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Stem Cells Banking


What are stem cells and why are they so important?

• Stem cells are master cells of a human body, unlike other cells in your body, stem cells do not perform any specified tasks. however, they have the capability to regenerate themselves and perform the tasks of any cells in the body.

• Stem cells are cells that have the potential to grow into any other type of cells“

• They are the building blocks of the blood and immune system that can reproduce into other cell types, including bone, heart, muscle, and nerve.


Basics of Stem Cells

• We all have stem cells. They are essentially those parts of the human body that are designed to make running repairs.

• When you cut your finger, stem cells get to work to repair your broken skin. But, not all parts of our bodies have these stem (building/repairing) cells.

• When you think of those parts of our bodies that can repair themselves: skin, bone, muscle, it's because of stem cells.


What are sources/types of stem cells in the Human Body?

4.Cord Blood Stem Cells1.Bone Marrow Stem Cells

2.Embryonic Stem cells

3.Peripheral Stem Cells

5.Cord Lining Stem Cells


Why stem cells from U cord ?

• Cord blood is being used increasingly on an experimental basis as a source of stem cells, as an alternative to bone marrow. Most cord blood transplants have been done to treat diseases of the blood and immune system. It has also been used to restore the functional deficiencies of several genetic metabolic diseases. To date, more than 70 different diseases have been treated with cord blood transplants.

• After a baby is born and the umbilical cord is cut, some blood remains in the blood vessels of the placenta and the portion of the umbilical cord that remains attached to it. After birth, the baby no longer needs this extra blood. This blood is called placental blood or umbilical cord blood: "cord blood" for short.

• Cord blood contains all the normal elements of blood - red blood cells, white blood cells, platelets and plasma. But it is also rich in hematopoietic (blood-forming) stem cells, similar to those found in bone marrow. This is why cord blood can be used for transplantation instead of bone marrow.

http://en.wikipedia.org/wiki/Image:Umbilicalcord.jpg


Why stem cells from U cord ?

• Yield is 50 times greater than stem cells from Bone Marrow.

• High potential for regenerative therapy. • Umbilical Cord + Cord blood = More cells &

more options for eventual stem cell therapy


Why not bone marrow stem cells if I ever require?

Bone marrow Cord blood

Old source of stem cells in use since 1950’s New source of stem cells since 1975

Harvested from pelvic / hip joint . Takes 4-6 hrs with side effects Harvested for Umbilical Cord (bio Medical waste). No harm to Mother or child

Requires donation of a quart or more of bone marrow (mixed with blood) for transplant

A few ounces can be used for transplantation.

Large dose of stem cells. Rapid engraftment. Smaller dose of stem cells. Slower engraftment

Potential donors may no longer be available or may have withdrawn consent. Donor must be found and retested to confirm the HLA typing and infectious disease results and to confirm that the donor is still willing and able to donate bone marrow. Significant donor attrition

Once frozen, a cord blood unit is available until used. Otherwise, no donor attrition

Generally requires a perfect match between donor and recipient for 6/6 HLA

Generally requires a match between donor and recipient for 4/6 ,5/6 ,6/6 HLA

After a formal search is begun, takes an average of 4 months to transplant, if a donor is available.

When a match is found, can take only a few days for confirmatory and special testing and shipment to the Transplant Center (less than 24 hours in an emergency).


Understanding Umbilical cord blood and cord lining stem cells

Cord Blood Cord lining

Rich in Hematopoietic Stem Cells Rich in Mesenchymal Stem Cells

Can differentiate into blood and immune cells Can differentiate into a variety of cell types

Harvesting is easy and well defined As it is a new source harvesting is slow and manual, requires in house R&D for proper harvesting techniques


How is Cord Blood & Cord lining connected?

• Soon after the Delivery the cord is clamped, cut and child is separated.• The cord blood is then collected into the blood bag.• Once the cord blood is collected, 15 cms of cord lining is cut and inserted into the conical tube.• The collection should be done within 10 minutes after delivery and does not involve the mother or child.• The collection is done by the Obstetrician or the Nurse.


Therapy

Stem cell

SurgeryPharmaceutical


How therapy is done using Stem Cells?

• In many diseases, cells are dead or damaged.

• Researchers are exploring ways of using stem cells to produce cells which could replace these. This is basically called as REGENERATIVE THERAPY

• Much research is currently focused on using new heart muscle cells to help heart failure patients, and on producing new brain neurons to treat people with Parkinson's or Alzheimer's diseases.


Therapy Focus


History of Stem Cell Therapy

"My brother's cord blood saved my life.“ Joseph Davis Jr., Cedar Hill, TexasA 7-year old boy who testified before the Florida Senate healthpolicy committee on the importance of cord blood stem celleducation. He was cured of sickle cell anemia with a transplantusing his younger sibling's cord blood stem cells.

