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After collection, the blood is transported to the laboratory. There, blood and cell parameters are measured, preparation takes place, i.e. all unnecessary components are removed, the sample is tested for the presence of viruses, bacteria and fungi. Cells are placed in a standard freezing bag, low-temperature cell-protecting agents are added and the sample is frozen to -190oC in a controlled manner.

In theory, there is no limit to the storage of cells. In practice, it was confirmed that the oldest cells (frozen in the mid-1980s) thawed after nearly 24 years behaved identically to those before freezing.

PBKM provides its services through a network of laboratories located in Poland and abroad. In each of the relevant markets (Poland, Spain, Turkey, Hungary, Romania), PBKM has its own laboratories for the preparation, testing and freezing of cord blood. These laboratories also store frozen samples (except for the laboratory in Spain). In addition, the FamiCord Group cooperates with partner laboratories in the United States, Switzerland and Germany, which perform the same functions as its own laboratories (USA, Switzerland – preparation and storage, Germany – storage only), however, the vast majority of samples obtained (>95%) go to its own laboratories. A special market is Poland, where PBKM and its subsidiaries have 3 in-house laboratories (Warsaw, Kraków, Szczecin) and one partner laboratory (Poznań).

You can with the consent of the Parents or the child upon reaching the age of majority.

Practically no. Samples have 3 independent markings: a unique number on the cassette, a bar-code on the material bag, and a manual description.

As much as possible. There are at least 5 technologies in the world that are in clinical trials. PBKM does not have its know-how in this area. We think that these technologies will become more widespread and then the quantitative limitation for the material will disappear.

It is not necessary. The most important thing is the proper unbuttoning of the baby. Blood is always obtained after this fact, in the maximum amount that still remains in the vessels of the umbilical cord. Even after the so-called late unbuttoning, there is still blood left in the placenta and vessels that can be obtained.

After information from Parents about the need for transplantation, bank specialists contact the transplant clinic to determine how to deliver the cells and the necessary documentation to confirm the parameters of the sample. The location of the sample is searched in the computer system. At the bank, the documents and unique numbers on the sample are confirmed to eliminate the risk of confusion. Cells using a special transport are transported to the clinic as a frozen preparation. Before transplantation takes place, transplant compatibility is confirmed. Immediately prior to administration in the clinic, the sample is thawed and the cells are administered intravenously after the so-called cryoprotective substances are washed off.

Currently, stem cells are used primarily in the treatment of diseases of the hematopoietic and lymphatic systems (including leukemia, lymphoma). The incidence rate was 16.8/100,000 inhabitants in Poland in 2010 (doubled since 1990). The risk of the disease increases with age – in children it is about 6/100 thousand. The second area of application of stem cells is regenerative medicine, where experimental therapies and clinical trials treat patients suffering from various other incurable diseases, mainly in the field of neurology. These diseases are much more common: cerebral palsy – about 2% of children, autism about 1.5% (US data); multiple sclerosis – about 25,000 patients, amyotrophic lateral sclerosis – 2,000 patients.

No, the cells can be used for any person compatible with the donor. In particular, it is most often a sibling of the donor. It is worth mentioning that for cord blood, the concept of “donor” is ambiguous, because cord blood comes from the afterbirth, i.e. it is not the blood of the child sensu stricto.

No, he uses stem cells for both autologous (for the donor himself) and allogeneic (donor other than the recipient) indications.

The standard treatments for stem (hematopoietic) cell transplantation are diseases of the hematopoietic and lymphatic systems, some metabolic diseases and cancer. In total, there are about 80
different diseases. These diseases use cells whose source is umbilical cord blood, marrow or mobilized peripheral blood.

Standard and experimental therapies for the use of stem cells differ in the level of evidence for a given therapy. Standard therapies take place in indications where there is a lot of evidence from various centers that stem cells given in a certain way will help the patient. Experimental therapies are used in situations where there is no other effective standard therapy, but there are reports that the cells can help the patient. The material from which the cells are derived can be the same, i.e., the cells can be either in-house or from a donor.

Viral therapies, stem cell therapies, gene therapies and monoclonal antibodies.

By the end of March 2021, we had treated 99 patients with cord blood stem cell preparations (most often donor siblings) and more than 1,600 patients with cord cord cell preparations. At the end of this period, we stored about 540,000 samples of four types of biological material (cord blood, placental blood, umbilical cord and adipose tissue.

For hematologic diseases, the 5-year survival rate of patients ranges from about 35% to 90%, depending on the type of disease and its stage. Taking into account the number of patients in the diseases in question, it can be estimated at an average of 70%-80%

It is estimated that the risk of a disease situation requiring a stem cell transplant during one’s lifetime (70 years) is between 1% and 0.25%. This probability was estimated based on indications for transplantation that existed in 2006 in the US. Given that there are more and more diseases that can be treated with stem cells – this percentage will grow, although it is already much higher than some of the diseases we are grafting for. As banks become longer, the percentage of portions used in therapy will increase. The oldest banks in the U.S. used 1 out of every 1,000 samples stored.

In addition to cord blood, stem cells can be found, for example, in bone marrow, peripheral blood, skin, fat, liver, placenta, teeth, hair follicles. However, only cells from umbilical cord blood, marrow and peripheral blood are standardly used in medicine. Other sources provide cells whose clinical usefulness is being verified in ongoing clinical trials.

