FAQ

Nowadays, stem cells are primarily used for therapy transplantations in patients who underwent intensive chemotherapy and/or radiotherapy, as a means of annihilating cancerous cells. Unfortunately, chemo and radiotherapy eradicate both neoplastic cells and healthy stem cells located in bone marrow. In order to restore the patient’s hematopoietic system and regenerate his/her immune system, stem cell transplantation is applied. The transplanted cells find their way to the bone marrow where they proliferate and create new blood cells and regenerate the immune system.

Umbilical cord blood, also referred to as “placental blood”, is the blood that remains in the umbilical cord and the placenta following delivery and cord separation. It is considered an invaluable and rich source of stem cells, which are genetically unique. Until recently, it has been considered as medical waste and discarded together with the placenta and umbilical cord.

Yes, if this form of therapy is medically justifiable and the tissues are sufficiently matched between the donor and the recipient. There is a 25% probability that sibling tissue antigens are fully matched.

Yes. Many experimental results provide evidence that stem cells derived from umbilical cord blood are more primitive, less developed and have a greater proliferation dynamic, compared to adult stem cells retrieved from bone marrow or peripheral blood. Freezing prevents cord blood stem cells from the process of ageing and protects them against defects which affect them in later stages of life. In general they are free from cancerous cells which form in later stages of cell life due to external environmental factors.

The donor - recipient match of bone marrow is extremely difficult because, in general, a perfect match is required. Cord stem cells are valued for their immunological immaturity which in turn results in a reduced amount of complications for the recipient (for allogeneic transplantation this means a less pronounced risk of rejection and ‘graft versus host disease’ expression). They can be used even if not fully compatible. This means that cord blood storage maximises the chances of a positive transplantation outcome among family members. A number of research studies indicate that the survival rate among related donors is nearly two times higher as opposed to unrelated donors, as a result of cord blood transplantation. Other reasons why cord blood is superior to bone marrow in transplantology:

• Immediate stem cell availability in case of emergency – they are harvested and stored prior to their use
• Reduced probability of ‘graft vs host disease’ incidence (Graft versus Host Disease, GvHD).

So far, more than 35 000 cord blood transplants have been performed both in children and adults. In numerous cases, cord blood was used for the benefit of the donor’s sibling. Over the last two years, studies have revealed that cord blood stem cells have the capacity to differentiate into another type of cell e.g. muscle or nerve cells. Stem cells’ regenerative properties are currently the topical issue dominating the field of regenerative medicine. Stem cells were recognized as an invaluable biological material. More and more, research studies are committed to understanding stem cells’ full potential which could be applied in future to treat conditions such as: Alzheimer’s disease, diabetes, cardiac and liver disorders, muscular dystrophy, Parkinson’s disease, spinal cord injuries and strokes.

PBKM S.A. performs tests on both maternal blood (a sample, approx. 9 ml, is collected at delivery) and the child’s umbilical cord blood. The maternal blood is tested for viral and bacterial infections. Naturally, these tests could be performed on the sample of the collected cord blood but this would be a waste of 9 ml of cord blood. Maternal blood test results provide sufficiently veritable information. Cord blood is tested for the following factors:

• *white blood cell count,
• *cell viability assessment,
• *microbiological testing for the presence of aerobic
• anaerobic and fungi bacteria.

Maternal blood is tested for the following components:

• *HBs Ag,
• *Anty-HBc,
• *Anti-HCV,
• *Anti-HIV 1,2,
• *Anti-CMV IgM,
• *syphilis

Upon signing the agreement with the Polish Stem Cell Bank, we provide a unique identification number which marks all components of the collection kit and the documentation. This excludes any mistakes or erroneous swaps.

Below is a list of the basic legal documents regulating our bank’s activity:

Three European Directives:

• Dyrektywa Komisji 2004/23/WE
• Dyrektywa Komisji 2006/17/WE
• Dyrektywa Komisji 2006/86/WE

And Act:

• Ustawa transplantacyjna z 01.07.2005.pdf

If the patient, whose stem cells are stored with PBKM S.A., is diagnosed with a condition and is eligible for stem cell treatment, it is essential to inform your doctor about the stem cell supply stored at our bank. The decision to apply them for therapeutic use is at the doctor’s discretion. Upon the decision to transplant the stem cells, the doctor in charge should get in touch with us to discuss the details of biological material procurement and provision of the necessary medical documentation. The parents should contact a member of staff from our Customer Service Department in order to request the relevant documentation, such as the certificate of stem cell deposit with PBKM S.A. Upon submitting the adequate documentation and determining the details of stem cell procurement with the doctor in charge, the material will be delivered to the designated centre/hospital for further use in therapy.

‘Graft versus host disease’ occurs when the transplanted lymphocytes (responsible for immunological reactions) from the donor function as previously programmed and recognize the recipient’s cells as enemy cells. The donor’s lymphocytes annihilate the recipient’s cells. The annihilation process affects virtually all of the recipient’s cell types. Short life cycle cells, such as epithelium and selected parenchymatous organs, are the cells most vulnerable to the attack. As a result, this condition is characterized by syndromes specific to epithelium damages (rashes, urticaria, dry patches of skin and epithelium desquamation e.g. of the digestive tract = diarrhoea). This condition is acute and resistant to treatment. The reactions are far less intense in case of cord blood transplants as the cord blood cells are immunologically “naïve”.

The match refers to proteins called HLA antigens which reside on the surface of white blood cells and other human cells. They determine the tissue compatibility between the donor and the recipient. Although complete compatibility is optimal, studies have revealed that cord blood transplantations result in a positive outcome even if the match is not perfect. Stem cells derived from cord blood are characteristic for being less mature, immunologically more “naive”, as opposed to stem cells retrieved from bone marrow.

