Review: Next CAP Review: Last Review cord_blood_as_a_source_of_stem_cells 2/2001 3/2015 3/2016 3/2015 Description

More information

Helping you find the one match.. Guide for Unrelated Stem Cell Transplant Patients OneMatch Stem Cell and Marrow Network BLOOD.

Helping you find the one match.. Guide for Unrelated Stem Cell Transplant Patients OneMatch Stem Cell and Marrow Network BLOOD. Helping you find the one match.. Guide for Unrelated Stem Cell Transplant Patients OneMatch Stem Cell and Marrow Network BLOOD.CA WWW This guide is intended for patients in need of an unrelated volunteer

More information

Canadian Blood Services National Public Cord Blood Bank Give Life Twice Transfusion Medicine Residents

Canadian Blood Services National Public Cord Blood Bank Give Life Twice Transfusion Medicine Residents Canadian Blood Services National Public Cord Blood Bank Give Life Twice Transfusion Medicine Residents Eileen Quinlan Collection Supervisor, Brampton (GTA) 2015-11-10 History One Match Stem Cell and Marrow

More information

Placental and Umbilical Cord Blood as a Source of Stem Cells

Placental and Umbilical Cord Blood as a Source of Stem Cells Placental and Umbilical Cord Blood as a Source of Stem Cells Policy Number: 7.01.50 Last Review: 12/2013 Origination: 12/2001 Next Review: 12/2014 Policy Blue Cross and Blue Shield of Kansas City (Blue

More information

UMBILICAL CORD BLOOD, STEM CELL BANKING

UMBILICAL CORD BLOOD, STEM CELL BANKING 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

More information

Placental/Umbilical Cord Blood as a Source of Stem Cells. Original Policy Date

Placental/Umbilical Cord Blood as a Source of Stem Cells. Original Policy Date MP 7.01.38 Placental/Umbilical Cord Blood as a Source of Stem Cells Medical Policy Section Surgery Issue 12:2013 Original Policy Date 12:2013 Last Review Status/Date Reviewed with literature search/12:2013

More information

10 th Annual International Cord Blood Transplantation Symposium June 7-9, 2012 Preliminary Scientific Program. Thursday, June 7

10 th Annual International Cord Blood Transplantation Symposium June 7-9, 2012 Preliminary Scientific Program. Thursday, June 7 10 th Annual International Cord Blood Transplantation Symposium June 7-9, 2012 Preliminary Scientific Program Thursday, June 7 7:00 8:00 AM Breakfast in Exhibit Hall Session IA 8:00 10:00 AM Advances in

More information

Stem Cell Background Paper

Stem Cell Background Paper Stem Cell Background Paper Introduction...2 Stem Cell Basics...3 Stem Cell Process Flow...9 Comparison of Blood, Stem Cells, Tissues and Organs Processes...10 Responsibilities for the Blood, Stem Cells,

More information

ANTHONY NOLAN SEARCH ALGORITHM FOR A BASIC CORD BLOOD UNIT SELECTION BY SERGIO QUEROL AND IRINA EVSEEVA FEBRUARY 2012

ANTHONY NOLAN SEARCH ALGORITHM FOR A BASIC CORD BLOOD UNIT SELECTION BY SERGIO QUEROL AND IRINA EVSEEVA FEBRUARY 2012 ANTHONY NOLAN SEARCH ALGORITHM FOR A BASIC CORD BLOOD UNIT SELECTION BY SERGIO QUEROL AND IRINA EVSEEVA FEBRUARY 2012 PAGE 1 OF 7 PRINCIPLES FOR A NEW ALGORITHM Once cord blood transplantation (CBT) is

More information

Sibling Donor Cord Blood Transplantation for Thalassemia Major: Experience of the Sibling Donor Cord Blood Program

Sibling Donor Cord Blood Transplantation for Thalassemia Major: Experience of the Sibling Donor Cord Blood Program Sibling Donor Cord Blood Transplantation for Thalassemia Major: Experience of the Sibling Donor Cord Blood Program MARK C. WALTERS, LYNN QUIROLO, ELIZABETH T. TRACHTENBERG, SANDIE EDWARDS, LISA HALE, JOANNA

More information

cord blood saves lives...

cord blood saves lives... cord blood saves lives... ...by providing a rich source of blood stem cells that can be used to treat over 80 different diseases including leukemia, lymphoma, thalassemia, Tay-Sachs and sickle cell anemia.

