Stem Cells - Placental Cord Blood

Embryology - 1 Dec 2023        Expand to Translate
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Introduction

Blood stem cells

Placenta and placental cord blood (umbilical cord blood, UCB) contains stem cells that can be harvested at birth (More? Placenta Development). The total amout of blood that can be collected is about 90 ml, from which stem cells can be collected, typed and stored in Cord Blood Banks. Both public and private Cord Blood Banks have arisen in this area. These cells provide a resource for bone marrow replacement therapy in many diseases, bone marrow transplantation was originally the only treatment available for many otherwise fatal diseases. Recently, cord blood transplantation has developed as a new alternative therapy for some of these same diseases.

Placental cord blood is a rich souce of haematopoietic stem cells for transplantation. Cord blood can collected at birth, with no impact on the mother or neonate, and stured in cord blood banks for later use.

BBC (UK) A brief article on Cord Blood stem cells and their therapeutic potential.

A useful guide (online PDF document) to stem cells was produced in a report by the National Institute of Health (NIH, USA, May 2000) Stem Cells: A Primer (PDF 1.89 MB) and more recently NIH has established a Stem Cell information page.

Note that placental cord Wharton's jelly can be also used to derive mesenchymal stem cells. These stem cells have been trans-differentiated into more advanced stages of germ cells by a simple two-step induction protocol using retinoic acid and Sertoli cell-conditioned medium.

Links: blood | placenta

Some Recent Findings

The law and problematic marketing by private umbilical cord blood banks "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. 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 "Several public cord blood banks are struggling financially, and the question remains as to whether additional allocations of funds to them are justified. To estimate the social benefits of public cord blood bank inventory net of cord blood banks' operational costs. 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. 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."

More recent papers

This table allows an automated computer search of the external PubMed database using the listed "Search term" text link. This search now requires a manual link as the original PubMed extension has been disabled. The displayed list of references do not reflect any editorial selection of material based on content or relevance. References also appear on this list based upon the date of the actual page viewing. References listed on the rest of the content page and the associated discussion page (listed under the publication year sub-headings) do include some editorial selection based upon both relevance and availability. More? References | Discussion Page | Journal Searches | 2019 References | 2020 References Search term: Cord Mesenchymal Stem Cell | Cord Stem Cell | cord blood banking

Older papers

These papers originally appeared in the Some Recent Findings table, but as that list grew in length have now been shuffled down to this collapsible table. See also the Discussion Page for other references listed by year and References on this current page. Trends in cord blood banking "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." Reprogramming of Human Umbilical Cord Stromal Mesenchymal Stem Cells for Myogenic Differentiation and Muscle Repair "Human umbilical cord stromal mesenchymal stem cells (hUCS-MSCs) have the potential to differentiate into numerous cell types including epithelial cells, neurons and hepatocytes in vitro, in addition to mesenchyme-derived cells such as osteocytes, chondrocytes and adipocytes. One important property of these cells is the lack of type II major histocompatibility complex class molecules, thus allowing them to be considered as an excellent candidate for transplantations." Human umbilical cord blood treatment in a mouse model of ALS "...These results demonstrate that treatment for ALS with an appropriate dose of MNC hUCB cells may provide a neuroprotective effect for motor neurons through active involvement of these cells in modulating the host immune inflammatory system response." Umbilical cord blood transplantation for myeloid malignancies "Umbilical cord blood is a valuable alternative source of hematopoietic stem cells for transplantation of patients with myeloid malignancies who need an allogeneic transplant, but lack a suitable sibling donor."

Cord Blood Registries

Placental cord blood banks (2009)

Cord blood collection statistics began in 1994 and have been increasing ever since. In January 2007, there were 254,000 cord blood units collected in worldwide registries.

Cord Blood Units Register (Data from: Bone Marrow Donors Worldwide Cord Blood Registries)

CBU Cord Blood Units

NVC Net Volume Collected of CBU Volume of the unit in milliliters; see note below.

TNC Total Nucleated Cells count of CBU The rounded number of nucleated cells in the units of 10 million.

CD34P Collected number of CD34+ cells of CBU Cell count after volume reduction; numeric value with decimal point in units of 1 million.

MONONUC Collected number of mononuclear cells of CBU The rounded number of mononuclear cells in the units of 10 million.

Diseases

The list of diseases that were transplanted with cord blood include the following: Acute Lymphoblastic Leukaemia, Acute Myeloblastic Leukaemia, Adrenoleukodystrophy, Blackfan-Diamond, Cancer-miscellaneous, Chronic Myeloid Leukaemia, Chronic Lymphocytic leukaemia, Fanconi's Anaemia, Genetic disorders - miscellaneous, Hurler's Syndrome, Immune deficiency-Miscellaneous, Krabbe's disease, Lymphomas, Myelodysplastic Syndrome, Mucolipopolysaccharide deficiency, Osteopetrosis, Syndrome Severe Aplastic Anaemia, Severe Combined Immunodeficiency Disease, Storage disorders, Thalassaemia, Wiskott-Aldrich Syndrome (From: The Sydney Cord Blood Bank)

Australia

Australia has three cord blood banks (CBBs) located in Brisbane (Queensland), Sydney (New South Wales) and Melbourne (Victoria). AusCord is the Australian national network of umbilical cord blood banks and cord blood collection centres.

