|Cord Blood Working Group|
Many stem cell donor registries and cord blood banks act as search coordinating centers for the provision of cord blood units. The Cord Blood Working Group (CBWG) gathers and shares information about cord blood registry activities and requirements. It also develops best practices to support and promote safe and effective international exchange of unrelated cord blood units. Subjects may include maternal donor recruitment and testing, cord blood unit collection, processing, testing, selection, release and shipment.
- Review of position papers and guidelines
- Analyse the reported S(P)EAR related to cord blood
- Develop tools for registries to audit cord blood banks
- Web medical eligibility
- Census (cord blood bank classification; inventory overview)
- Chapter 8 of the registry handbook: How to start a cord blood bank.
Recommendations of the Cord Blood WG (CBWG):
FORMS FOR ALL STEM CELL DONOR REGISTRIES AND CORD BLOOD BANKS
The Cord Blood WG has developed two forms which can be sent to the requesting registry/transplant centre to provide more information about the cord blood product.
- CB10: Cord Blood Unit Request (in development)
- CB30: Cord Blood Unit Shipment Request (in development)
FAMILY-DIRECTED CORD BLOOD BANKING (E. Gluckman, A. Ruggeri, V. Rocha, E. Baudoux, M. Boo, J. Kurtzberg, K. Welte, C. Navarrete, S.M. van Walraven, Haematologica (2011): 96, 1703-1707)
Umbilical cord blood transplantation from HLA-identical siblings provides good results in children. These results support targeted efforts to bank family cord blood units that can be used for a sibling diagnosed with a disease which can be cured by allogeneic hematopoietic stem cell transplantation or for research that investigates the use of allogeneic or autologous cord blood cells. Over 500 patients transplanted with related cord blood units have been reported to the Eurocord registry with a 4-year overall survival of 91% for patients with non-malignant diseases and 56% for patients with malignant diseases. Main hematologic indications in children are leukemia, hemoglobinopathies or inherited hematologic, immunological or metabolic disorders. However, family-directed cord blood banking is not widely promoted; many cord blood units used in sibling transplantation have been obtained from private banks that do not meet the necessary criteria required to store these units. Marketing by private banks who predominantly store autologous cord blood units has created public confusion. There are very few current validated indications for autologous storage but some new indications might appear in the future. Little effort is devoted to provide unbiased information and to educate the public as to the distinction between the different types of banking, economic models and standards involved in such programs. In order to provide a better service for families in need, directed-family cord blood banking activities should be encouraged and closely monitored with common standards, and better information on current and future indications should be made available. Read more....
The WMDA has built a strong relationship with the Netcord Foundation and is actively participating in the development of the new Netcord-FACT standards. The major objective of the NetCord-FACT International Standards for Cord Blood Collection, Banking, and Release for Administration (Standards) is to promote quality medical and laboratory practices and banking to achieve consistent production of high quality placental and umbilical cord blood units for administration. The NetCord-FACT Standards apply to cord blood units intended for unrelated allogeneic use and to units collected and stored for the directed use by a specific individual recipient or family member of the donor. All phases of cord blood collection, banking, and release for administration are included. You can read more about the Netcord-FACT accreditation programme...
Find here the list of Netcord-FACT accredited cord blood banks.
WMDA ANNUAL REPORT
The WMDA Annual Reports describe the current status of public cord blood banks in the world. The annual reports of the WMDA have become an established instrument to describe the current status of and to observe the trends for the number of cord blood units stored and shipped worldwide.
RESPONSE TIME TO REQUESTS FOR ADDITIONAL UNIT INFORMATION
- For urgent cord blood verfication typing requests: time from request received to results reported to the transplant centre should be 7 calendar days for 80% of the requests received.
- For standard cord blood verification typing requests: time from request received to results reported to the transplant center should be 13 calendar days for 80% of requests received.
RECOMMENDATION FOR THE USE OF CORD BLOOD SAMPLES
The Cord Blood Working Group (CBWG) was asked to review the problem that has been experienced by some registries and cord blood banks (CBB) when transplant centers ask the cord blood bank/registry to fully work up cord units and then persistently "delay" the date of transplant - finally to "cancel" the unit. Although all parties recognize that this is sometimes unavoidable, some transplant centers appear to be working up many cord units and making "final" selection decisions late in the process. Since the number of pilot tubes (attached segments) is limited, the penalty, apart from the unpaid work-up costs, is that this leads to units available for subsequent searches lacking the required testing samples. The CBWG was asked to establish guidelines related to this practice and to suggest penalty costs associated with abuse of the system. You can read here the guidelines.
The Cord Blood WG has approved a motion that strongly recommends for international shipments to contain a data logger.
NIMA (non inherited maternal antigens)
Two recent publications presented evidence that selecting mismatche cord blood units (CBU) with non inherited maternal antigens (NIMA) identical to the patient mismatched antigen(s), will identify acceptable mismatches with improved survival. Substituting the CBU HLA phenotypes by NIMA creates so called virtual phenotypes in contrast to the 'real' HLA phenotypes. Find here two presentations from the last Cord Blood WG meeting:
INVESTIGATIONAL NEW DRUG (IND) QUALIFICATION FOR CORD BLOOD BANKS
All cord blood units (CBU) used for transplant in United States patients are subject to FDA licensure requirements. As of October 20th, 2011 all units under these regulations must be classified as licensed or unlicensed.
Unlicensed cord blood units will only be accessible when requested as part of an FDA-accepted Investigational New Drug protocol. The NMDP is sponsoring an FDA approved protocol, referred to as 10-CBA, which is being utilized by many U.S transplant centers as a way to access unlicensed cord blood units. You can read here the slides presented at the last meeting in Sydney, where NMDP shared their experience how they went through this project.
Eurocord updates the WMDA membership frequently about their work. Find here two presentations:
The following three documents link to a survey, which was sent out in 2009. The cord blood banks were asked to share information about the eligibility criteria.
Minutes: link to the minutes of the last meetings (only available for members)
Presentation at the last WMDA Cord Blood WG Meeting (Minneapolis 2012).
Chair: Sergio Querol, Spain
Vice-chair: Merry Duffy, United States
Last update: 12:50 20/12 2012