Talk:Stem Cells - Placental Cord Blood
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Cite this page: Hill, M.A. (2021, April 20) Embryology Stem Cells - Placental Cord Blood. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Talk:Stem_Cells_-_Placental_Cord_Blood
The law and problematic marketing by private umbilical cord blood banks
Background: Private umbilical cord blood banking is a for-profit industry in which parents pay to store blood for potential future use. Governments have noted the tendency for private banks to oversell the potential for cord blood use, especially in relation to speculative cell therapies not yet supported by clinical evidence. We assessed the regulatory landscape governing private cord bank marketing in Canada.
Main body: Because the problematic marketing of private cord blood banking for future use often relates to speculative future cell therapies that do not exist and are not being advertised for current clinical use, most private blood bank marketing seems to fall outside Health Canada's regulatory scope. However, this problematic marketing is regulated by the Competition Bureau pursuant to the Competition Act. While representations relating to future hypothetical treatments may not always be subject to the legal requirement for claim substantiation, the law also prohibits individuals and companies from knowingly or recklessly making representations that are "false or misleading in a material respect." A representation is materially false or misleading when it could "influence a consumer's behavior or purchasing decisions," and consumers are likely to be considered to be "credulous and inexperienced" for the purposes of assessing an advertisement's general impression. Because all of the potential benefit of the banking is derived from the potential future use of the biological material for health interventions directed toward the customers and their relatives, and because we know the best available medical evidence indicates a very low probability of utility in this context, we can say with confidence that some private cord blood banking claims are materially misleading. Moreover, to the extent that medical professionals are involved in private bank interactions with customers or hold ownership stakes in private banks, they are subject to professional codes, standards of practice, and potentially fiduciary obligations that further prohibit misleading marketing.
Conclusions: Private cord blood bank marketing that advertises hypothetical future treatments can be misleading and may influence consumer behaviour. This marketing may breach existing advertising law. Regulatory bodies should enforce the law in order to help prevent public health and personal financial harm.
ACOG Committee Opinion No. 771: Umbilical Cord Blood Banking
Since the first successful umbilical cord blood transplant in 1988, it has been estimated that more than 35,000 transplants have been performed in children and adults for the correction of inborn errors of metabolism, hematopoietic malignancies, and genetic disorders of the blood and immune system. Two types of banks have emerged for the collection and storage of umbilical cord blood: 1) public banks and 2) private banks. The benefits and limitations of public versus private umbilical cord blood banking should be reviewed with the patient because they serve different purposes. This patient discussion also should include the concept of autologous and allogeneic use of umbilical cord blood. Umbilical cord blood collected from a neonate cannot be used to treat a genetic disease or malignancy in that same individual (autologous transplant) because stored cord blood contains the same genetic variant or premalignant cells that led to the condition being treated. There is no current evidence to support the use of an autologous umbilical cord blood sample in regenerative medicine. Patients should be made aware of the quality control and regulatory organizations that provide oversight for the process of umbilical cord collection and storage. Umbilical cord blood collection should not compromise obstetric or neonatal care or alter routine practice of delayed umbilical cord clamping with the rare exception of medical indications for directed donation. Therefore, it is important to inform patients that the medical condition of the woman or neonate may prevent adequate umbilical cord blood collection. This document is updated with a statement that the routine use of private cord blood banking is not supported by available evidence and that public banking is the recommended method of obtaining cord blood. In addition, the importance of contribution from all ethnicities and races to public banks is highlighted.
