This week we are raising awareness of stem cell transplants.

Stem cell transplants are most commonly used in the treatment of cancers and blood disorders including leukaemia, lymphoma, myeloma, and sickle cell disease.

Intensive chemotherapy is sometimes used in the treatment of cancer as it kills cancer cells.  However, chemotherapy also kills bone marrow which is responsible for producing blood cells and maintaining the immune system.  A stem cell transplant after chemotherapy helps to rebuild the immune system; however it is not without risks, primarily leaving the patient vulnerable to infection as their immune system becomes compromised.  Intensive chemotherapy is only considered as a treatment option when the benefits of the treatment outweigh the risks, something which the treating physician will discuss at the right time with the patient.

There are different kinds of stem cell transplants, different sources of stem cells and tests which need to be performed to ascertain if the stem cells available are suitable to be transplanted to the patient (HLA matching).

There are three sources of stem cells currently used for transplant, these are:

• Bone Marrow – Bone marrow is found inside the bones, it is usually extracted from the hip ready for transplant.

• Peripheral Blood – Drugs are given to the donor (or patient) and stem cells are released into the blood stream which are harvested and processed ready for transplant later.

• Cord Blood – After the birth of a baby and after the cord has been cut, the remaining cord and placenta are taken away where the blood from the cord, which is naturally rich in stem cells, is procured.

There are three different types of stem cell transplant:

• Autologous – These transplants use the patient’s own stem cells which have been stored prior to treatment.  They could be sourced from bone marrow, peripheral blood or umbilical cord blood.  The chance of these stem cells being rejected is minimal as the body recognises these cells as its own.

• Allogeneic – These transplants use stem cells from a donor.  The donor may be a family member or could even be a stranger who was found to be a match through a stem cell registry.  HLA matching reduces the chances of these stem cells being rejected by the patient’s body.

• Syngeneic – These types of transplants are incredibly rare.  A syngeneic transplant uses stem cells from a donor; the donor and patient are siblings who are identical twins or triplets.  Due to the genetic make-up of identical siblings, the chances of rejection are greatly reduced than that of a regular donor and the patient’s body should accept these stem cells willingly.

HLA matching is used when a patient requires stem cells from a donor; the matching process is to reduce the chances of the patient suffering post-transplant complications such as rejection of the donor stem cells.  When looking for a suitable match between donor and patient, doctors look at the 6 major human leukocyte antigen (HLA) proteins to try and find a match.  While a perfect match is ideal, in some cases a match of 5 out of 6 may be acceptable for stem cells from bone marrow and peripheral blood and 4 out of 6 for cord blood.  Because cord blood requires a minimum match of 4 out of 6 the HLA proteins, cord blood can be more easily matched between donors and patients.

Racial and ethnic heritage also plays an important role in transplant medicine; you are more likely to find a stem cell match with someone who shares your racial heritage.  Mixed heritage and minority backgrounds are underserved in stem cell registries, making it more difficult for people in these communities to find a stem cell match.  An increase in cord blood banking and people joining the stem cell register from these communities could help those in need access transplant medicine.

A stem cell match is most likely to be found within the family, cord blood banking could be a particularly astute choice for families from minority backgrounds or with mixed heritage.

What makes Cells4Life stand out as industry leaders?

Cells4Life was founded back in 2002 by our Chief Scientific Officer, Dr Jeff Drew BSc PhD.  Jeff holds a PhD in molecular virology and has 25 years of experience in microbiology, cancer and genetic research and has almost 30 patents to his name.  Due to his background, Jeff understood the importance of umbilical cord blood banking and while expecting his first child, Jeff went to find a suitable cord blood bank to store his first-born baby’s stem cells.  However, Jeff was unable to find a cord blood bank which met the strict criteria he was looking for and so Jeff created Cells4Life.

Not only is Cells4Life born from one man’s desire to provide his family with the best cord blood storage available, it was created as a science-led organisation.

Cells4Life is passionate about enabling parents to make a fully-informed decision when deciding to bank their baby’s umbilical cord blood; we facilitate this by providing substantive clinical, scientific and evidence-based information available to parents.  As an organisation, Cells4Life works incredibly hard to set and raise standards in the testing, processing and assessment of these precious cord blood samples.

How is Cells4Life changing cord blood banking?

Passionate about cord blood, we want to see more samples being stored and that includes reducing the amount of discarded samples in public banks too. Currently, 80-90% of donated cord blood samples are discarded by public banks due to insufficient volume of stem cells in the samples donated, usually caused by current processing technologies.  However, TotiCyte^TM, developed by Cells4Life, could revolutionise the whole cord blood banking industry and improve cord blood storage across the board.

Volume reduction is the current technology employed and preferred by most cord blood banks (not Cells4Life, however, even though we do offer this option).  Volume reduction uses a centrifuge to separate red blood cells and plasma, which are of no use in a stem cell sample, from the stem cells; this also reduces the volume of the sample, for example, from 100ml to 25ml.

