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1 Cordblood Stem Cells and The Role of Cordblood Bank in Supporting Stem Cells Research Presentation Overview Company profile Haematopoietic stem cells in cordblood What we can do to help 1 2 PT CordLife Indonesia PT CordLife Indonesia Part of CordLife Services, Limited (listed on Australian Stock Exchange) CordLife collects, processes, stores and distributes Adult Stem Cells (Private Banking) PT CordLife Indonesia : joint venture between PT Kalbe Farma Tbk & CordLife Pte Ltd, Singapore Headquartered in Singapore, also present in other countries Known for quality CordLife Singapore has been accredited by American Association of Blood Banks (AABB) First in Southeast Asia 8 th accredited outside of USA Only 40 accredited cordblood banks worldwide 1

2 PT CordLife Indonesia First and only licensed cordblood bank in Indonesia by Departemen Kesehatan Indonesia Part of other CordLife cordblood banks network in Asia and Australia. All procedures and processing are according to AABB guidelines and standards. Stem Cells Characteristics 1. Unspecialized 2. Ability to self-renew 3. Ability to produce daughter cells which differentiates into different cell types All blood cells originate from HSCs Haematopoietic stem cells (HSCs) have the ability to: Divide and regenerate into other blood cells types, such as red and white blood cells, platelets. Self-renew Sources of HSCs: Umbilical Cord Blood Bone Marrow Peripheral Blood (require drugs) Cord Blood Stem Cells Banking and Transplantation Milestones & Developments 7 8 2

3 History of UCB stem cell transplant Overview of Stem Cell Transplant 1988: First related UCB transplant in France to treat Fanconi s anemia Status of UCB transplants today: > 8000 worldwide (as of Dec 2006) > 40 in Singapore (reported in 2007) ~50% of HSC transplants done in Japan are with cord blood stem cells (Gluckman et al., 2006) UCB transplant has become a viable alternative to bone marrow transplant Patient has defective blood cells (blood disorder/cancer) Stem Cell Transplant Radiation/ Chemotherapy Cord blood / Bone marrrow stem cells The patient begins to produce normal blood/immune cells from the transplanted HSCs present in UCB cells Ref: June World s first cord blood transplant for Thalassemia Major patient in Singapore Cord blood transplants for grown-ups Straits Times, 28th Jun 2002 Boy treated for Thalassemia Major in Singapore in 2001 Transplant success was due to: High cell dose (4x more than int l recommended dose of 15 million cells/kg) Good management of immuno-suppressive therapy Good pediatric care

4 Cordlife sample successfully used for transplant The Straits Times, July 1 st Ryan Foo; 3 years old. Diagnosed with acute lymphoblastic leukemia (ALL). Transplanted with younger sister s umbilical cord blood stored with CordLife. 18 months later: Leukemia in remission and Ryan has since started school. 80 disorders can be treated with UCB stem cells to date Number of diseases treated by UCB stem cells are ever increasing: 72 in or more in 2007 Malignant (Cancerous) Non-malignant Acute Lymphocytic Leukemia Fanconi Anemia Acute Myelocytic Leukemia Severe Aplastic Anemia Juvenile Chronic Myelogenous Thalassemia Leukemia Sickle Cell Anemia Chronic Myelogenous Leukemia Severe Combined Immuno- Neuroblastoma Deficiency (SCID) Myelodysplastic Syndromes Gunther Disease Hurler s Syndrome Hunter s Syndrome New applications of UCB stem cells recent clinical successes Emerging role of UCB stem cells in regenerative medicine Cancers, eg., breast / kidney cancers Autoimmune diseases, eg., lupus Cerebral palsy Type 1 diabetes Early successes reported in 2007, cord blood stem cells came from patients themselves Reported by U.S. private cord blood bank, Cord Blood Registry A 3-year old girl with leukemia in the U.S. underwent stem cell transplantation using her cord blood sample (Pediatrics, Jan 2007)

5 Potential clinical applications of UCB stem cells Experimental successes (animal studies) Regenerate heart tissue in heart disease (Ma et al., 2006) UCB stem cells can give rise to liver cells Enhances recovery in function and morphology in animal model of stroke (MJA, 2006) Stem cell expansion Increase the number of available stem cells in the lab Ongoing clinical trials using expanded cord blood stem cells in the U.S. Example, at Fred Hutchison Center, cells expanded 150 times were transplanted; promising early results (March 2007) SUMMARY Cord Blood Transplantation and Banking Cord Blood is a rich source of HSCs with proven clinical use Transplant outcome depends d on cell dose and HLA matching Increasing clinical applications of cord blood stem cells in transplantation and regenerative medicine Our roles in Indonesia Help saving lives. Educate the society about stem cells, in particular hospitals, O&Gs, pregnant mothers. Help cordblood researchers in Indonesia with experience and knowledge. Create government awareness on cell therapy, thus establishing the law. THANK YOU What was a discard [the umbilical cord] has become valuable indeed priceless to many children with leukemia, and perhaps in the future to children (and adults) with AIDS and autoimmune diseases, such as diabetes and rheumatoid arthritis. Science,, Vol

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