What are stem cells? A stem cell can differentiate into any one of 220 different specialised cells in the body STEM CELLS

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1 What are stem cells? Stem cells are often called MASTER CELLS, and form the foundation for your entire body as building blocks for the blood, immune system, tissue and organs. They can REPLICATE or REGENERATE themselves and has the ability the to DIFFERENTIATE into any kind of specialised cell in the body. A stem cell can differentiate into any one of 220 different specialised cells in the body There are different kinds of stem cells that are found in the human body throughout the course of life. They vary in exactly what they can and cannot do, but fall within two main categories. Can only differentiate into certain types of specialised cells. Work as a repair system in maintaining the specific tissues. Multipontent /adult Found in e.g. blood stem cells forming red blood cells, white blood cells and platelets, mesenchymal stem cells forming only certain tissue cells etc. STEM CELLS Cord blood and tissue stem cells can be found in a newborn baby s umbilical cord and are classified as adult stem cells. These stem cells are practically brand new and have a greater capacity to grow, multiply and differentiate meaning that they have enhanced regenerative abilities in comparison to other sources. Can differentiate into all specialised cells in the body. Embryonic stem cells. Induced pluripotent stem cells. Pluripotent Controversial and not part of our business or education process. Generated from specialised cells by using a technique called reprogramming. This ground breaking work was awarded the Nobel Prize in Physiology or Medicine in 2012 and is in the very early stages of research.

2 What are blood stem cell transplants? New York, 1956 American doctor E. Donnall Thomas did the first successful bone marrow transplant to cure leukaemia. Blood stem cell transplantation, using stem blood cells from sources such as bone marrow, has been performed for MORE THAN 50 YEARS, with more than 1 MILLION BLOOD STEM CELL TRANSPLANTS across the world playing an important role in the treatment of bone marrow failures, blood cancers, blood disorders, metabolic diseases, immune deficiencies and autoimmune diseases. Why may a bone marrow transplant (also called a blood stem cell transplant) be needed? To treat and/or cure certain types of blood related disease, for example to: replace diseased bone marrow with healthy bone marrow to treat/cure patients with e.g. blood cancer replace non-functioning bone marrow with healthy functioning bone marrow in patients with e.g. acquired bone marrow failure. regenerate a healthy immune system in patients with e.g. immune deficiencies, auto-immune disease. replace bone marrow with genetically healthy functioning bone marrow in patients with inherited blood related diseases. What are your chances of finding a blood stem cell donor in SA? 70% of patients in need of a blood stem cell transplant won t have a sibling donor Bone marrow transplants require a perfect tissue match in most cases 1 in a Depending in a person s tissue type, the chance of finding a bone marrow donor may be less than 1 in a healthy donors registered on the SABMR THERE IS NO PUBLIC UMBILICAL CORD BLOOD BANK IN SOUTH AFRICA.

3 Why should we store umbilical cord stem cells? Banked umbilical cord blood can potentially provide easier access to a stem cell transplant Blood stem cells used in transplants can be collected from: bone marrow circulating blood umbilical cord blood 1 in 217 The chances of needing a stem cell transplant in a lifetime of 70 years A newborn s stem cells are young and flexible, which means they have better regenerative abilities. Umbilical cord stem cells have greater therapeutic potential than bone marrow stem cells. They are young and active in comparison with stem cells from other sources a maximum of nine months old which means that they can differentiate faster. Cord blood is collected in advance, tested, cryopreserved and stored ready to use when needed. Because your baby s stem cells were collected at birth, they are ready to use if necessary. Unlike bone marrow, there is no need to take time to locate a possible donor and then determine whether he or she is still willing and able to donate if required for a sibling transplant. Cord blood transplants do not always require a perfect match. Studies have shown that cord blood transplants can be performed in cases where the donor and the recipient are only partially matched. In contrast, bone marrow grafts require a perfect degree match in most cases. Because partially matched cord blood transplants can be performed, cord blood potentially increases a patient s chance to find a suitable donor. Cord blood transplants are associated with a lower incidence of graft-versus-host-disease (GVHD) in allogeneic transplants (e.g. between siblings). The immune cells in cord blood are less likely to attack the recipient s own tissues and cause the transplant-related complication of GVHD. THERE ARE NEARLY 8 TIMES AS MANY BLOOD STEM CELLS IN CORD BLOOD IN COMPARISON TO BONE MARROW. Single umbilical cord ML BLOOD Bone marrow from a donor ML BLOOD Same amount of blood stem cells Source: European Parliament - European Commission

4 How is it collected? Collecting stem cells from umbilical cord blood is QUICK, PAINLESS and NON-INVASIVE posing no medical risk to mother or baby. Once a baby is born, the umbilical cord is clamped and cut as per normal in any birth. It is only after this that the blood and tissue are collected from the umbilical cord for stem cell processing, so cord blood and tissue collection poses no medical risk to the newborn baby or mother. The umbilical cord stem cells are collected from what is usually discarded as medical waste after the birth of a baby. Umbilical cord blood collection The average labour for a first time mom is about hours. Cord blood and tissue collection is usually done within 10 MINUTES of giving birth COURIER The sample is secured in a collection kit and retrieved by a medical courier COLLECT The cord is drawn into a collection bag. The tissue is cut and saved. 10 min CLAMP & CUT The umbilical cord is clamped and detached from the baby. Then it is cleaned. Can successfully be combined with delayed cord clamping

