Blood cells are vital to the human body

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1 Candide FONT-SALA

2 Blood cells are vital to the human body Red cells transport oxygen From Red cell life span 120 days 200 bilion cells produced/day = 2 million per second!!!

3 Blood cells are vital to the human body white cells play an essential role in the immune system by fighting infection, foreign particles or tumours White cell life span 2 to 10 days 50 to 100 bilion cells produced/day

4 Blood cells are vital to the human body platelets prevent from bleeding out Platelets life span 10 days 100 bilion cells produced/day

5 Haematopoietic Stem Cells : Bone Marrow Haematopoietic stem cells = immature cells/ undiferenciated, potential to turn into the different types of blood cells. Mostly be found in the bone marrow (centre of certain bones), where originally dividing themselves to produce the body blood cells. => Once these blood cells are mature, they leave the bone to enter the bloodstream.

6 Haematopoietic Stem Cells When challenged by a malignant (leukaemia, lymphoma, etc.) or a non-malignant haematological disease (bone marrow failure, inherited disorders, etc.) => Haematopoietic Stem Cells transplantation represents a potential curative treatment to restore the patient's normal blood cell production and immunity

7 Haematopoietic Stem Cells Transplantation HSCT saves lives. However, since the degree of compatibility required is considerably higher than for organs, about a third of patients requiring HSCT find a compatible donor within their family Those patients without a family compatible donor rely then on unrelated donors.

8 Haematopoietic Stem Cells : compatibility between 2 unrelated persons One chance in a million 1 / is the compatibility likelihood between 2 unrelated persons within the population

9 Haematopoietic Stem Cells : Bone Marrow Haematopoietic stem cells can be collected in the bone marrow (iliac crest) Bone marrow collection from the iliac crest from a volunteer donor (under strict quality and safety criteria). (Photos Benoit Rajau for the Agence de la biomédecine).

10 Haematopoietic Stem Cells : peripheral blood cells A small number of HSC can naturally also get into the bloodstream : peripheral blood stem cells. Those cells that can be collected (apheresis) after stimulation by a synthetic growth factor and used for transplantation. Peripheral Blood Stem cell Collection (under strict quality and safety criteria). (Photos Benoit Rajau for the Agence de la biomédecine).

11 Haematopoietic Stem Cells : Cord Blood HSC are also present in the foetal blood remaining in the umbilical cord and placenta after delivery. Strict safety and quality criteria: (Medical contraindications diseases, cell count etc. ) mother/baby, serological status infectious 100 Cord blood Units collected Cord blood collection right after the birth, tests, quality criteria, storage. (Photos Benoit Rajau for the Agence de la biomédecine). 20 to 30 meet the requirements stored to be used for Transplantation

12 Developments of Registries Unrelated Cord Blood Units Unrelated Donors - Bone Marrow - Peripheral Blood Stem Cells Cord Blood Banks Registries HLA typing Laboratories (Biological identity profile) A registry is a national organization with the responsibility of processing requests for haematopoietic stem cells from donors originating from the country and emanating from abroad. The Registry may coordinate the activities of Donor, Collection, and Transplants Centres in the respective country. Donors are listed in the registry. They are in "stand by" and called when matching a patient in a need of a transplantation. (Photo Benoit Rajau for the Agence de la biomédecine) Patients Transplant Centre

13 Contribution of the POSEIDON project Unrelated Cord Blood Units Unrelated Donors - Bone Marrow - Peripheral Blood Stem Cells Cord Blood Banks POSEIDON Project ( ) (Photo Benoit Rajau for the Agence de la biomédecine) Registries HLA typing Laboratories (Biological identity profile) - Mapping of Minorities in EU - Recommendation: Patients Transplant Centre Development of registry and Cord blood banks in countries lacking ones and especially having important migrants / minorities abroad Strategic Development of registries and cord blood bank to a greater variety of Biological Identity profile

14 Contribution of the POSEIDON project Unrelated Cord Blood Units Unrelated Donors - Bone Marrow - Peripheral Blood Stem Cells Cord Blood Banks POSEIDON Project ( ) (Photo Benoit Rajau for the Agence de la biomédecine) Registries HLA typing Laboratories (Biological identity profile) - Support development laboratories assessing biological ID profile and compatibility (+ GR, PL, IR, AT) initiated). Patients Transplant Centre - Follow-up related and unrelated Donors (registries) ARTHIQS 2013 Joint Action Call for proposals

15 EU Contribution to the JACIE accreditation programme Unrelated Cord Blood Units Unrelated Donors - Bone Marrow - Peripheral Blood Stem Cells JACIE accreditation programme ( ) Cord Blood Banks (Photo Benoit Rajau for the Agence de la biomédecine) Registries HLA typing Laboratories (Biological identity profile) One of the main aims of the JACIE project was to ensure the integral role of the JACIE accreditation programme in standard setting, inspection and accreditation of health facilities involved in haematopoietic stem cell collection, processing and transplantation (HSCT) in Europe. Patients Processing site Transplant Centre Collection site (Aphereris, Bone Marrow, Cord Blood) (Photo Benoit Rajau for the Agence de la biomédecine)

16 EU Contribution to the JACIE accreditation programme Accreditation: ensures that the level of practises meets quality and safety standards. Strengthen implementation of JACIE : JACIE office online (IT Tool) Internet based management tool to assist HSC Transplant centres to apply for an accreditation Tool for : applicants, inspectors, JACIE administrator, JACIE Medical Director, JACIE National Representative Fundamental to the effective management, document down load for applicants Facilitated collection, tracking and monitoring of the implementation of the JACIE programme Document upload : Inspection details, Inspection Report online, Medical Director s report online with recommendation for Accreditation speed up communication and allow overview of progresses 1. Harmonisation of the JACIE standards and programme of accreditation with EU Directive 2004/23/EC 2. Implementation of JACIE standards and accreditation in haematopoietic stem cell (HSC) facilities 3. Promotion of JACIE amongst medical professionals, national authorities, Community officials, with view to encouraging harmonisation of standards and systems of accreditation across the Community - Strengthening of central resources of the JACIE programme and extending and enhancing the effectiveness of the existing JACIE network - Establishment of equivalent JACIE training courses for medical professionals and inspectors across the Community and facilitating the exchange of experience and best practice between them - Contributing to the comparability of data across Member States by supporting the collection of compatible and comparative data

17 JACIE accreditation programme : 10 years after Impact of JACIE accreditation on outcome after hematopoietic stem cell transplantation: an EBMT megafile analysis A. Gratwohl, et al., Retrospective study : > HSC Transplantations 421 European teams These data demonstrate a direct chronologic association of the JACIE quality management system accreditation process with improved patient outcome after allogeneic HSCT. What could be next? JACIE Inspector Training for Nurses (Nurses are involved in the quality management part of the JACIE guide deals with nurses role): Training in national language Translation of the JACIE Guide in all EU National Languages (English only)

18 Haematopoietic Stem Cells Donation One chance in a million 1 / is the compatibility likelihood between 2 unrelated persons within the population Regarding HSC, the Network is worldwide Bone marrow donation is a long-term commitment, a volunteer donor does not give immediately at registration but when a patient having a matching biological profile needs a HSC transplantation. European Haematopoietic Stem Cells Donation Day?????

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