Links: Australian Bone Marrow Donor Registry | The Sydney Cord Blood Bank (SCBB) | Melbourne - BMDI Cord Blood Bank | Queensland Cord Blood Bank | PDF - AusCord Brochure

United States

On August 9, 2001, at 9:00 p.m. EDT, the President announced his decision to allow Federal funds to be used for research on existing human embryonic stem cell lines as long as prior to his announcement (1) the derivation process (which commences with the removal of the inner cell mass from the blastocyst) had already been initiated and (2) the embryo from which the stem cell line was derived no longer had the possibility of development as a human being.

In addition, the President established the following criteria that must be met:

• The stem cells must have been derived from an embryo that was created for reproductive purposes;
• The embryo was no longer needed for these purposes;
• Informed consent must have been obtained for the donation of the embryo;
• No financial inducements were provided for donation of the embryo.

In order to facilitate research using human embryonic stem cells, the NIH is creating a Human Embryonic Stem Cell Registry that will list the human embryonic stem cell lines -- at varying stages of development -- that meet the eligibility criteria. Listed below are entities that have developed stem cell lines that meet the President's criteria and are therefore eligible for federal funding. Please click on the name of the laboratory or company for contact information.

Dartmouth ethics professor discusses promise and pitfalls of stem cell research (2005)

NIH Clinical Trials (May 2004) Launches Study of Hematopoietic Stem Cell Transplantation for Severe, Treatment-Resistant Lupus (NIAMS, May 13,2004)

A clinical therapeutic trial in the USA for hematopoietic stem cells in an autoimmune disease.

"A five-year study to see whether a therapy using transplantation of hematopoietic stem cells, blood stem cells found in bone marrow, can produce long-term remission for patients with severe, treatment-resistant systemic lupus erythematosus (or lupus), a rheumatic autoimmune disease that can affect the body's major organs. The study will include a basic research component to examine the roles of B and T cells, white blood cells in the immune system, in triggering lupus symptoms."

Read more of the NIH Press Release

Note that a May search of NIH Clinical Trials with "stem cell" found 302 study results.

Repeat search: NIH Clinical Trials with "stem cell"

A recent paper has also identified SP cells in ovarian cancer which have properties similar to stem cells.

References

Journals

• Cell Stem Cell is the official affiliated journal of the International Society for Stem Cell Research (ISSCR).
• Stem Cells welcomes original articles and concise reviews describing basic laboratory investigations of stem cells and the translation of their clinical aspects of characterization and manipulation from the bench to patient care. The journal covers all aspects of stem cells: embryonic stem cells; tissue-specific stem cells; cancer stem cells; the stem cell niche; stem cell genomics and proteomics; and translational and clinical researc

Reviews

Sanchez-Ramos J. (2006). Stem cells from umbilical cord blood. Semin. Reprod. Med. , 24, 358-69. PMID: 17123231 DOI.

O'Brien TA, Tiedemann K & Vowels MR. (2006). No longer a biological waste product: umbilical cord blood. Med. J. Aust. , 184, 407-10. PMID: 16618241

Brunstein CG & Wagner JE. (2006). Umbilical cord blood transplantation and banking. Annu. Rev. Med. , 57, 403-17. PMID: 16409157 DOI.

Saulnier N, Di Campli C, Zocco MA, Di Gioacchino G, Novi M & Gasbarrini A. (2005). From stem cell to solid organ. Bone marrow, peripheral blood or umbilical cord blood as favorable source?. Eur Rev Med Pharmacol Sci , 9, 315-24. PMID: 16479735

Articles

Garbuzova-Davis S, Sanberg CD, Kuzmin-Nichols N, Willing AE, Gemma C, Bickford PC, Miller C, Rossi R & Sanberg PR. (2008). Human umbilical cord blood treatment in a mouse model of ALS: optimization of cell dose. PLoS ONE , 3, e2494. PMID: 18575617 DOI.

Brunstein CG, Baker KS & Wagner JE. (2007). Umbilical cord blood transplantation for myeloid malignancies. Curr. Opin. Hematol. , 14, 162-9. PMID: 17255794 DOI.

Rubinstein P. (2006). Why cord blood?. Hum. Immunol. , 67, 398-404. PMID: 16728260 DOI.

Search PubMed

July 2010 "cord stem cell" All (9884) Review (1260) Free Full Text (2357)

Search PubMed Now: cord stem cell | cord blood bank

External Links

External Links Notice - The dynamic nature of the internet may mean that some of these listed links may no longer function. If the link no longer works search the web with the link text or name. Links to any external commercial sites are provided for information purposes only and should never be considered an endorsement. UNSW Embryology is provided as an educational resource with no clinical information or commercial affiliation.

• Sydney Cord Blood Bank (SCBB) | How to Search Cord Blood (Sydney Children's Hospital, Sydney, NSW)
• Murdoch Childrens Research Institute BMDI Cord Blood Bank (The Royal Children's Hospital, Parkville, Victoria)
• Bone Marrow Donors Worldwide (BMDW) | Number of donors/CBU's per registry in BMDW
• WHO Nomenclature for Factors of the HLA System
• International Society for Stem Cell Research (ISSCR) is an independent, nonprofit organization formed in 2002 to foster the exchange of information on stem cell research.

Glossary Links

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Cite this page: Hill, M.A. (2023, December 1) Embryology Stem Cells - Placental Cord Blood. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Stem_Cells_-_Placental_Cord_Blood

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© Dr Mark Hill 2023, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G