The first transplantation was performed in 1988. By now, over 85 000 transplants have been conducted. By the end of 1995, collection and storage facilities were more common, making the service more available. Nowadays, thousands of parents are beneficiaries of this unique opportunity.

Cord blood is harvested from the umbilical cord following the delivery and cord separation. The procedure is simple and painless, non-invasive and does not interfere with the course of the delivery.

Cord blood is drawn into a collection bag filled with preservative fluid (CPD), an anticoagulant. The CPD allows sufficient time for the blood to be delivered to the laboratory, where it can then be processed.

It is theoretically assumed that deeply frozen stem cells (-150 °C) can be stored for centuries. In practice, we base our knowledge on the findings made by Japanese scientists who tested stem cell viability frozen in 1973. These studies support the hypothesis that the defrosted cells have the potential to proliferate and to form colonies. Current findings substantiate the theory that cord blood stem cells preserved for 24 years still maintain their properties.

* The likelihood of using cord blood is estimated on the basis of the average life duration of 70 years.

Research studies conducted on stem cells are highly promising. The latest findings reveal that:

• Stem cells derived from cord blood have a chance to be used in Alzheimer and Parkinson disease treatment
• Stem cells have the potential to differentiate into muscle tissues which may one day be used in cardiac disorders treatment
• Clinical trials on stem cell transplantation for hereditary and immune disorder therapy are underway

No. Cord blood is harvested only after the child’s delivery and cord separation. Collection takes approximately 5 minutes. It is painless, simple and safe both for the mother and child.

No. Upon signing the agreement, parents are sent a “collection kit” which contains all relevant components for their child’s cord blood collection. It is the parents’ responsibility to remember to bring the collection kit to the hospital at the time of delivery.

In the event of a caesarean section, the blood is collected directly after placenta expulsion. Medical studies indicate that the blood volumes drawn at vaginal or caesarean section delivery are comparable./p>

No, as it is not mandatory for routine procedures. Individual stem cell banking relies on the principle that the donor and the recipient is the same person. Naturally, in case the stem cells are intended for therapeutic use by siblings or other family members, it is required for the stem cells to be tested for tissue compatibility. To this end, a small vial is attached to each frozen container, which when the need arises, is retrieved and subjected to testing (for tissue compatibility).

Odpowiedź: Podpisując umowę na bankowanie krwi pępowinowej Matka wyraża zgodę na pobranie jej krwi i przebadanie jej pod kątem:

• zakażenia wirusem zapalenia wątroby typu B (WZW B),
• zakażenia wirusem zapalenia wątroby typu C (WZW C),
• zakażenia wirusem cytomegalii (CMV),
• zakażenia wirusem ludzkiego niedoboru odporności (HIV),
• zakażenia krętkiem bladym (kiła).

CMV

Jeżeli wynik badania serologicznego na obecność wirusa cytomegalii (CMV) z krwi Matki dziecka będzie wątpliwy lub dodatni, PBKM poprosi o wykonanie powtórnego badania z krwi Matki i Dziecka, celem wykluczenia ewentualnego wrodzonego zakażenia u Dziecka. Jeżeli zakażenie wirusem cytomegalii zostanie potwierdzone u Dziecka, PBKM rekomenduje konsultacje ze specjalistą chorób zakaźnych. Wykrycie wrodzonego zakażenia u dziecka nie dyskwalifikuje próbki do zamrożenia, przechowywania i użycia a dodatkowe badania mają je jedynie potwierdzić lub wykluczyć. Jeżeli zakażenie wirusem cytomegalii zostanie potwierdzone u Dziecka, PBKM rekomenduje konsultacje ze specjalistą chorób zakaźnych.

WZW B / WZW C

Jeżeli wynik HBV DNA i/lub HCV RNA z krwi matki dziecka będzie wątpliwy lub dodatni, Rodzice zostaną informowani o tym na piśmie w terminie 8 tygodni od daty porodu i są zobowiązani do wykonania badania z krwi dziecka metodą genetyczną. Jeżeli wynik badania krwi dziecka będzie ujemny, to krew może być dalej przechowywana. Dodatni wynik badania dyskwalifikuje materiał do dalszego przechowywania. Niewykonanie badań wykluczających powyższe zakażenie (zakażenia) będzie skutkować przeniesieniem zamrożonego preparatu krwi pępowinowej do pojemnika z zakażonymi jednostkami. Rodzice zawsze zostają poinformowani na piśmie o ostatecznej kwalifikacji materiału.

HIV/KIŁA

W przypadku gdy badanie krwi Matki wykaże wynik dodatni w kierunku zakażenia bakteriami kiły lub zakażenia wirusem HIV, PBKM odmówi przyjęcia próbki do przechowywania, a materiał zostanie zniszczony zgodnie z procedurami. Rodzice zawsze zostają poinformowani na piśmie o ostatecznej kwalifikacji materiału.

Two options for cord blood banking are available:

• In a family bank, such as the Polish Stem Cell Bank, a member of FamiCord Group, for autologous or allogeneic transplantation for related donors.,
• In public banks for allogeneic transplantations for unrelated recipients – whereby the parents abandon their rights to the blood, and the donation is altruistic. PBKM facilitates blood collection in these instances in selected hospitals.https://www.pbkm.pl/o-nas/pbkm/o-pbkm/bankowanie-publiczne

Every parent has the freedom to choose whether to donate their child’s blood to a public bank or to secure the blood for the exclusive use or their children and family.

To ensure that the cord blood stem cells can be used for therapy treatment at any given moment. This dismisses the necessity to search for donors, which is a costly, time-consuming, risky and does not guarantee a positive outcome. Early treatment minimises the progress of the disease and boosts chances for complete recovery.