5 Who can use banked umbilical cord blood? THE GOAL OF A BONE MARROW TRANSPLANT / BLOOD STEM CELL TRANSPLANT IS TO TREAT AND/OR CURE CERTAIN TYPES OF BLOOD RELATED DISEASES. Banked umbilical cord blood can potentially provide easier access to a stem cell transplant. Studies have shown that cord blood transplants can be performed in cases where the donor and the recipient are only partially matched, depending, for example, on the number of stem cells in the collection. In contrast, bone marrow transplants require a perfect match in most cases Your baby s cord blood stem cells will always be: 100%/PERFECT MATCH Autologous: using your own stem cells Syngeneic: using stem cells from an identical twin AT LEAST A HALF MATCH Haplo-identical: using stem cells from biological parents 25% CHANCE OF BEING A PERFECT MATCH FOR Allogeneic: using your sibling s stem cells 1: CHANCE OF BEING A PERFECT MATCH Allogeneic: using an unrelated donor s stem cells (recruited through the South African Bone Marrow Registry) The good news is that with umbilical cord blood stem cells, you don t always need a perfect match. This increases your chances of finding a matching donor.

6 What is the difference between umbilical cord blood and cord tissue stem cells CORD BLOOD How is it collected After birth the umbilical cord is clamped and cut before the baby is taken away for care. The blood is collected from the umbilical cord in a quick, painless and non-invasive procedure. What type of stem cells it contains Blood stem cells/ Haematopoietic stem cells (HSCs) in umbilical cord blood are blood-forming stem cells that can differentiate into red blood cells, white blood cells and platelets. What is it used for Blood-forming stem cells are used to treat bone marrow failure, blood cancer and other blood disorders. First used Cord blood stem cells were 1 st successfully transplanted in 1988, and now it is used to treat over 80 blood-related diseases. Evolving medicine In addition to the current treatments, FDA-regulated clinical trails are underway to study ways in which cord blood stem cells can be used as treatment for: cerebral palsy traumatic brain injury acquired hearing loss juvenile diabetes CORD TISSUE How is it collected A 20-25cm segment of the umbilical cord is collected after birth. What type of stem cells it contains The stem cells found in the umbilical cord tissue (Wharton s jelly) is called mesenchymal stem cells (MSC). The umbilical cord vein and arteries contain endothelial stem cells and the umbilical cord lining contains both mesenchymal stem cells and epithelial stem cells. What is it used for MSCs are able to differentiate into cartilage cells, muscle cells, bone cells, nerve cells, etc. Future treatments may include Alzheimer s, liver and heart failure, bone regeneration, HIV, Type 1 diabetes, and more. First used Clinical trials using MSCs started in 1995, with more than 200 trials currently underway. Evolving medicine Cord tissue MSC are being evaluated in laboratory studies and clinical trials to treat: heart disease spinal cord injury cartilage injury liver disease

7 What have stem cells done so far? Stem cell therapies, bioprinting and other technologies are transforming the future of healthcare Replace dead or diseased cells Stem cells are used to replace dead or diseased cells e.g. blood stem cell transplant. Regenerate tissue and organs Stem cells are used in clinical trials to regenerate tissues and organs. Bioprint tissues or organs Stem cells are being used to 3D print tissues and organs. Enhance the body s regenerative potential Scientists are studying ways to use the body s intrinsic regenerative ability to initiate and enhance repair. What will future results be for cord blood and tissue stem cell therapy? YEAR blood-related disease was treated YEAR types of diseases were treated YEAR types of diseases were treated YEAR 2020 Who knows what the future still holds, but it looks promising As medical science continues its research into stem cells and their flexibility, the list of possible treatments grows. Recent research into the stem cells found in cord tissue has shown potential in regenerative medicine. These cells, also known as mesenchymal stem cells (MSC), can transform into many types of cells and tissues, including organs, muscles, skin and bone. Trials are underway that look into using stem cell therapies with MSC to potentially treat autism, cerebral palsy, diabetes, spinal injuries and many others. For up to date information about new developments in stem cell research, visit

8 Diseases Currently Treatable (Most Common) Therapies in Clinical Trials with cord blood BLOOD CANCERS Acute Lymphoblastic Leukaemia (ALL) Acute Myeloid Leukaemia (AML) Chronic Myeloid Leukaemia (CML) Myelodysplastic Syndrome (MDS) Multiple Myeloma Hodgkin's Lymphoma Non-Hodgkin's Lymphoma Bone marrow failure syndromes Severe Aplastic Anaemia, Unspecified Fanconi Anaemia BLOOD DISORDERS Sickle Cell Disease Thalassemia IMMUNODEFICIENCIES Severe Combined Immune Deficiency (SCID) Wiskott-Aldrich Syndrome INHERITED METABOLIC DISORDERS Hurler Disease (MPS type IH) Osteopetrosis Adrenoleukodystrophy Krabbe Disease AUTOIMMUNE DISEASES Systemic Lupus (SLE) NEUROLOGIC DISORDER Autism (Phase 2) Cerebral Palsy (Phase 2) Hearing Loss (acquired sensori-neural) (Phase 2) Hypoxic Ischemic Encephalopathy (HIE) (Phase 1) Spinal Cord Injury (Phase 2) AUTO-IMMUNE DISORDERS Crohn's Disease (Phase 3) Diabetes, Type 1 (Phase 2) Graft-versus-Host Disease (GvHD) (Phase 3) Kidney plus stem cell transplant (Phase 2) Systemic Lupus (SLE) (Phase 2) Multiple Sclerosis (Phase 1) Rheumatoid Arthritis (Phase 2) Scleroderma (Phase 2) CARDIOVASCULAR Critical Limb Ischemia (Phase 3) Ischemic Stroke (Phase 2 placenta) (Phase 3) Myocardial Infarction (Phase 3) Cardiomyopathy (Phase 3) Reference: National Cord Blood Program,