Cord Blood Bank Technology E. Baudoux M. Duffy S. Querol L. Foeken Survey Introduction
Preliminary considerations
CB comparable to BM (Children) CB comparable to BM (Adults) Haplo identical transplants Heterogeneity of inventory Importance of HLA C CD34 recovery associated with banking practices FACT NetCord FACT NetCord Standards Standards st edition2 nd edition EU directive 2004/23/CE FACT NetCord Standards 3 rd edition US FDA licensure FACT NetCord FACT NetCord Standards Standards 4 th edition 5 th edition
Rationale for the survey Attempt of WMDA CBWG to: Understand the current trends Identify the main procedures in cord blood collection, processing, testing and storage Identify the main technical procedures currently used by public cord blood banks worldwide S. Querol Cord blood banking: current status Hematology 202
Intentions Catching the OPERATIONAL INVENTORY Make available to transplant centers, increasingly interested in o Characteristics of cord blood banks o Information about a specific cord blood unit Make available back to cord blood banks compare practices improve processes at their individual centers Potentially used for publication as a description of global public cord blood banking
Study design
Study design General data o Location, contact person Bank description and listing Cord Blood Units in Inventory Accreditations-licensescertifications Cord Blood Collection Conditioning and transport from Collection Centre to Cord Blood Bank Pre-processing evaluation Processing-Packaging Testing Storage Verification/Extended HLA Typing Confirmatory/verification typing Reservation/cancellation policies Release-Shipment Adverse Events Reporting
Preview of responses
Overall response 5 3 2 5 5 3 2 3 Country CBBs Country CBBs Country CBBs Country CBBs BELGIUM 5 Finland Japan Sweden Brazil 3 FRANCE 2 Russia Switzerland 2 Canada 2 Germany 3 Singapore Thailand China Greece Slovakia Turkey CYPRUS Israel 2 Slovenia UK 2 Czech Republic Italy 5 SPAIN 3 USA 5 24 Countries 57 responding banks
Inventory of responders by country UK, 23,564 China, 20,959 Germany, 3,29 SPAIN, 42,63 BELGIUM, 9,223 FRANCE, 3,926 Italy, Singapore, 0,894 0,908 Israel, 0,209 Canada Japan Russia USA, 22,950 Others 57 590 Brazil Sweden Czech Republic Finland Cyprus Slovakia Greece Switzerland Thailand Slovenia Turkey TOTAL SURVEYED INVENTORY: 467 709
Creation of banks Implementation of current process 0 9 8 7 6 5 4 3 2 0 993 995 997 999 200 2003 2005 2007 2009 20 203 Bank created Started with current process
Plan for storage in 205 25 30,000 20 25,000 5 20,000 5,000 0 0,000 5 5,000 0 NR 00 and below 00-500 500-000 above 000 0
Plan for storage in 205 2 9 Expected growth and inventory size 8 8 No Growth 0-50/000 7 7 50-00/000 00-50/000 Number of banks 6 5 4 3 2 2 4 2 5 3 50-200/000 200-500/000 Over 500/000 4 3 3 2 2 2 2 0 up to 2000 2000-5000 5000-0000 0000-20000 over 20000 Size of existing inventory
Fulfilling evolving requirements TNC threshold Number of Banks Special policy for minorities 23 7 7 9 3 5 Under 00 00-20 20-50 50 and above NR Pre-Processing TNC threshold (x0e7)
Fulfilling evolving requirements HLA 80% 70% 60% LR IR HR 50% 40% 30% 20% N=42 N=42 N=35 N=42 N=5 N=7 0% 0% HLA A HLA B HLA C HLA DRB HLA DQB HLA DPB
TNC Counts of the CBUs listed in BMDW TNC count CBUs (%) > 300 250 299 200 249 50 99 25 49 90 24 50 89 49 not available 0 3 4 2 4 30 34 0 5 0 5 20 25 30 35 40
Total nucleated cells in surveyed inventory >99 75-99 TNC (x0e7) 50-74 25-49 90-24 50-90 Below 50 0% 5% 0% 5% 20% 25% 30% 35%
Listed in BMDW BMDW No 27% Yes 73%
Affiliation to donor registry No % Yes 89%
Accreditations State license Both (FATC+AABB) FACT Only AABB only None 3 banks 25 banks 8 banks 7 banks 60 50 40 30 20 Yes No In process NR 0 0 FACT and/or AABB Audited by registry Competent authority ISO
Processing methods 45 40 35 30 Currently Never Done previously, not anymore 25 20 5 0 5 0 Liquid phase Vapour phase LPh VPh LPh VPh LPh VPh LPh VPh LPh VPh VOLRED MANUAL VOLRED AUTO Plasmaredonly VOLRED MANUAL VOLRED AUTO Plasmaredonly WITH SEGMENTS NO SEGMENT
Type of units in inventory % 6% 38% Plasma and RBC RED Manual Plasma and RBC RED Automatic RBC reduction only No VR 55%
Plan Preview Monaco CBWG discussion Istambul (WMDA spring meeting) Data compilation, questions to responders (spring and summer) Online ressource for TCs and banks Online catalog of units in pictures Summary and paper draft (WMDA fall meeting) Publication (?? Late 205)
REFERENCES Raiola et al. Unmanipulated Haploidentical Transplants Compared with other Alternative Donors and Matched Sibling Grafts Biol Blood Marrow Transplant 20 (204) 573-579 Querol Cord blood banking: current status Hematology. 04/202; 7 Suppl :S85-8 Purtill et al. Dominant unit CD34 cell dose predicts engraftment after double-unit cord blood transplantation and is influenced by bank practice Blood, Vol 24 (204)
Responders Thanks Sergio Querol Merry Duffy Lydia Foeken Rachel Glissmann Katie Paulson Monique Joris Amy Andrews Sue Armitage Anne Arvola Janete Baldissera Etienne Baudoux Paola Bergamaschi Dazey Bernard Flavio Braga Theofanis Chatzistamatiou Dominique De Bleser Cécile De Bruyn Timothy Devos Nicholas Dibdin Judy DiSanti Suanne Dorr Susana G Gomez Ronit Goldman-Levi Jose Hernandez Renate Hintermeier-Knabe Donald Hudspeth Susie Joron Vincent Kindler Gesine Kögler Metka Krasna Pawinee Kupatawintu Marie Kurikova Dominique Latinne IOULIETA LIATSOU Juan Lieu Alfredo Mendrone Junior Zbigniew Mrowiec Kerstin Nessel Azita Nourani Mario Pagano Phil Paul Ovchinnikov Pavel MIGUEL ANGEL PEREZ Laura Ponce Fabienne POUTHIER Arun Prasath SERGIO QUEROL Shimon Rabinowitz Donna Regan Alex Ross Maria Sanciova Maria Screnci Yesi Sevilla Dorothy Sung Minoko Takanashi Anna Tamburini Carol Taylor Dimitrios Tsakiris SERENA URBANI Berit Waldner Stephanie Warnell Xiaofei Wei Pinar Yurdakul