On the Value of the Umbilical Cord Blood Supply
Strong A1, Gračner T2, Chen P2, Kapinos K2. Author information Abstract BACKGROUND: Several public cord blood banks are struggling financially, and the question remains as to whether additional allocations of funds to them are justified. OBJECTIVES: To estimate the social benefits of public cord blood bank inventory net of cord blood banks' operational costs. METHODS: We used publicly available data from the Health Resources and Service Administration on the number of annual cord blood transplants as well as the patient age distribution in 2010, and the survival estimates between 2008 and 2012 for the several diseases treated by cord blood transplantation. Data on aggregate annual costs to the cord blood industry for recruitment, processing, and storage were obtained from published work. We used estimated increases in life expectancy due to treatment using umbilical cord blood and value for life-years gained to estimate the social benefits of the public cord blood inventory annually. RESULTS: We found that the annual social benefits of between $500 million and $1.5 billion outweigh the current operational annual costs of running cord blood banks of $60 to $70 million by a significant margin. CONCLUSIONS: We estimated that the annual social benefit of having a cord blood system far outweighs its costs, by more than an order of magnitude. Thus, the social benefits of maintaining the US public cord blood banking system at the present time far outweigh the costs of collecting, storing, and distributing cord blood. This suggests that there is a potential justification for government intervention to align social benefits and costs. Nevertheless, simple fixes may produce unintended consequences, and so a careful design for subsidies is needed. Copyright © 2018 ISPOR–The Professional Society for Health Economics and Outcomes Research. Published by Elsevier Inc. All rights reserved. KEYWORDS: banking; umbilical cord blood; value PMID: 30224112 DOI: 10.1016/j.jval.2018.03.003
Conditioned medium from umbilical cord mesenchymal stem cells induces migration and angiogenesis
Mol Med Rep. 2015 Mar 4. doi: 10.3892/mmr.2015.3409.
Shen C1, Lie P2, Miao T3, Yu M1, Lu Q4, Feng T1, Li J4, Zu T1, Liu X4, Li H1.
Umbilical cord mesenchymal stem cells (UC‑MSCs) have been suggested as a candidate for various clinical applications, however, major limitations include the lack of organ‑specific accumulation and low survival rates of transplanted cells. In the present study, it was hypothesized that the paracrine effects of UC‑MSCs may enhance stem cell‑based tissue repair and regeneration by promoting the specific homing of stem/progenitor cells and the overall ability to drive them to the damaged area. UC‑MSCs‑derived conditioned medium (UC‑CM) was analyzed using liquid chip and ELISA techniques. In vitro tube formation assays of human umbilical vein endothelial cells (HUVECs) and UC‑MSCs were then performed to assess the angiogenic properties of UC‑CM. Subsequently, UC‑MSCs, HUVECs and fibroblasts were labeled with PKH26 for an in vivo cell migration assay. The expression levels of C‑X‑C chemokine receptor 4 (CXCR4), C‑C chemokine receptor 2 (CCR2) and c‑met were determined in the UC‑MSCs, HUVECs and fibroblasts using reverse transcription‑quantitative polymerase chain reaction and flow cytometry. UC‑CM was incubated with or without antibodies, and the contribution of stromal cell‑derived factor 1 (SDF‑1), monocyte chemotactic protein 1 (MCP‑1) and hepatocyte growth factor (HGF) on the migration of cells was investigated in vitro. The results demonstrated that UC‑MSCs secreted different cytokines and chemokines, including increased quantities of SDF‑1, MCP‑1 and HGF, in addition to the angiogenic factors, vascular cell adhesion protein‑1, interleukin‑8, insulin‑like growth factor‑1 and vascular endothelial growth factor. The total lengths of the tubes were significantly increased in the UC‑MSCs and HUVECs incubated in UC‑CM compared with those incubated in Dulbecco's modified Eagle's medium. In vivo cell migration assays demonstrated that UC‑CM was a chemotactic stimulus for the UC‑MSCs and HUVECs. In vitro Matrigel migration and scratch healing assays demonstrated that UC‑CM increased the migration of CXCR4‑postive or/and CCR2‑positive cells in a dose‑dependent manner. In addition, different molecules were screened under antibody‑based blocking migration conditions. The data revealed that the SDF‑1/CXCR4 and MCP‑1/CCR2 axes were involved in the chemoattractive activity of UC‑CM and suggested that the effective paracrine factor of UC‑CM is a large complex rather than a single factor. The results of the present study supported the hypothesis that UC‑MSCs release soluble factors, which may extend the therapeutic applicability of stem cells.
Hematopoietic stem and progenitor cell harvesting: technical advances and clinical utility
J Blood Med. 2015 Feb 18;6:55-67. doi: 10.2147/JBM.S52783. eCollection 2015.