Unfortunately a side-effect of volume reduction technologies is a loss of stem cells, in some cases a loss of up to 40% and in some instances an almost total loss of stem cells with low abundance but of potential importance ^[1].  In addition to the serious loss of stem cells, a significant level of red blood cells remain, the very thing that volume reduction is trying to eradicate, which can be up to 30% of the starting concentration ^[2].

Developed by Cells4Life, TotiCyte^TM selectively removes the red blood cells in cord blood and yields:

• over 95% recovery of the white cell fraction,

• 99.5% removal of the red cells,

• removes the need for washing to remove DMSO and red cells, and

• exceptionally high post thaw viable cell recovery ^[3]

Using a mixture of compounds already commonly used in blood product processing, TotiCyte^TM causes the red cells to selectively sediment within 30 minutes of being added to cord blood while white cells remain in solution.  The white cells can be easily removed from the red cells by means of gentle centrifugation creating a sample of a smaller volume and with less than 0.5% of the original red cell content.

In addition to the improvements made while processing cord blood samples, TotiCyte^TM also greatly reduces the amount of cells lost after thawing from cryopreservation, meaning more cells available for use in therapies.

How will Toticyte^TM positively impact the cord blood banking industry?

•Cord blood processing with TotiCyte^TM will be cheaper than current methods.

•Fewer donations will be wasted because the higher cell yield enables many more collections to meet the threshold for storage.

•More high TNC cord blood units in storage means more units that are desirable to be purchased for transplant.

•Building the inventory of high TNC cord blood units also means that heavier patients can be transplanted, moving the therapeutic use segment from primarily children to adults.

•TotiCyte^TM‘s high TNC yield should enable only one cord blood unit to be used for larger adults, obviating the need for very expensive double cord blood transplants. ^[3]

Through increasing access to cord blood banking through our private stem cell bank and by creating products such as Toticyte^TM, which reduces the waste of donated cord blood samples, Cells4Life is committed to improving the levels of cord blood samples stored across the world – benefiting the global community.

^[1] Lapierre, V., Pellegrini, N.,Bardey, I., Malugani, C., Saas, P., Garnach, F., Racadot, E., Maddens, S., & Schillinger, F.

Cord blood volume reduction using an automated system (Sepax) vs. a semi-automated system (Optipress II) and a manual method (hydroxyethyl starch sedimentation) for routine cord blood banking: a comparative study.

Cytotherapy. 2007; 9(2):165-9. PMID: 17453968

^[2] Bhartiya, D., Shaikh, A., Nagvenkar, P., Kasiviswanathan, S., Pethe, P., Pawani, H., Mohanty, S., Rao, A., Zaveri, K. & Hinduja, I. 2012.

Very Small Embryonic-Like Stem Cells with Maximum Regenerative Potential Get Discarded During Cord Blood Banking and Bone Marrow Processing for Autologous Stem Cell Therapy

Stem Cells and Development. 2012; 21(1):1-6.

^[3] http://parentsguidecordblood.org/newsletters.php#toti accessed 15/07/2015.

April is Caesarean Awareness Month. 

There are many reasons why a woman may give birth to her baby via a caesarean section; it may be planned in advance, there may be complications during labour or it may be a medical emergency, although thankfully emergency caesareans are rare.

In some areas of the United Kingdom as many as 30% of babies are born and delivered via a caesarean section. ^[1]  Only 40% of caesarean births are planned. ^[2]  A caesarean section is considered major surgery so when a mother needs an emergency section, it can be a daunting experience to say the least.  If a woman has planned to deliver her baby with a birth plan in place which did not include a caesarean birth, cord blood banking could offer some continuity even if the original plans could not be adhered to.

Unplanned, urgent and emergency caesareans account for 60% of all caesarean sections.  Elective caesarean births may be chosen for many reasons including health complications of the mother or baby, multiple pregnancies or it may even simply be the case that an elective caesarean section is the mother’s preferred way to give birth to her baby.

Fortunately umbilical cord blood and tissue banking is completely compatible with a caesarean birth so even in the event of an unexpected caesarean section birth your baby’s umbilical cord blood and tissue stem cells could still be procured for storage.  This would allow you the opportunity to safeguard your baby’s long term health and provide them with access to stem cell therapies using their own stem cells should they ever need to utilise them in the future.

[1] http://www.nct.org.uk/birth/giving-birth-caesarean-section-elective-and-emergency-caesareans

[2] http://www.babycentre.co.uk/a160/caesarean-section

April is Sarcoidosis Awareness Month, we’re showing our support by raising awareness of this autoimmune condition.

Sarcoidosis is an autoimmune disease; an autoimmune disease is an illness which results from the immune system attacking the body.  In the case of sarcoidosis, the lungs and skin are most commonly affected.  In the case of sarcoidosis it is thought that the immune system has gone into “overdrive” and is attacking the skin and organs of the body. As a result of the immune system attacking the body in this way, granulomas develop in the organs ^[1].  Granulomas are clumps of white blood cells ^[2].