More information

Skeptical UCB Customer: Experiences of University of Rochester/Strong Memorial Transplant Program with Umbilical Cord Blood Units

Skeptical UCB Customer: Experiences of University of Rochester/Strong Memorial Transplant Program with Umbilical Cord Blood Units Skeptical UCB Customer: Experiences of University of Rochester/Strong Memorial Transplant Program with Umbilical Cord Blood Units Craig Mullen, MD, PhD Chief, Pediatric Hematology/Oncology/HSC Transplantation

More information

Hematopoietic Stem Cell Transplantation. Imad A. Tabbara, M.D. Professor of Medicine

Hematopoietic Stem Cell Transplantation. Imad A. Tabbara, M.D. Professor of Medicine Hematopoietic Stem Cell Transplantation Imad A. Tabbara, M.D. Professor of Medicine Hematopoietic Stem Cells Harvested from blood, bone marrow, umbilical cord blood Positive selection of CD34 (+) cells

More information

Outcome of Unrelated HSCT in Patients Lacking HLA Matched Related Donors: Iranian Stem Cell Donor Program (ISCDP)

Outcome of Unrelated HSCT in Patients Lacking HLA Matched Related Donors: Iranian Stem Cell Donor Program (ISCDP) Outcome of Unrelated HSCT in Patients Lacking HLA Matched Related Donors: Iranian Stem Cell Donor Program (ISCDP) October 18, 2014 19th Congress of APBMT, Hangzhou, China AMIR ALI HAMIDIEH, MD Iranian

More information

Stem cells from Cord Blood: Myths, reality and potential. Elisabeth Semple, PhD Scientific Director Cells for Life Cord Blood Institute

Stem cells from Cord Blood: Myths, reality and potential. Elisabeth Semple, PhD Scientific Director Cells for Life Cord Blood Institute Stem cells from Cord Blood: Myths, reality and potential Elisabeth Semple, PhD Scientific Director Cells for Life Cord Blood Institute Learning objectives Understand the current usage of stem cells from

More information

Placental and Umbilical Cord Blood as a Source of Stem Cells

Placental and Umbilical Cord Blood as a Source of Stem Cells Placental and Umbilical Cord Blood as a Source of Stem Cells Policy Number: 7.01.50 Last Review: 12/2014 Origination: 12/2001 Next Review: 12/2015 Policy Blue Cross and Blue Shield of Kansas City (Blue

More information

Not All Stem Cells are the Same

Not All Stem Cells are the Same Cord Blood Banking and Transplantation Jennifer Willert, M.D. Hematology/Oncology Blood and Marrow Transplant Rady Children s Hospital San Diego Clinical Professor UCSD Not All Stem Cells are the Same

More information

Cord Cor Blood Banking Scott N. Furlan, MD Ellen S. Plummer, Plummer MD

Cord Cor Blood Banking Scott N. Furlan, MD Ellen S. Plummer, Plummer MD Cord Blood Banking Scott N. Furlan, MD Ellen S.Plummer, MD Overview Background Biology of Stem Cell Transplant Opportunities i at Parkland Logistics of Banking Potential Barriers Indications for HCT Cancer

More information

Umbilical Cord Blood: An Alternative Allogeneic Stem Cell Source for Transplantation

Umbilical Cord Blood: An Alternative Allogeneic Stem Cell Source for Transplantation Umbilical Cord Blood: An Alternative Allogeneic Stem Cell Source for Transplantation Mary J. Laughlin, MD Associate Professor of Medicine and Pathology Dr. Donald and Ruth Weber Goodman Professor of Innovative

More information

POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT VARIATIONS DISCLAIMER CODING INFORMATION REFERENCES POLICY HISTORY

POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT VARIATIONS DISCLAIMER CODING INFORMATION REFERENCES POLICY HISTORY Original Issue Date (Created): 4/1/2011 Most Recent Review Date (Revised): 3/24/2015 Effective Date: 6/1/2015 POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT VARIATIONS DISCLAIMER

More information

Umbilical Cord Blood Stem Cells Current Status & Future Potential

Umbilical Cord Blood Stem Cells Current Status & Future Potential Umbilical Cord Blood Stem Cells Current Status & Future Potential Natasha Ali Assistant Professor Haematology Department of Pathology & Laboratory Medicine/Oncology The Aga Khan University Email: natasha.ali@aku.edu