Hematopoietic stem and progenitor cell (HSPC) transplantations require prior harvesting of allogeneic or autologous HSPCs. HSPCs are usually present in bone marrow (BM) during the entire life, in cord blood (CB) at birth, or in peripheral blood (PB) under particular circumstances. HSPCs were first harvested in BM and later in CB and PB, as studies showed interesting features of such grafts. All harvesting methods were in use throughout the years, except BM harvesting for HSPC autologous transplantation, which was replaced by PB harvesting. BM, CB, and PB harvesting methods have been developed, and materials and devices technically improved to increase the number of HSPCs harvested. In parallel, knowing the features of the donors or patients associated with successful numbers of HSPCs allows the adaptation of appropriate harvesting methods. Moreover, it is important to ensure the safety of donors or patients while harvesting. This review describes the methods used for harvesting based on recent studies or developments around these methods, and more particularly, the means developed to increase the numbers of HSPCs harvested in each method. It also explains briefly the influence of technical improvements in HSPC harvesting on potential changes in HSPC graft composition. KEYWORDS: apheresis; bone marrow; cord blood; harvesting; hematopoietic stem cell; mobilization; peripheral blood
Trends in cord blood banking
Blood Transfus. 2012 Jan;10(1):95-100. doi: 10.2450/2011.0032-11. Epub 2011 Nov 15.
Arrojo IP, Lamas Mdel C, Verdugo LP, Alfaro PR, Pena RR, Gordo FS, Maldonado PG, Gémar GG. Source Andalusian Cord Blood Bank, Regional Blood Transfusion Centre, Malaga, Spain. email@example.com
BACKGROUND: Umbilical cord blood (UCB) is a source of hematopoietic precursor cells for transplantation. The creation of UCB banks in 1992 led to the possibility of storing units of UCB for unrelated transplants. The distribution of cell contents in historical inventories is not homogenous and many units are not, therefore, suitable for adults. The aim of this study was to analyse our UCB bank inventory, evaluate the units released for transplantation and calculate the cost of the current process per unit of UCB stored. METHODS: Three study periods were defined. In the first period, from January 1996 to January 2006, the total nucleated cell (TNC) count acceptable for processing was 4-6×10(8) and a manual processing system was used. In the second period, from October 2006 to July 2010, processing was automated and the acceptable TNC count varied from 8-10×10(8). In the third period, from January 2009 to June 2010, an automated Sepax-BioArchive procedure was used and the accepted initial TNC count was >10×10(8). Within each period the units were categorised according to various ranges of cryopreserved TNC counts in the units: A, >16.2×10(8); B1, from 12.5-16.1×10(8); B2, from 5.2-12.4×10(8); and C, <5.1×10(8). RESULTS: The third period is best representative of current practices, with homogenous TNC acceptance criteria and automated processing. In this period 15.7% of the units were category A and 25.5% were category B. Overall, the mean TNC count of units released for transplantation was 14×10(8) (range, 4.6×10(8) to 36.5×10(8)). The cost of the processed UCB in 2009 was 720.41 euros per unit. CONCLUSION: An UCB bank should store units of high-quality, in terms of the TNC count of units issued for transplantation, have a training programme to optimise the selection of donors prior to delivery, use similar volume reduction systems and homogenous recovery indices, express its indicators in the same units, use validated analytical techniques, and bear in mind ethnic minorities.
Donating umbilical cord blood to a public bank or storing it in a private bank: knowledge and preference of blood donors and of pregnant women
Blood Transfus. 2012 Mar 28:1-7. doi: 10.2450/2012.0081-11. [Epub ahead of print]
Screnci M, Murgi E, Pirrè G, Valente E, Gesuiti P, Corona F, Girelli G. Source Unit of Immunohaematology and Transfusion Medicine, "Umberto I" Polyclinic Hospital, Rome, Italy.
