This fact sheet has been prepared to assist parents in

Transcription

This fact sheet has been prepared to assist parents in
Cord Blood + Tissue Banking Fact Sheet
This fact sheet has been prepared to assist parents in
understanding more about umbilical cord blood and
cord tissue banking. You may find it useful to review this
information so that you can make an informed decision about
whether you wish to store your baby’s cord blood and tissue.
Your maternity health care providers are committed to
patient choice and will support your decision whether you
decide to store your child’s cord blood and tissue or not.
Introduction
What is Family Banking?
The collection and storage of cord
blood taken from the umbilical cord of
a baby at birth is becoming increasingly
common. The reason for this is that
the cells contained in the blood have
potential therapeutic value in the
treatment of blood disorders, immune
diseases and the emerging field of
regenerative medicine. Recently, the
option to collect and store a section
of the umbilical cord itself has been
introduced into Australia. The tissue
of the umbilical cord contains different
types of stem cells and other cells that
are being studied in clinical trials for
their medical benefit.
Cord blood banking is the process of
collecting the blood from the umbilical
cord immediately after birth and storing
it for potential medical uses. Family
banking means your baby’s cord blood
can be stored for use by your baby and
other compatible family members.
What is Cord Blood?
Cord blood is the blood that remains in
your baby’s umbilical cord and placenta
after the birth and the umbilical cord has
been cut. It is a rich source of stem cells
which can be used in medical treatments.
Cord blood stem cells are similar to
those found in the bone marrow and
have the ability to develop into all the
different blood cell types, creating the
blood and immune system. Cord blood
stem cells may also have a role in the
treatment of neurological injuries such as
cerebral palsy and autoimmune diseases
such as type 1 diabetes.
What is Cord Tissue?
Cord tissue fills the baby’s umbilical
cord around the blood vessels
and contains types of stem cells
(mesenchymal stem cells or MSCs) that
are not generally found in cord blood.
MSCs are the stem cells that give rise
to many of the “support tissues” in the
body, including bone, cartilage, fat and
muscle. They also have the potential to
develop into nerve cells and are known
to have a positive impact in reducing
inflammation. Medical clinical trials
in the use of MSCs are still at an early
stage and no therapy using MSCs
has yet been approved in Australia. It
is, however, an area that is of major
scientific interest and early results of
trials are reported to be promising.
An educational factsheet based on information
provided by Parent’s Guide to Cord Blood Foundation.
Table 1
Emerging Therapies where children use their own Cord Blood
Diagnosis
Occurrence in Stage of Use
Australia
Clinical Trial Reference
(www.clinicaltrials.gov)
Cerebral Palsy
2 per 1000 full Clinical Trials: Phase NCT01147653
term births1
1&2
NCT01072370
Pending in Australia
Hypoxic
Ischemic
Encephalopathy
1 per 1000 full
term births2
Clinical Trials:
Phase 1
NCT00593242
NCT01506258
(oxygen deprivation)
Traumatic Brain
Injury
1 in 1,077
ages 0-143
Clinical Trial:
Phase 1
NCT01251003
Type 1 Diabetes
1 in 2504
Clinical Trials: Phase NCT01343394
1&2
11/SCHN/211 (CHW/Cell
Care)
Hearing Loss,
Sensorineural
20 per 10,000
at birth5
Clinical Trial:
Phase 1
NCT01343394
Hypoplastic Left
Heart Syndrome
1 in 6259 at
birth6
Clinical Trial:
Phase 1
NCT01445041
Autism
1 in 1607
Clinical Trial:
Phase 2
NCT01638819
What are Cord Blood and Tissue
used for?
Cord blood has been used in transplant
medicine to treat blood diseases and
cancers since 1988. By the end of
2009 there had been approximately
20,000 cord blood transplants
worldwide1. Currently, in Australia
cord blood stem cells may be used
in place of bone marrow to treat a
range of blood disorders and immune
system conditions such as leukaemia,
anaemia and autoimmune diseases.
They are largely used in the treatment
of children but have also started being
used for adults following chemotherapy
treatment.
Cord blood is also being researched
for use in regenerative medicine where
stem cells may help induce healing
or regenerate cells to repair damaged
tissues (Table 1). This research has led
to clinical trials using cord blood in
experimental therapies to treat cerebral
MSCs are currently being investigated in
the treatment of bone fractures, cartilage
damage, heart and skeletal muscle
diseases. As with the immune cells in
cord blood, MSCs dampen unwanted or
excessive immune responses, and they
are therefore being investigated for the
treatment of autoimmune diseases and
the complications of incompatibility in
transplantation.
Lastly, in animal studies, co-transplanting
mesenchymal stem cells taken from cord
tissue together with cord blood stem
cells results in improved engraftment
(ie acceptance of the transplant) - up to
a 6-fold increase over cord blood alone.