Keegan Doheney, Oak Park, CA, Disease: LeukemiaTransplant facility: Kaiser Permanente - Los Angeles, CA"Your son has leukemia." "We were so relieved that we had savedKeldan's stem cells," Wendy recalls. "When I was pregnant, anotherparent had told us about cord blood and all the wonderful thingsthat were being done with it. We looked into it and once we sawthe potential, we knew we wanted the peace of mind that bankingwould give us." The good news came quickly: the boys were a match. Doctorsperformed the transplant and Keegan has now been healthy fornine years and counting.


History of Stem Cell Therapy

Titus ChangStockton, CADisease: Aplastic AnemiaTransplant facility: University of California Davis Medical Center - Sacramento, CA

Titus was diagnosed with aplastic anemia at 18 months of age and was immediately put on medication to sustain his damaged immune system. The birth of a second child provided a perfect stem cell match and immediate access to related stem cells, and eliminated the need to obtain bone marrow or peripheral blood. The newborn's cord blood was collected and stored at no cost through a public service program provided by a family cord blood bank.

Several rounds of chemotherapy were administered prior to infusing the patient with his sibling's newborn stem cells.

One year after the cord blood transplant, physicians pronounced him cured of aplastic anemia.

Mothers speak out about family banking"You never know what can happen, so that's why I tell mothers to save every child's cord blood."

Cathy Pell, mother of Abby, treated for anoxic brain injury with her own newborn stem cells

"When my son's doctor realized I was pregnant, she suggested saving the baby's cord blood. I was never given that option for any of our other children." Diane Heacock, mother of Hank, cured of leukemia with a cord blood transplant


History of Stem Cell Therapy in India

By David Ewing Duncan, FortuneOctober 24 2007: 6:54 AM EDT

(Fortune Magazine) -- Eye surgeon Virendar Sngwan has perfected a procedure so cutting-edge that most who have tried it have failed. In an operating theater in the central Indian city of Hyderabad, he surgically implants corneas grown in a petri dish from stem cells by his colleague Geeta Vemuganti in patients with damaged eyes. Together they perform about 80 corneal regeneration procedures a year, making the L.V. Prasad Eye Institute where they work one of the most prolific facilities in the world using stem cells to regenerate tissue of any kind.

The Sangwan-Vemuganti team uses stem cells found in the tissues of living adults, not ones derived from embryos. Teams all over the world are working with adult stem cells, trying to coax them to regrow cells in hearts, brains, livers, and other organs, but progress is slow

Besides corneas, scientists have had some success regrowing skin cells and bone tissue, but those procedures remain experimental. "A number of programs around the world have tried to perfect this treatment, but they have had bad outcomes," says University of Cincinnati eye surgeon and stem cell specialist Edward Holland.

"It's impressive what they are doing at Prasad." In addition to the Hyderabad project, only Holland's program and a half-dozen others in the world conduct operations using corneas grown from stem cells.

Stem cells bring sight to the blind in India An eye institute in India has developed a way to grow new corneas from adult stem cells and restore sight to the blind.



Treatment of heart problems using stem cells was first in March 2005 by AIIMS in New Delhi when trials were conducted on 35 patients.

There was no mortality reported and all patients were brought in at a stage where surgery was ineffective. After six months, 56 % of the affected area injected with these cells showed improvement.

After 18 months, this went up to 64%



Manipal Hospital discovers cure for Parkinson`s disease (April 4th, 2007)

Mr Andrew Kisana, a 58-year-old patient affected by Parkinson’s disease has shown positive signs of cure with stem cell therapy.

With the success in treating this patient, India-based Manipal Hospital has proved that stem cell therapy could be a potential option for easing out symptoms in a patient suffering from Parkinson’s disease.

Parkinson’s disease is a neuro-degenerative disease that affects people over the age of 50.



Lifeline Hospital, Chennai, 2005

Four-month-old Aarohi Bhatt recently created medical history for being cured of a rare heart condition believed to be untreatable.

The cause of her cure—Stem Cell Therapy using her father's blood at Frontier Lifeline Hospital, Chennai. Besides being a difficult surgery, it was for the first time in the world that SCT was successfully done on a child so young.


Most recent applications (India)

1. Diabetes (National Centre for Cell Sciences, Pune University – Dr. Ramesh Bhonde)2. High Risk Pregnancies Dr. Satish Patki (kolhapur)3. Heart (Dr. Venugopal Rao – AIMS)Liver Disease Parkinson's Disease (Manipal Dr. Satish Totey)Spinal Cord Injury (AFMC, Pune)Stroke Alzheimer's DiseaseWorldwideAround 6000 transplants done world-wide.Around 20 done in India (reported cases).5 done in Chennai (Thalassemia and Leukaemia)


Future Applications


Indian hospitals offering stem cell therapies

Hospital Area of Specialization

AIMS Delhi Cardiac, Neuro Surgery, Vascular Surgery, Diabetes, Ophthalmology, cancer

Christian College Vellore Cardiac, Diabetes

L V Prasad eye inst Ophthalmology

TATA Memorial Cancer

Manipal Hospital, Bangalore

Cardiac, Ophthalmology, Neurosurgery, Vascular Surgery, Diabetes, Cancers

Life Line Hospital Cardiac

Apollo Hospital Cardiac, Cancer


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Cord Blood Banking - Total Pregnancy Care