BACKGROUND: Umbilical cord blood (UCB) is a source of stem cells for allogeneic haematopoietic transplantation in paediatric and adult patients with haematological malignancies and other indications. Voluntary donation is the basis for the success of unrelated UCB transplantation programmes. In the last few years a growing number of private banks offer their services to expectant parents, to store UCB for future use. The debate concerning UCB donation and private preservation has been ongoing for several years. The aims of this single centre study were to explore knowledge about UCB stem cells and attitudes towards voluntary UCB donation or private UCB preservation among both blood donors and pregnant women. MATERIALS AND METHODS: This study was conducted at the "Sapienza" University of Rome. Two types of anonymous questionnaires were prepared: one type was administered to 1,000 blood donors while the other type was distributed to 300 pregnant women. RESULTS: Most blood donors as well as the majority of pregnant women had some general knowledge about UCB (89% and 93%, respectively) and were aware of the possibility of donating it (82% and 95%). However, the level of knowledge regarding current therapeutic use resulted generally low, only 91 (10%) among informed blood donors and 69 (31%) among informed pregnant women gave a correct answer. The survey revealed a preference for voluntary donation both among blood donors (76%) and among pregnant woman (55%). Indeed, a minority of blood donors (6.5%) and of pregnant women (9%) would opt to store UCB for private use. DISCUSSION: The study raises the following considerations: (i) the large support for UCB donation expressed by blood donors and by pregnant women suggests that UCB preservation does not represent an obstacle to the expansion of UCB donation and to development of unrelated transplantation programmes; (ii) information about UCB donation and preservation should be carefully given by professionals and institutions.
Umbilical cord blood: current status & promise for the future
Indian J Med Res. 2011 Sep;134:261-9. McKenna D, Sheth J. Source Foundation for Research in Genetics & Endocrinology, Ahmedabad, India.
Umbilical cord blood (UCB) has been shown to be a suitable source of haematopoietic stem cells (HSCs) for haematopoietic reconstitution. An increase in the number of UCB transplants indicates an expansion of utility in a broad spectrum of disease conditions. Along with the advantages, UCB also has limitations, and hence several investigators are working to further optimize UCB for this use. Beyond haematopoietic transplantation, additional potential applications of UCB include immunotherapy, tissue engineering and regenerative medicine. UCB banking has improved with time largely due to involvement of professional organizations and their published standards. However, accreditation of these organizations remains voluntary, and in India three of ten banks are public with the remaining being private. Only one public and one private bank are American Association of Blood Banks (AABB) accredited in India. Government agencies need to provide regulatory and safety oversight, which is lacking in serveral countries. Public policy regarding UCB is in its infancy throughout most of the world. Ethical issues, including access to UCB banking and use as therapy for diseases other than haematological and metabolic disorders are in the early phase of trials and remain speculative.
Intrathecal injection of human umbilical cord blood-derived mesenchymal stem cells for the treatment of basilar artery dissection: a case report
J Med Case Reports. 2011 Dec 4;5:562.
Han H, Chang SK, Chang JJ, Hwang SH, Han SH, Chun BH. Source Seoul Cord Blood Bank, Histostem Ltd,, Seoul Life Foundation Building, 518-4, Dunchon-dong, Kang Dong-gu, Seoul 134-060, Korea. firstname.lastname@example.org. Abstract ABSTRACT: INTRODUCTION: Basilar artery dissection is a rare occurrence, and is significantly associated with morbidity and mortality. To the best of our knowledge, we report the first case of basilar artery dissection treated with mesenchymal stem cells. CASE PRESENTATION: We present the case of a 17-year-old Korean man who was diagnosed with basilar artery dissection. Infarction of the bilateral pons, midbrain and right superior cerebellum due to his basilar artery dissection was partially recanalized by intrathecal injection of human umbilical cord blood-derived mesenchymal stem cells. No immunosuppressants were given to our patient, and human leukocyte antigen alloantibodies were not detected after cell therapy. CONCLUSIONS: This case indicates that intrathecal injections of mesenchymal stem cells can be used in the treatment of basilar artery dissection.
World's first public-private cord blood bank launched in UK (2007) "The Virgin Health Bank will provide parents with the facility to store their child's umbilical cord blood in two portions - one as a private sample (about 80%) for the sole use of the child and his or her family and the second as a public sample (20%), available free of charge to anyone requiring stem cell transplantation."
- <pubmed>17289702</pubmed>|Virgin Health Bank