Their results suggest a potential role
for MSCs in transplantation medicine,
helping ensure better transplant take up
and allowing lower volume cord blood
units to be successfully used.
Graph 1: Lifetime Probability of a
Stem Cell Transplant
How is cord blood and tissue
collected?
Collection of cord blood and tissue is
normally performed by your obstetrician,
midwife or trained collector. Immediately
after the birth of your baby, the umbilical
cord is clamped and cut, separating your
baby from you and the placenta. The
collector will then clean the umbilical
cord and collect the cord blood in a sterile
collection bag. Cord tissue is collected
after the cord blood has been collected.
A short section of the umbilical cord is
cut from the cord, washed and placed in
a storage vial. The cord blood and cord
tissue is then labelled and packaged in the
collection kit. The kit is then transported
to the banking facility where the cord
blood is processed to concentrate the
stem cells and then frozen and stored
under controlled conditions (for private
banking you are responsible for calling
the cord blood bank’s medical courier to
arrange collection).
Cord blood and cord tissue collection is
quick, safe and painless for both mother
and baby.
This is a brief overview of cord blood and cord tissue banking.
Further information can be obtained as follows:
Public Donation: www.abmdr.org.au
Private Cord Blood + Tissue Banking:
www.cellcareaustralia.com
Private Cord Blood Banking:
www.cellcareaustralia.com
www.stemlife.com.au
www.cryosite.com
References:
1. www.cerebralpalsy.org.au
2. www.health.qld.gov.au
3. www.bia.net.au
4. Australian Institute of Health and Welfare 2011. Diabetes prevalence in Australia: detailed estimates for 2007-08. Diabetes series no. 17. Cat no. CVD 56. Canberra: AIHW
5. www.hearingloss.com.au
6. www.aihw.gov.au
7. www.autismaus.com.au
8. Verter, F & JJ Nietfeld, Cytotherapy 2010;12:Suppl.1, abstract#157
9. Nietfeld JJ, Pasquini MC, Logan BR, Verter F, Horowitz MM. Lifetime probabilities of hematopoietic
stem cell transplantation in the US. Biol Blood Marrow transplant. Mar 2008; 14(3): 316-322
An educational factsheet based on information
provided by Parent’s Guide to Cord Blood Foundation.
0.50%
0.45%
Cumulative Probability (%)
palsy, brain injury and juvenile (Type
1) diabetes (www.clinicaltrials.gov).
Furthermore, many clinical trials are
underway looking at the use of stem
cells taken from bone marrow. For many
of these potential treatments, cord blood
stems cells may be a suitable substitute
and offer many advantages over bone
marrow.
0.40%
0.35%
0.30%
0.25%
0.20%
0.15%
0.10%
0.05%
0.00%
0
10
20 30 40 50 60 70 80
Age (Years)
Collection options in Australia
If you are an expectant parent in Australia
you have three choices with your baby’s
cord blood:
•
•
•
Store your baby’s cord blood with a
family cord bank for future individual
or family use;
Donate your baby’s cord blood
to a government funded public
cord blood bank for use by anyone
needing a transplant; or
Allow your baby’s cord blood to be
discarded at birth.
Family cord banks are commercial
operations, and charge fees for their
services. Ownership of the cord blood and
tissue remains with you and your child
and can only be released for use by your
child or a compatible family member. All
cord blood banks in Australia are regulated
by the Therapeutic Goods Administration.
With a public bank, your baby’s cord
blood is a donation, and is then available
for use in therapies by anyone (in
Australia or overseas) who is a suitable
genetic match. While public banks do
not charge for their services, cord blood
stored in a public bank may or may not
be available for your child’s own use
if the need arises. Collections for the
public cord blood banks are carried
out at a small number of hospitals
throughout Australia.
What is the likelihood of ever
using banked cord blood?
It is difficult to know the exact probability
that cord blood banked today will be
used, as new therapies are continually
emerging and are still being investigated.
The minimum odds of use come from
the traditional therapy of stem cell
transplants. Hospital statistics show
that the probability of a person having
a stem cell transplant, either using their
own cells or from a donor, increases
over one’s lifetime (Graph 1)8. While a
person’s chance of transplant are only 1
in 1700 up to age 20, they rise to 1 in 200
by age 709.
Families are even more likely to use
their child’s cord blood if some of the
experimental therapies become standard,
such as cord blood therapy for cerebral
palsy (1 in 400 children) or autism
(1 in 160 children). The experience of
private cord blood banks in the US,
where storage has been taking place for
considerably longer than in Australia,
indicates a usage rate to date of 1 in
1,200 to 1 in 2,500 after an average
length of storage of 5-6 years.