More information

Processing & Utilization of Cord Blood for Transplant

Processing & Utilization of Cord Blood for Transplant Processing & Utilization of Cord Blood for Transplant 2010-Jan Jan-15 Nicole L. Prokopishyn, PhD HPC Processing Laboratory Director Calgary Laboratory Services Overview Cord Blood Processing Pre-Freeze

More information

Graft Failure After HSCT

Graft Failure After HSCT Graft Failure After HSCT Vanderson Rocha, MD, PhD Professor of Haematology- Oxford University Bone Marrow Transplant Unit- Sirio Libanes Hospital- Sao Paulo Scientific Director of Eurocord-Paris Clinical

More information

CORD BLOOD TRANSPLANTATION: PAST, PRESENT AND FUTURE

CORD BLOOD TRANSPLANTATION: PAST, PRESENT AND FUTURE CORD BLOOD TRANSPLANTATION: PAST, PRESENT AND FUTURE Dennis M. Todd, Ph.D. The New Jersey Cord Blood Bank a Division of Bergen Community Regional Blood Center Montvale, NJ Hematopoietic Stem Cell Transplantation

More information

Name of Policy: Placental/Umbilical Cord Blood as a Source of Stem Cells

Name of Policy: Placental/Umbilical Cord Blood as a Source of Stem Cells Name of Policy: Placental/Umbilical Cord Blood as a Source of Stem Cells Policy #: 439 Latest Review Date: September 2014 Category: Medical Policy Grade: A Background/Definitions: As a general rule, benefits

More information

SAVE A LIFE... BY GIVING LIFE!

SAVE A LIFE... BY GIVING LIFE! SAVE A LIFE... BY GIVING LIFE! FOLLOW US ON: HÉMA-QUÉBEC PUBLIC CORD BLOOD BANK www.hema-quebec.qc.ca Scan this code with your smart phone to access the page Register to the Public Cord Blood Bank on the

More information

Cord Blood Stem Cell Transplantation

Cord Blood Stem Cell Transplantation LEUKEMIA LYMPHOMA MYELOMA FACTS Cord Blood Stem Cell Transplantation No. 2 in a series providing the latest information on blood cancers Highlights Umbilical cord blood, like bone marrow and peripheral

More information

Public Cord Blood Tissue Bank Committee on Health Care Services and Representative Peaden

Public Cord Blood Tissue Bank Committee on Health Care Services and Representative Peaden HOUSE OF REPRESENTATIVES COMMITTEE ON HEALTH CARE SERVICES ANALYSIS BILL #: HB 2337 (PCB HCS 00-07) RELATING TO: SPONSOR(S): TIED BILL(S): Public Cord Blood Tissue Bank Committee on Health Care Services

More information

What we will discuss today

What we will discuss today Umbilical cord blood banking It s Utility? Dr. Nita Radhakrishnan Pediatric Hematology Oncology Unit, Sir Ganga Ram Hospital, New Delhi What we will discuss today What are stem cells? What are the sources

More information

A Public Cord Blood Bank for South Africa? i

A Public Cord Blood Bank for South Africa? i No. 42/2007 A Public Cord Blood Bank for South Africa? i By Dr Robert Crookes MBChB (Wits), Dip. Internal Medicine (American Board of Internal Medicine, USA) Transfusion Medicine Consultant. South African

More information

Placental and Umbilical Cord Blood as a Source of Stem Cells

Placental and Umbilical Cord Blood as a Source of Stem Cells Placental and Umbilical Cord Blood as a Source of Stem Cells Policy Number: 7.01.50 Last Review: 12/2015 Origination: 12/2001 Next Review: 12/2016 Policy Blue Cross and Blue Shield of Kansas City (Blue

More information

Transplantation of cord blood stem cells from related or unrelated donors is considered investigational in all other situations.

Transplantation of cord blood stem cells from related or unrelated donors is considered investigational in all other situations. MEDICAL POLICY POLICY RELATED POLICIES POLICY GUIDELINES DESCRIPTION SCOPE BENEFIT APPLICATION RATIONALE REFERENCES CODING APPENDIX HISTORY Placental and Umbilical Cord Blood as a Source of Stem Cells

More information

Statement of Joanne Kurtzberg, M.D.