Sarcoidosis affects each person differently and the symptoms a patient experiences will be dependent upon which organs are affected.  As sacroidosis most commonly affects the lungs and skin, symptom typically include red bumps on the skin which are tender and a persistent cough ^[1].

Sarcoidosis has conditions which are similar to other conditions which can make diagnosis quite difficult.  In order for a sarcoidosis diagnosis to be confirmed, doctors must eliminate other possible conditions.  Often, sarcoidosis is only discovered when an x-ray of the chest reveals the characteristic swollen lymph nodes or shadowing in the lungs ^[3].

It is estimated that Sarcoidosis affects about 1 in every 10,000 people in the UK.  While there is no cure for sarcoidosis, most people develop symptoms suddenly and they usually disappear within a few months or years without returning; this is called acute sarcoidosis ^[1].

A clinical trial at Northwestern University, which is headed by Dr. Richard Burt, aims to evaluate if an autologous stem cell transplant will produce a normal immune system that will no longer attack the body in sarcoidosis patients.  The trial is expected to end in 2018 and could offer hope to sarcoidosis patients, particularly whose sarcoidosis gradually deteriorates rather than improves.

^[1] http://www.nhs.uk/conditions/sarcoidosis/Pages/Introduction.aspx

^[2] https://chronicillnessrecovery.org

^[3] http://www.breathingmatters.co.uk/sarcoidosis/

This week we’re taking a look at the world of tissue engineering and what this could mean for the future of medicine.

Tissue engineering is an exciting area of medicine, it is the study of the growth of new connective tissues, or organs, from cells and a collagenous scaffold to produce a fully functional organ for implantation back into the donor host.  The development of tissue engineering has seen the advancement of techniques and produced results that just 20 years ago would have seemed impossible.

The bio-engineering process of tissue engineering takes cells donated from the patient and manipulates them to become replacement body parts for the same patient.  Current body parts engineered in this way include valves, vessels and even more complex structures including organs such as tracheas and bladders.  While tracheas and bladders are more simple organs, scientists are pushing the boundaries and trying to create complex organs such as hearts and even brains.

As scientists continue to develop tissue engineering, the possibilities seem endless.  Tissue engineering could open medicine up to a tailor made approach with medicines being tested on tissues of patients to ascertain suitability for the patients and even determine possible complications before they arise.  Another possibility is that scientists could study neurological conditions of patients in the lab by using their cells to grow tissue which they can then observe, as John Hopkins have done with motor neurone disease (also known as MND, ALS, and Lou Gehrig’s disease) patients ^[1].

Over the course of the week we will take a look at cardiovascular tissue engineering and how scientists in America are using stem cells to engineer hearts which could be just a decade from human transplant.  We will also take a look at Dr. Atala, a pioneering researcher who has transplanted a tissue engineered bladder into a patient.

^[1] http://www.futurity.org/als-brains-skin-stem-cells-900442/

Here we take a look at Diamond-Blackfan Anaemia, a rare haematological disorder, also known as DBA.

What is Diamond Blackfan Anaemia?

DBA is the result of the body’s bone marrow not making enough red blood cells; red blood cells are the cells in blood which are responsible for carrying oxygen around the body ^[1].

What are the symptoms of Diamond Blackfan Anaemia?

The symptoms of DBA are shared with other kinds of anaemia and include; pale skin, sleepiness, rapid heartbeat, and heart murmurs.  In many cases there are no physical signs of DBA, however, in approximately 25% of cases abnormal features may be present which could affect the face, head and hands, particularly the thumbs ^[1].

How rare is Diamond Blackfan Anaemia?

Fortunately DBA is incredibly rare, affecting just 125 people in the UK and less than 1000 people world-wide ^[2].  DBA is usually diagnosed in the first year of life and affects both boys and girls equally, occurring across all ethnicities ^[1].

How rare is Diamond Blackfan Anaemia genetic?

DBA is a genetic disorder; in about half of families studied, only one person in the family has DBA.  The children of those with DBA have a 50% chance of inheriting the condition with symptoms varying in severity ^[1].  In families where DBA has been diagnosed, genetic counselling may be available to determine the risk to future children.

What are the treatment options for Diamond Blackfan Anaemia?

The treatment of DBA varies.  Common treatments for very low blood counts in DBA patients include blood transfusions and corticosteroids.  In some patients a stem cell transplant may be considered ^[1].  Stem cells used in the treatment of DBA may be sourced from bone marrow or cord blood.  Cord blood banking for families affected by Diamond-Blackfan Anaemia could increase the chances of a stem cell match being found for loved ones.

^[1] http://dbafoundation.org/learn-more/faqs/

^[2] http://diamondblackfan.org.uk/wordpress/wp-content/uploads/2010/09/DBA-UK-Leaflet-2012.pdf