Immediate availability – low risk of complications
“Private banking”, or private storage, involves sending the cord blood abroad after the export licence has been obtained. It is chosen by all those mothers who want to guarantee their babies an extra “natural resource” that can be speedily retrieved and used in any country, Italy included, as long as the biobank observes the international quality standards for the collection, processing and banking of cord cells and European directives.
This possibility was introduced in Italy with Law 219 of 21 October 2005, “New discipline in transfusions and the national production of blood derivatives”.
In later years the right of Italian parents to export their cord blood sample has been confirmed and is currently disciplined by the Ministerial Ordinance of 26-02-2009, “Provisions with regards to the preservation of stem cells from umbilical cord blood” and by Agreement 62 between State, Regions and Autonomous Provinces of 26-04-2010 that has recently amended the procedure.
For information on how to obtain the export licence go to the Guide to the Service page.
Instead, for using the sample preserved abroad in Italy an import licence is needed, issued each time by the Ministry of Health - Office VIII – Prevention and Communications Department – Health Prevention Head Office, in compliance with law 219/2005.
To re-import a sample stored abroad into Italy the relevant local authority’s guidelines and European directives must be observed; the quality of the laboratory chosen for storage is also important.
To date SmartBank is the only storage bank that has re-imported a sample into Italy.
It was in 1988 that the first successful transplant with haematopoietic stem cells from cord blood was performed on a patient with Fanconi anaemia. Since then it has become evident that “neonatal” (cord blood) stem cells can be an effective substitute for bone marrow in transplants (Broxmeyer et al. 1989).
According to the diseases to treat, transplantations are divided into:
- autologous (the cells belong to and are used by the donor)
- allogeneic or heterologous (from different donors, including a family member)
In autologous transplantation, the problem of compatibility between two different tissues does not exist since stem cells belonging to same patient are used, considerably reducing the risk of immunologic complications such as rejection.
The autologous use of Haematopoietic stem cells is recommended as first choice in treating:
| Lyphomas | Leukaemias | Other diseases |
| Hodgkin’s lymphoma (relapse) | Chronic lymphoid leukaemia | Amyloidosis |
| Non-Hodgkin’s lymphoma | Autoimmune disorders | |
| Diffuse B-cell lymphoma (relapse) | Myeloma | |
| Mantle cell lymphoma | Neuroblastoma | |
| Lymphoblastic lymphoma | Retinoblastoma | |
| Burkitt lymphoma | ||
| Follicular B-cell lymphoma | ||
| T-cell NHL |
In allogeneic or heterologous transplantations it is necessary to check the compatibility of stem cells between donor and recipient through a tissue typing procedure to see if they are HLA (Human Leucocyte Antigens) compatible. See also HLA compatibility test.
Samples are frequently used among siblings,
given the high probability they are compatible (total 25% and partial 39%).
Over 1/3 of transplants occur between siblings
(Haematologica, July 2011).
Until the Nineties, intra-familial allogeneic transplants had a much higher survival percentage
than transplants between non-blood relations.
Thanks to new transplant preparation techniques, in recent years this difference has been reduced even though umbilical cord stem cells always represent a valid alternative, especially for those patients without a compatible family or voluntary donor.
Advantages and disadvantages of umbilical cord stem cell transplants
| TRANSPLANTS WITH CORD BLOOD CELLS | |
| ADVANTAGES | DISADVANTAGES |
| Easy collection without risks for mother or baby | Low cell dose |
| GVHD less frequent and less severe | Delayed engraftment |
| Transplant possible also with partial HLA compatibility | Delayed platelet and neutrophil recovery |
| Minor risk of virus transmissions | Greater risk of contracting infections before the transplanted cells take root (around 2 weeks, more than bone marrow) |
| Immediate availability | Potential transmission of congenital diseases |
| Simplicity in retrieving sample compared to bone marrow sample | |
| Flexibility in transplant dates | |
| Greater proportion of ethnic representation in umbilical cord banks than in bone marrow registers | |
Amended from: A.Stanevsky , A.Shimoni – R.Yerushalmi – A.Nagler “Cord Blood Stem Cells for Hematopoetic Transplantation” (2010) – Stem Cell Rev and Rep.
Autologous transplants will mainly be used in regenerative medicine. To learn more go to “CLINICAL STUDIES” page.
SmartBank is proud to show the average volume of cryopreserved samples it has collected to date. These figures are in line with the British national values published in S. Querol, SG. Gomez, A. Pagliuca, M. Torrabadella and JA. Madrigal, “Quality rather than quantity: the cord blood bank dilemma” in Bone Marrow Transplantation (2010) 45, 970-978.
Distribution (%) of the number of samples compared to volume of cord blood collected at the moment of birth.
Each group represents a 10 ml interval with the exception of the last group ranging from 170 ml to 251 ml of cord blood. The reference is to samples taken between 2006 and 30-06-2011.
There are numerous parameters affecting collection and it is impossible to make a certain estimate with regards to the time of gestation, the physiological conditions of the birth, the weight of the baby and placenta, the type of birth, etc. It is thus impossible to guarantee that the single sample harvested will correspond to these average values which – basically homogenous over the years – prove SmartBank’s great reliability over time.
With current knowledge and with regards to the thousands of people who have benefitted from a successful stem cell transplant, it is a great shame if the baby’s umbilical cord with its precious content is disposed of as mere hospital waste.
If having speedy and guaranteed access to your baby’s stem cells is what most counts for you and your family, then private banking could be the right choice.