Statement of Joanne Kurtzberg, M.D. Statement of Joanne Kurtzberg, M.D. President of the Cord Blood Association Jerome Harris Distinguished Professor of Pediatrics and Pathology Chief Scientific Officer and Medical Director, Robertson Clinical

More information

Jamie Peregrine, MD, PGY-4 KU-Wichita, OB/GYN Wesley Medical Center

Jamie Peregrine, MD, PGY-4 KU-Wichita, OB/GYN Wesley Medical Center Jamie Peregrine, MD, PGY-4 KU-Wichita, OB/GYN Wesley Medical Center Uses for umbilical cord stem cells Describe the indications and uses for umbilical cord stem cells. Counsel patients on the advantages

More information

Stem Cell Transplantation In Patients with Fanconi Anemia

Stem Cell Transplantation In Patients with Fanconi Anemia Stem Cell Transplantation In Patients with Fanconi Anemia FARF Annual Family Meeting 6/28/15 Casco, ME Parinda A. Mehta, M.D. Cincinnati Children s Hospital Medical Center Improvements in Unrelated Donor

More information

Challenges of Hematopoietic Stem Cell Transplantation. Robert J. Soiffer, MD Dana Farber Cancer Institute

Challenges of Hematopoietic Stem Cell Transplantation. Robert J. Soiffer, MD Dana Farber Cancer Institute Challenges of Hematopoietic Stem Cell Transplantation Robert J. Soiffer, MD Dana Farber Cancer Institute Hematopoietic Stem Cell Transplantation Objectives Deliver sufficient chemo-radio therapy to destroy

More information

A fact sheet UNRELATED BONE MARROW AND CORD BLOOD STEM CELL TRANSPLANTS

A fact sheet UNRELATED BONE MARROW AND CORD BLOOD STEM CELL TRANSPLANTS A fact sheet UNRELATED BONE MARROW AND CORD BLOOD STEM CELL TRANSPLANTS Each year, thousands of patients are diagnosed with diseases treatable by a blood stem cell transplant. These blood stem cells can

More information

* CHAPTER 6. Choice of the donor according to HLA typing and stem cell source. Eliane Gluckman

* CHAPTER 6. Choice of the donor according to HLA typing and stem cell source. Eliane Gluckman * CHAPTER 6 Choice of the donor according to HLA typing and stem cell source Eliane Gluckman CHAPTER 6 Choice of the donor according to HLA typing and stem cell source 1. Introduction Allogeneic haematopoietic

More information

UMBILICAL CORD BLOOD COLLECTION

UMBILICAL CORD BLOOD COLLECTION UMBILICAL CORD BLOOD COLLECTION by Frances Verter, PhD Founder & Director, Parent's Guide to Cord Blood Foundation info@parentsguidecordblood.org and Kim Petrella, RN Department of Obstetrics and Gynecology

More information

Rationale for cord blood banking from hematopoietic stem cell transplant to regenerative medicine. Milan November 2008

Rationale for cord blood banking from hematopoietic stem cell transplant to regenerative medicine. Milan November 2008 Rationale for cord blood banking from hematopoietic stem cell transplant to regenerative medicine Milan November 2008 Hematopoietic reconstitution in a patient with Fanconi's anemia by means of umbilical

More information

Disclosures. I have no disclosures.

Disclosures. I have no disclosures. Not Your Own Marrow Jenni Krajewski, MD Clinical Assistant Professor, Rutgers New Jersey Medical School Attending Physician, Pediatric Blood and Marrow Transplantation The Institute for Pediatric Cancer

More information

How to select a donor and product for allogeneic HCT

How to select a donor and product for allogeneic HCT How to select a donor and product for allogeneic HCT Dr Bronwen Shaw 10 February 2015 Overview Who (and where) are the donors What factors determine how we choose between them Acquisition Clinical Donor

More information

Double cord blood transplantation

Double cord blood transplantation DCTH - 2 2013-113-121 REVIEW Double cord blood transplantation R. Angarano, I. Donnini, B. Bartolozzi, A. Bosi Ematologia, Azienda Ospedaliera Universitaria Careggi, Università di Firenze, Italy SUMMARY

More information

In contrast to the very high transplant-related

In contrast to the very high transplant-related Cord Blood: an Alternative Stem Cell Source or a New Standard? Juliet N. BARKER Memorial Sloan-Kettering Cancer Center, NY, ABD In contrast to the very high transplant-related mortality (TRM) associated

