Cord blood banking & cord tissue banking of umbilical stem cells

Since the first umbilical cord blood transplant in 1988 the medical literature on umbilical cord blood collection, storage and transplantation has increased on an almost daily basis.

Smart Cells International firmly believes that umbilical cord cell collection from blood and tissue at the time of birth is a safe and reliable way to collect umbilical stem cells.

Umbilical cord blood banking and transplantation is now widely accepted by the medical and scientific profession as a valid and immensely useful procedure. There have been over 6000 UCB transplants to date for over 70 diseases worldwide. (Statistics from New York Cord Blood Bank and Leukemia and Lymphoma Society 2005), confirming the use in regenerative medicine of stem cells from umbilical cord blood and mesenchymal stem cells derived from umbilical cord tissue.

Reports by leading scientists have shown that the Wharton's Jelly of the umbilical cord is a rich source of a different, but equally important type of stem cell called, Mesenchymal Stem Cells (MSC's). MSC's have been shown to be able to differentiate into a variety of cell types: bone, cartilage, nerve, adipose, cardiac, smooth muscle, hepatic and skin cells and are therefore extremely promising in regenerative medicine.

The availability of cord blood for transplantation is a particular advantage for those patients requiring urgent transplantation. Transplant patients receiving umbilical cord stem cells from a relative are significantly less likely to develop graft-versus-host disease (GVHD)  This is an immune complication which can result after transplantation where the transplanted material ‘attacks’ the host or recipient. There is a significantly reduced rate of GVHD and greater immunological naivete when compared to transplants using bone marrow.

Further studies have also shown the acceptability and advantages of umbilical cord blood banking for HLA (tissue typing) mismatched recipients, and also to HLA typed siblings.

Umbilical cord blood is a recognised alternative to bone marrow in the reconstitution of blood cells (the haemopoietic system) following treatment for cancer.

Other significant recent advances in the use of umbilical cord stem cells include:

• Non-Hodgkin’s lymphoma (Ooi et al, 2003);
• Transplantation in Wiskott Aldrich syndrome (Knutsen et al, 2003);
• Unrelated cord blood transplantation for beta-thallasemia major (Fang et al, 2003),
• Sibling cord blood banking for children with sickle cell disease (Reed et al, 2001),
• Transplantation for chronic granulomatous disease (Bhattacharya et al, 2003);
• Unrelated transplantation for severe combined immunodeficiency syndrome
• (Fagioli et al, 2003) and transplantation in myelodysplastic syndrome and Behcet disease (Yamato 2003).

Current research demonstrates the potential of umbilical cord blood and mesenchymal stem cells in the repair of tissue and organs such as those in the liver, kidneys, heart muscle and the central nervous system.

Umbilical cord blood (UBC)is enriched with umbilical stem cells. Thus the ability of cord blood stem cells to repopulate the bone marrow is superior to bone marrow or mobilized (peripheral or circulating) blood. (Wang et al, Blood, 1997)

UBC is approximately ten times richer than bone marrow in the proportion of progenitors of haematopoietic stem cells. (Broxmeyer et al, Journal of Tropical Paediatrics, 2002). It is these progenitors, as immature undefined cells that that can be used to assist with tissue repair following rapid cell division.

Engrafting levels of hematopoietic stem cells from cord blood stored for 15 years was comparable to fresh cord blood samples. Thus confirming Cord Blood can be cryopreserved and retrieved in a functionally competent form (Broxmeyer et al, Medical Sciences 2002).

The one year survival rate for UCB transplantation a) for HLA-tissue matched siblings is 63% but only 29% for unrelated donors. (Gluckman et al, New England J of Medicine, 1997)

Mesenchymal stem cells (MSC’s) in UCB show plasticity to differentiate into all 3 germ layers (all three germ layers form the embryonic cells) and thus huge potential for regenerative medicine (Lee et al, Blood, 2003)

Some advantages of MSC’s are:

• Embryonic like stem cells found in UCB.  (Forraz et al, Cell Proliferation, 2005)
• Graft Versus Host Disease (GVHD) is significantly reduced in related transplants. GVHD is reported in 42% of unrelated UCB transplants and only 3% in related transplants.  (Wagner et al, The Lancet, 1995 and Krutzberg et al, New England Journal of Medicine, 1996)
• The frequency and severity of GVHD after a cord blood transplant (CBT) is lower than after a bone marrow transplant (BMT), even when HLA disparate cord blood grafts are given. (Benito et al, Bone Marrow Transplantation, 2004)

Other significant applications in the use of cord blood include:

• Krabbe Disease treated with UCB hematopoietic stem cell transplantation. (Krutzberg et al, Radiology 2005 and NEJM 2005)
• Central nervous system manifestations of Globoid-cell leukodystrophy can be reversed by allogenic hematopoeietic stem cell transplantation. (Krivit et al, NEJM, 1998)
• Related umbilical cord blood transplantation in patients with thallassemia and sickle cell disease. (Locatelli et al, Blood, 2003)
• Allogenic stem cell transplantation using mismatched family members for children with severe aplastic anaemia. (Bone Marrow Transplant, PubMed 1996)
• Cord blood transplants from unrelated donors used to treat patients with Hurler’s Syndrome. (Staba et al, NEJM 2004)

Smart Cells International, July 2011

Please see below for medical references and further source material.

Medical References
Gluckman et al, (1989)
Fasouliotis & Schenker, 2000; Barker, J.N. & Wagner, J.E. (2002). Umbilical cord blood transplantation: current state of the art. Curr Opin Oncol, 14, 160-164
Barker, J.N. et al., (2002). Searching for unrelated donor hematopoietic system cells: availability and speed of umbilical cord blood versus bone marrow. Biol Blood Marrow Transplant, 8, 257-260
Barker, J.N. & Wagner, J.E. (2003). Umbilical-cord blood transplantation for the treatment of cancer. Nature Reviews Cancer, 3, 526-532
Barker et al, 2002; Sanz & Sanz, 2002
Bhattacharya, A. et al., (2003). Successful umbilical cord blood stem cell transplantation for chronic granulomatous disease. Bone Marrow Transplant, 31, 403-405.
Bron, D. et al., (2002). Hematopoietic stem cells: source, indications and perspectives. Bull. Mem. Acad. R. Med Belg.,157, 135-145
Fagioli, F. et al., (2003). Successful unrelated cord blood transplantation in two children with severe combined immunodeficiency syndrome. Bone Marrow Transplant, 31, 133-136
Fang, J. et al., (2003). Unrelated umbilical cord blood transplant for beta-thalassemia major. J. Trop. Pediatr, 49, 7173
Fasouliotis, S.J. & Schenker, J.G. (2000). Human umbilical cord blood banking and transplantation: a state of the art. Eur. J Obstet Gynecol Reprod Biol, 90, 13-25
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