The SA Bone Marrow Registry (SABMR) has joined hands with Netcells, the largest and longest established private cord blood bank in Africa, who will be making cord blood available to patients in need of a bone marrow transplant, starting this April.
Since the ‘90s, advances in umbilical cord blood technology have made cord blood transplants a viable alternative to conventional bone marrow or stem cell transplants, but up till now, access has been a challenge.
Jane Ward, Deputy Director at the SABMR explains that unlike other parts of the world, there is no public cord blood bank in South Africa and the prohibitive cost of bringing in cord blood units from overseas simply isn’t feasible for most patients.
She says access to cord blood will greatly assist the registry with finding matches, especially for ethnic patients.
“Currently, there is only a 1 in 100 000 chance of finding a bone marrow stem cell donor match for patients of European descent. The odds drop even further for patients of other races due to the low donor numbers from these groups. Finding donor matches for patients of mixed ethnic race is even more challenging.
“South Africa has one of the most culturally diverse groups of people, which translates into an extensive genetic diversity. Most bone marrow registries around the world, including us, struggle to increase the donor pool among ethnic populations and when volunteers do sign up, there is an added risk that they are unavailable upon request.
“This makes access to cord blood vitally important,” remarks Ward.
Cord blood is one of three sources of blood-forming cells used in transplants. The others include bone marrow and peripheral blood stem cells (PBSC). Umbilical cord blood is rich in graft T cells, which decreases the risk of graft-vs-host disease (GVHD), which may develop when transplanted stem cells from a donor attack a patient’s own cells.
To fill the need, Netcells has launched a first for SA: a Community Stem Cell Bank, where fees are subsidised in an effort to boost cord blood banking among parents.
In addition, Netcells will also be making existing cord blood units available to the SABMR once the storage period expires. Shelley Bredin, Managing Director of Netcells explains:
“Cord blood is collected from a newborn’s umbilical cord after delivery which is then tested, frozen and stored in a cord blood bank for future use. Parents generally opt in for different storage periods and once the period expires, they are asked if they would like to renew or discard the unit. Starting this April, parents will be asked if they want to renew, discard, or donate the cord blood unit to the SABMR. Parents will then sign a consent releasing the product to the SABMR and the cord unit is then added to their database. This will provide local (and overseas) patients with a better chance of finding a matched donor.
“The main difference between our Community- and Private Stem Cell Bank is that the testing and storage fee will be reduced in the case of the former, in which instance the cord blood unit can be either used by the family themselves or by another. It works on a first-come-first-serve basis and will go to the person who needs it the most. In private cord blood banking, parents pay the full price to have their baby’s cord unit banked for his or her own use in the future or for use by a family member. In essence, the family owns the cord blood and can decide how they would like to use it,” says Bredin.
Collecting stem cells at birth is easy and painless. Since stem cells are usually discarded as medical waste, collecting them should not conflict with any moral, ethical or religious belief.
Another major advantage of cord blood is that it doesn’t have to be a 100% tissue match for a transplant as it is considered more naïve or biologically younger and thus better able to tolerate human leukocyte antigens (HLA) mismatches. This opens the door to more possible matches. Other advantages include prompt availability of the transplant, decreased risk of GVHD and better long-term immune recovery, resulting in long-term survival.
Umbilical cord blood transplantation has become recognised as an effective form of therapy for an increasing number of both malignant and non-malignant disorders, and an established method of haematopoietic reconstitution. It has potential therapeutic value in the treatment of blood disorders, immune diseases and the emerging field of regenerative medicine.
Ward says the partnership will facilitate equitable access to a matched transplant and may in future even out-compete the gold standard of matched sibling donors. Thus far, more than 40 000 cord blood stem cell transplants have been performed around the world – 23 of which were facilitated by the SABMR in SA.