More information

OUR JOURNEY THROUGH THE YEARS

OUR JOURNEY THROUGH THE YEARS The King Faisal Specialist Hospital and Research Centre Experience in Hematology, Oncology and Bone Marrow Transplantation OUR JOURNEY THROUGH THE YEARS REGGIE BELKHEDIM A Brief Overview: King Faisal Specialist

More information

The Role of Hematopoietic Stem Cell Transplantation in Nuclear Emergencies

The Role of Hematopoietic Stem Cell Transplantation in Nuclear Emergencies The Possible Role of Cord Blood in the Management of Radiation Damage. Pablo Rubinstein, M.D., Director, National Cord Blood Program, New York Blood Center These comments are presented in the hope that

More information

Section: Transplant Last Reviewed Date: January 2015. Policy No: 45.16 Effective Date: April 1, 2015

Section: Transplant Last Reviewed Date: January 2015. Policy No: 45.16 Effective Date: April 1, 2015 Medical Policy Manual Topic: Placental and Umbilical Cord Blood as a Source of Stem Cells Date of Origin: December 2009 Section: Transplant Last Reviewed Date: January 2015 Policy No: 45.16 Effective Date:

More information

SEARCHING FOR A BONE MARROW DONOR

SEARCHING FOR A BONE MARROW DONOR SEARCHING FOR A BONE MARROW DONOR Angela received a bone marrow transplant from an unrelated donor to treat her non-hodgkin s lymphoma. INFORMATION FOR PATIENTS AND THEIR FAMILIES For patients who need

More information

Summary of Advisory Council on Blood Stem Cell Transplantation: Recommendations and Status

Summary of Advisory Council on Blood Stem Cell Transplantation: Recommendations and Status of Advisory Council on Blood Stem Cell Transplantation: Recommendations and Shelley Grant Branch Chief, Blood Stem Cell Transplantation Program September 11, 2015 Overview December 20, 2005 - HRSA began

More information

Narrator: Transplants using stem cells from the blood, bone marrow or umbilical cord blood

Narrator: Transplants using stem cells from the blood, bone marrow or umbilical cord blood [Track 2: What Is a Transplant?] Narrator: Transplants using stem cells from the blood, bone marrow or umbilical cord blood can be an effective treatment for people with blood cancers such as leukemia,

More information

Corporate Medical Policy

Corporate Medical Policy Corporate Medical Policy Hematopoietic Stem-Cell Transplantation for CLL and SLL File Name: Origination: Last CAP Review: Next CAP Review: Last Review: hematopoietic_stem-cell_transplantation_for_cll_and_sll

More information

Advances in HSC Transplantation for Myelodysplasia: Cord Blood Transplantation & RIC

Advances in HSC Transplantation for Myelodysplasia: Cord Blood Transplantation & RIC Advances in HSC Transplantation for Myelodysplasia: Cord Blood Transplantation & RIC -7-6 -5-4 -3-2 -1 0 30 100 CSA/ MMF Juliet N. Barker, MBBS (Hons), FRACP Associate Attending Director Cord Blood Transplant

More information

The Power & Potential of Cord Blood

The Power & Potential of Cord Blood The Power & Potential of Cord Blood Donna Regan, MT(ASCP)SBB, Director St. Louis Cord Blood Bank & Cellular Therapy Laboratory SSM Cardinal Glennon Children s Medical Center April 30, 2014 Objectives Since

More information

Neutrophil Recovery: The First Step in Posttransplant Recovery

Neutrophil Recovery: The First Step in Posttransplant Recovery Neutrophil Recovery: The First Step in Posttransplant Recovery is Made in the Bone Stem Cell CFU- GEMM BFU-E Pre-B CFU-E White cells B Lymphocyte T Lymphocyte Neutrophils Red cells No conflicts of interest

More information

Unrelated donor umbilical cord blood transplantation for the treatment of hematologic malignancies Craig Sauter and Juliet N.

Unrelated donor umbilical cord blood transplantation for the treatment of hematologic malignancies Craig Sauter and Juliet N. Unrelated donor umbilical cord blood transplantation for the treatment of hematologic malignancies Craig Sauter and Juliet N. Barker Adult Allogeneic Bone Marrow Transplantation Service, Memorial Sloan-Kettering

More information

Reference: NHS England B04/P/a

Reference: NHS England B04/P/a Clinical Commissioning Policy: Haematopoietic Stem Cell Transplantation (HSCT) (All Ages): Revised Reference: NHS England B04/P/a 1 NHS England Clinical Commissioning Policy: Haematopoietic Stem Cell Transplantation

More information

Populations Interventions Comparators Outcomes Individuals: With an appropriate indication for allogeneic stem cell transplant.