Cord blood is an alternative source of cells to bone marrow. Advantages of these cells include easier acquisition, greater potential for multiplication, a simplified pre-transplant procedure, fewer severe complications and easier matching between recipient and donor. Disadvantages include limited quantities, the possibility of donation only once in a lifetime and a slightly longer period of hematopoietic recovery after transplantation. The effectiveness of the treatments is considered comparable.

For several years now in the US, cord blood has equaled marrow in terms of the number of its uses in standard therapies. Thus, it seems that cord blood has found its place in medicine, from which, due to the potential of the cells derived from it and its other advantages, it will be difficult to replace. In particular, cells from fat, although an interesting area for research, do not currently have indications for use in standard (hematooncological) indications. They are interesting in the context of applications in regenerative medicine, but only in adults (it is difficult to imagine taking fat from a child), however, they will always have a limitation compared to cells taken from cord blood / cord due to the moment of collection – they will always be “older”.

Certainly, the creation and full availability of effective therapies for hematooncologic and other currently incurable diseases would reduce interest in stem cell banking.

Yes, there are many diseases that are standardly treated with their own stem cells (such as lymphomas). However, it should be mentioned that these diseases are more likely to occur at an older age, so patients usually do not have their own cells from cord blood in the bank and therefore most often receive their own cells from the bone marrow.

Overall in the world, 60% of transplants are autologous (own cells), 20% of transplants are among relatives, and 20% are transplants of unrelated individuals. In about 30% of cases a donor for transplantation cannot be found. Private banking addresses the needs of oneself and family/siblings and minimizes the risk of not having a compatible donor. It also in no way competes with public banking, but only complements its offerings. Everyone has theoretical access to the portions collected in the public bank, as they operate on the basis of international registries (just like bone marrow donor registries). In practice, access depends on the ability of the transplant clinic to “buy” such a portion, which often costs a lot of money. Private banking increases the availability of cells, because if the family needs to use the cells – they can be donated to the clinic at no additional cost – which makes transplantation decisions much easier, and sometimes is the only chance to treat the patient (if no other donor is available).

Yes, there are about 160 public banks in the world, which store about 730,000 portions. These portions are cataloged in registries (along with bone marrow donors) and can be used for any patient in the world. They are part of public health systems and are funded by states or other funders. Despite this, it is impossible to meet 100% of every patient’s needs; despite the huge resources for the banks’ operations, for about 30% of patients in need of standard transplants no suitable donor can be found. In addition, public banks do not provide cells for experimental and autologous therapies. It should be mentioned that while family banks obtain blood at a few percent of births and public banks at less than one percent of births, the vast majority of blood is irretrievably destroyed. Hence the growing trend of cooperation between family banks and public bank institutions.

The family bank service is a service whose value will not be realized until several years after using it at the earliest. It is therefore necessary to carefully analyze the banks’ offerings and choose the right provider of this service. The most important questions to ask the bank are:

1. Scale of operation – the larger the operation, the more experience the bank has, the better prepared it is to handle the batches of blood flowing in at various times to be prepared and frozen.

2. Transplant experience – the greater (and some banks have none) the better, such a bank has evidence that it can prepare blood well that transplant clinics will not be afraid to use.

3. quality standards – the more specialized certificates for cord blood banking certificates the better. A license from the Ministry of Health is a prerequisite for a bank to operate and certifies the bank’s basic standard. In addition, however, banks can submit themselves to accreditation by international organizations such as AABB, Netcord, ISO, GMP.

4. Transparency – banks should present all documents to the customer before signing to avoid misunderstandings. The decision to bank is a decision for many years.

5. Sound organizational foundations – when entrusting blood to a bank, we bind ourselves to the entity for many years, and it is important to make sure that it has the foundations for a long presence in the market. Some banks are very small companies, often without their own laboratories, which do not have long-term plans of operation (they are sometimes called parabanks). Customers of such banks are exposed to unnecessary stress and formal difficulties if such a company gets into trouble, as has happened in the past in many countries, including Poland.

Yes, if appropriate written consent is obtained from the donor/parent of the donor.

Many of the negative statements stem from the past, where the role of private/family banks was approached with caution. There was unequivocal support for public blood donations as an altruistic impulse. Unnecessarily, the impression of competition between these types of banks was created in some countries. In reality, this competition does not exist, as more than 95% of blood is destroyed and does not go to any bank. Public banks could obtain blood without a problem on the part of donors, but the barrier is the cost, which no country has been able to bear (a paradoxical situation has occurred in France, where family banks are practically prevented from operating in most hospitals by not collecting blood for public banks). Family banks are part of private health care and do not have these problems, however, operating in an area of economic freedom, they sometimes exaggerated the advantages of their services, which caused reactions from the medical community.

In particular, Europe was/is an area of such perception of family banks, in the US it looks a little different. However, for several years there has been a noticeable, changing view expressed in the European Parliament Resolution of 2012, where the right of Parents to be informed and choose what to do with cord blood is given.

In addition, more and more specialists are speaking positively about the role of family banks (e.g. Prof. Mariusz Ratajczak, Prof. Krzysztof Kalwak, Prof. Marcin Majka, Prof. Boguslaw Machalinski).