Populations Interventions Comparators Outcomes Individuals: With an appropriate indication for allogeneic stem cell transplant. Protocol Placental and Umbilical Cord Blood as a Source of Stem Cells (70150) Medical Benefit Effective Date: 04/01/13 Next Review Date: 11/17 Preauthorization Yes Review Dates: 04/07, 05/08, 07/11, 07/12,

More information

Bone Marrow Transplantation and Peripheral Blood Stem Cell Transplantation: Questions and Answers. Key Points

Bone Marrow Transplantation and Peripheral Blood Stem Cell Transplantation: Questions and Answers. Key Points CANCER FACTS N a t i o n a l C a n c e r I n s t i t u t e N a t i o n a l I n s t i t u t e s o f H e a l t h D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s Bone Marrow Transplantation

More information

Guidance for Industry and FDA Staff

Guidance for Industry and FDA Staff Guidance for Industry and FDA Staff Investigational New Drug Applications for Minimally Manipulated, Unrelated Allogeneic Placental/Umbilical Cord Blood Intended for Hematopoietic and Immunologic Reconstitution

More information

Cord Blood: Research Progress and Future Promise

Cord Blood: Research Progress and Future Promise Cord Blood: Research Progress and Future Promise By Al Staropoli, AABB Contributing Writer Sue Fister found out she had leukemia when she was 50 years old. Doctors suggested a bone marrow transplant as

More information

Dr Saeed Al Amoudi. Consultant Hematologist King s college hospital Director of Regional Lab Jeddah

Dr Saeed Al Amoudi. Consultant Hematologist King s college hospital Director of Regional Lab Jeddah Dr Saeed Al Amoudi Consultant Hematologist King s college hospital Director of Regional Lab Jeddah MAGIC BULLET Cord Blood Banking What is Cord Blood? Cord blood is the blood left in the placenta and umbilical

More information

Determinants of Engraftment after Double-Unit Cord Blood Transplantation

Determinants of Engraftment after Double-Unit Cord Blood Transplantation In: Broxmeyer HE, ed. Cord Blood: Biology, Transplantation, Banking, and Regulation Bethesda, MD: AABB Press, 2011 26 Determinants of Engraftment after Double-Unit Cord Blood Transplantation Doris M. Ponce,

More information

Your Cord Blood Donation Options

Your Cord Blood Donation Options Your Cord Blood Donation Options Our Mission To develop and maintain a statewide resource for potentially life-saving cord blood to treat children and adults. What is cord blood? Cord blood is the blood

More information

Blood-Forming Stem Cell Transplants

Blood-Forming Stem Cell Transplants Blood-Forming Stem Cell Transplants What are bone marrow and hematopoietic stem cells? Bone marrow is the soft, sponge-like material found inside bones. It contains immature cells known as hematopoietic

More information

Hematopoietic Stem Cells, Stem Cell Processing, and Transplantation

Hematopoietic Stem Cells, Stem Cell Processing, and Transplantation Hematopoietic Stem Cells, Stem Cell Processing, and Joseph (Yossi) Schwartz, MD Director, Hemotherapy and Stem Cell Processing Facility E-mail: js2745@columbia.edu A 40-year old man with acute myelogenous

More information

5. All cord blood banks should be subject to the same standards, regulations and accreditation requirements.

5. All cord blood banks should be subject to the same standards, regulations and accreditation requirements. WMDA Policy Statement for the Utility of Autologous or Family Cord Blood Unit Storage (This policy statement has been approved and adopted by the WMDA board on the 25 th of May 2006) The Cord Blood Registries

More information

Hematopoietic Stem Cell Transplantation: Current Status and Future Directions RICHARD W. CHILDS M.D. NIH, BETHESDA MD

Hematopoietic Stem Cell Transplantation: Current Status and Future Directions RICHARD W. CHILDS M.D. NIH, BETHESDA MD Hematopoietic Stem Cell Transplantation: Current Status and Future Directions RICHARD W. CHILDS M.D. NIH, BETHESDA MD Stem cell transplantation Autologous Autologous stem cell collection Freeze Stem Cells

More information